Related Experiment Video
Updated: Nov 18, 2025
08:34
Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
Published on: February 6, 2019
20.7K
Second tumor risk in children treated with proton therapy
Daniel J Indelicato1, James E Bates2, Raymond B Mailhot Vega1
1Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, Florida, USA.
Pediatric Blood & Cancer
|February 10, 2021
Summary
Pediatric proton therapy is linked to rare second tumors, especially in young children or those with genetic syndromes. Early detection and risk stratification are key for managing these risks.
Area of Science:
- Oncology
- Radiation Oncology
- Pediatric Oncology
Background:
- Concerns exist regarding out-of-field neutron scatter from double-scattered proton therapy (DSPT) potentially increasing second malignancy risk in children.
- Pediatric patients face higher risks due to developing tissues and larger proportional body exposure to scatter dose.
Purpose of the Study:
- To provide empirical data on the incidence of early second tumors following DSPT in pediatric patients.
- To identify risk factors associated with second tumor development after DSPT.
Main Methods:
- Retrospective analysis of 1713 pediatric patients treated with DSPT between 2006 and 2019.
- Median follow-up of 3.3 years, with a focus on cumulative incidence of second tumors and comparison to SEER data.
- Analysis of patient age, tumor predisposition syndromes, and radiation dose in relation to second tumor development.
Main Results:
- The 5- and 10-year cumulative incidences of second tumors were 0.8% and 3.1%, respectively.
- A significantly elevated standardized incidence ratio (13.5) was observed compared to the general population.
- Second tumors were strongly associated with irradiation at age ≤5 years and tumor predisposition syndromes.
Conclusions:
- Second tumors are rare within a decade after DSPT.
- Children irradiated at >5 years old and those without tumor predisposition syndromes have a lower risk.
- Findings highlight the importance of age and genetic factors in second tumor risk stratification.
More Related Videos
Related Concept Videos
01:20The Retinoblastoma Gene
4.4K
Tumor suppressor genes are normal genes that can slow down cell division, repair DNA mistakes, or program the cells for apoptosis in case of irreparable damage. Hence, they play an essential role in preventing the proliferation of damaged cells.
The first-ever tumor suppressor gene called Rb was identified in retinoblastoma - a rare eye tumor in children. In inherited forms of the disease, a child inherits one defective copy of the Rb gene, which predisposes them to retinoblastoma. However,...
The first-ever tumor suppressor gene called Rb was identified in retinoblastoma - a rare eye tumor in children. In inherited forms of the disease, a child inherits one defective copy of the Rb gene, which predisposes them to retinoblastoma. However,...
4.4K
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
122
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
122
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
89
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
89
02:56Treatment Resistant Cancers
3.5K
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
3.5K
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
102
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
102