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Acute side effects of proton and photon radiotherapy for medulloblastoma: a retrospective national multicenter study

Linn Söderlund Diaz1, Måns Agrup2, Anna Askild3,4

  • 1Department of Oncology, Sahlgrenska University Hospital, Blå Stråket 2, Gothenburg, 413 46, Sweden. Linn.soderlund@vgregion.se.

Journal of Neuro-Oncology
|April 15, 2025
PubMed

Insights

Proton radiotherapy (RT) showed comparable acute toxicity to photon RT in pediatric medulloblastoma patients. Proton RT delivered a lower radiation dose to organs at risk, suggesting potential long-term benefits.

Area of Science:

  • Pediatric Oncology
  • Radiation Oncology
  • Medical Physics

Background:

  • Medulloblastoma is a common pediatric brain tumor.
  • Radiotherapy is a standard treatment for medulloblastoma.
  • Photon and proton radiotherapy are two modalities used for treatment.

Purpose of the Study:

  • To compare acute toxicity between photon and proton radiotherapy in children with medulloblastoma.
  • To assess radiation dose to intracranial organs at risk (OARs) for both treatment types.

Main Methods:

  • Retrospective multi-institutional cohort study of 96 children (<18 years) treated for medulloblastoma.
  • Comparison of patients treated with protons (n=37) and photons (n=59).
  • Acute side effects graded using CTCAE; hematological toxicity and OAR radiation doses were analyzed.

Main Results:

  • No significant differences in incidence or severity of acute symptoms (fatigue, headache, nausea, dermatitis) between proton and photon RT.
  • Significantly smaller reduction in hemoglobin during proton RT (p<0.001).
  • Significantly lower absorbed mean dose to intracranial OARs with proton RT.

Conclusions:

  • Proton radiotherapy is safe and well-tolerated regarding acute side effects in pediatric medulloblastoma patients.
  • Proton RT significantly reduces radiation dose to intracranial OARs compared to photon RT.
  • Further studies on long-term effects and cognitive outcomes are warranted to confirm clinical value.
Abstract

Keywords:
Acute toxicityCraniospinal irradiationHematologic toxicity.MedulloblastomaProton radiation

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