Research progress on dosimetry-related long-term complications of pediatric cancer radiotherapy
Qiu Wenlong1, Shi Pengyue2, Wang Jingfu3, Zhu Jian1, Yu Jinming4
1Department of Radiation Oncology Physics, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan 250117, China; 2Department of Abdominal Radiation Oncology Ⅰ, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan 250117, China; 3Department of Pediatric Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan 250117, China; 4Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan 250117, China
Abstract：Children with pediatric tumors have better prognosis and longer survival than adults, suggesting that attention should be paid to the long-term complications induced by radiotherapy. In this article, the data from more than 40 clinical studies of pediatric tumor radiotherapy published in the recent decade were retrospectively analyzed. Long-term complications of nervous system, cardio-cerebrovascular system, respiratory system, endocrine system, urinary system, reproductive system, skeletal development, long-term secondary tumors were considered and the corresponding radiation dose-volume parameters were summarized, aiming to guide radiation oncology physicians and physicists to optimize radiotherapy plans for children with pediatric tumors.
Qiu Wenlong,Shi Pengyue,Wang Jingfu et al. Research progress on dosimetry-related long-term complications of pediatric cancer radiotherapy[J]. Chinese Journal of Radiation Oncology, 2021, 30(4): 413-418.
[1] Howlader N, Noone AM, Krapcho M, et al. SEER cancer statistics review, 1975-2017[M/OL]. Bethesda, MD:National Cancer Institute, 2020. https://seer.cancer.gov/csr/1975_2017/. [2] Hudson MM, Ness KK, Gurney JG, et al. Clinical ascertainment of health outcomes among adults treated for childhood cancer[J]. JAMA, 2013, 309(22):2371-2381. DOI:10.1001/jama.2013.6296. [3] Whelan KF, Stratton K, Kawashima T, et al. Ocular late effects in childhood and adolescent cancer survivors:a report from the childhood cancer survivor study[J]. Pediatr Blood Cancer, 2010, 54(1):103-109. DOI:10.1002/pbc.22277. [4] Whelan K, Stratton K, Kawashima T, et al. Auditory complications in childhood cancer survivors:a report from the childhood cancer survivor study[J]. Pediatr Blood Cancer, 2011, 57(1):126-134. DOI:10.1002/pbc.23025. [5] Wells EM, Ullrich NJ, Seidel K, et al. Longitudinal assessment of late-onset neurologic conditions in survivors of childhood central nervous system tumors:a childhood cancer survivor study report[J]. Neuro Oncol, 2018, 20(1):132-142. DOI:10.1093/neuonc/nox148. [6] Brinkman TM, Krasin MJ, Liu W, et al. Long-term neurocognitive functioning and social attainment in adult survivors of pediatric CNS tumors:results from the St Jude lifetime cohort study[J]. J Clin Oncol, 2016, 34(12):1358-1367. DOI:10.1200/JCO.2015.62.2589. [7] Merchant TE, Conklin HM, Wu S, et al. Late effects of conformal radiation therapy for pediatric patients with low-grade glioma:prospective evaluation of cognitive, endocrine, and hearing deficits[J]. J Clin Oncol, 2009, 27(22):3691-3697. DOI:10.1200/JCO.2008.21.2738. [8] Armstrong GT, Jain N, Liu W, et al. Region-specific radiotherapy and neuropsychological outcomes in adult survivors of childhood CNS malignancies[J]. Neuro Oncol, 2010, 12(11):1173-1186. DOI:10.1093/neuonc/noq104. [9] Yock TI, Bhat S, Szymonifka J, et al. Quality of life outcomes in proton and photon treated pediatric brain tumor survivors[J]. Radiother Oncol, 2014, 113(1):89-94. DOI:10.1016/j.radonc.2014.08.017. [10] Kahalley LS, Ris MD, Grosshans DR, et al. Comparing intelligence quotient change after treatment with proton versus photon radiation therapy for pediatric brain tumors[J]. J Clin Oncol, 2016, 34(10):1043-1049. DOI:10.1200/JCO.2015.62.1383. [11] Brinkman TM, Zhang N, Recklitis CJ, et al. Suicide ideation and associated mortality in adult survivors of childhood cancer[J]. Cancer, 2014, 120(2):271-277. DOI:10.1002/cncr.28385. [12] Gunnes MW, Lie RT, Bjorge T, et al. Suicide and violent deaths in survivors of cancer in childhood, adolescence and young adulthood-a national cohort study[J]. Int J Cancer, 2017, 140(3):575-580. DOI:10.1002/ijc.30474. [13] Zureick AH, Evans CL, Niemierko A, et al. Left hippocampal dosimetry correlates with visual and verbal memory outcomes in survivors of pediatric brain tumors[J]. Cancer, 2018, 124(10):2238-2245. DOI:10.1002/cncr.31143. [14] Gondi V, Pugh SL, Tome WA, et al. Preservation of memory with conformal avoidance of the hippocampal neural stem-cell compartment during whole-brain radiotherapy for brain metastases (RTOG 0933):a phase Ⅱ multi-institutional trial[J]. J Clin Oncol, 2014, 32(34):3810-3816. DOI:10.1200/JCO.2014.57.2909. [15] Gondi V, Hermann BP, Mehta MP, et al. Hippocampal dosimetry predicts neurocognitive function impairment after fractionated stereotactic radiotherapy for benign or low-grade adult brain tumors[J]. Int J Radiat Oncol Biol Phys, 2012, 83(4):e487-493. DOI:10.1016/j.ijrobp.2012.11.031. [16] Marks LB, Yorke ED, Jackson A, et al. Use of normal tissue complication probability models in the clinic[J]. Int J Radiat Oncol Biol Phys, 2010, 76(3 suppl):S10-19. DOI:10.1016/j.ijrobp.2009.07.1754. [17] Mulrooney DA, Yeazel MW, Kawashima T, et al. Cardiac outcomes in a cohort of adult survivors of childhood and adolescent cancer:retrospective analysis of the childhood cancer survivor study cohort[J]. BMJ, 2009, 339:b4606. DOI:10.1136/bmj.b4606. [18] Bates;JE, Howell RM, Liu Q, et al. Therapy-related cardiac risk in childhood cancer survivors:an analysis of the childhood cancer survivor study[J]. J Clin Oncol, 2019, 37(13):1090-1101. DOI:10.1200/JCO.18.01764. [19] El-Fayech C, Haddy N, Allodji RS, et al. Cerebrovascular diseases in childhood cancer survivors:role of the radiation dose to willis circle arteries[J]. Int J Radiat Oncol Biol Phys, 2017, 97(2):278-286. DOI:10.1016/j.ijrobp.2016.10.015. [20] Venkatramani R, Kamath S, Wong K, et al. Pulmonary outcomes in patients with Hodgkin lymphoma treated with involved field radiation[J]. Pediatr Blood Cancer, 2014, 61(7):1277-1281. DOI:10.1002/pbc.24969. [21] Lewis GD, Agrusa JE, Teh BS, et al. Radiation pneumonitis in pediatric Hodgkin lymphoma patients receiving radiation therapy to the chest[J]. Pract Radiat Oncol, 2018, 8(5):e364-e368. DOI:10.1016/j.prro.2018.01.007. [22] Chemaitilly W, Li Z, Huang S, et al. Anterior hypopituitarism in adult survivors of childhood cancers treated with cranial radiotherapy:a report from the St Jude lifetime cohort study[J]. J Clin Oncol, 2015, 33(5):492-500. DOI:10.1200/JCO.2014.56.7933. [23] Chemaitilly W, Sklar CA. Childhood cancer treatments and associated endocrine late effects:a concise guide for the pediatric endocrinologist[J]. Horm Res Paediatr, 2019, 91(2):74-82. DOI:10.1159/000493943. [24] Eaton BR, Esiashvili N, Kim S, et al. Endocrine outcomes with proton and photon radiotherapy for standard risk medulloblastoma[J]. Neuro Oncol, 2016, 18(6):881-887. DOI:10.1093/neuonc/nov302. [25] De Vathaire F, El-Fayech C, Ben Ayed FF, et al. Radiation dose to the pancreas and risk of diabetes mellitus in childhood cancer survivors:a retrospective cohort study[J]. Lancet Oncol, 2012, 13(10):1002-1010. DOI:10.1016/S1470-2045(12)70323-6. [26] Jouglar E, Wagner A, Delpon G, et al. Can we spare the pancreas and other abdominal organs at risk? A comparison of conformal radiotherapy, helical tomotherapy and proton beam therapy in pediatric irradiation[J]. PLoS One, 2016, 11(10):e0164643. DOI:10.1371/journal.pone.0164643. [27] Jones DP, Spunt SL, Green D, et al. Renal late effects in patients treated for cancer in childhood:a report from the children's oncology group[J]. Pediatr Blood Cancer, 2008, 51(6):724-731. DOI:10.1002/pbc.21695. [28] Ritchey M, Ferrer F, Shearer P, et al. Late effects on the urinary bladder in patients treated for cancer in childhood:a report from the children's oncology group[J]. Pediatr Blood Cancer, 2009, 52(4):439-446. DOI:10.1002/pbc.21826. [29] Signorello LB, Cohen SS, Bosetti C, et al. Female survivors of childhood cancer:preterm birth and low birth weight among their children[J]. J Natl Cancer Inst, 2006, 98(20):1453-1461. DOI:10.1093/jnci/djj394. [30] Kenney LB, Cohen LE, Shnorhavorian M, et al. Male reproductive health after childhood, adolescent, and young adult cancers:a report from the children's oncology group[J]. J Clin Oncol, 2012, 30(27):3408-3416. DOI:10.1200/JCO.2011.38.6938. [31] Kenney LB, Antal Z, Ginsberg JP, et al. Improving male reproductive health after childhood, adolescent, and young adult cancer:progress and future directions for survivorship research[J]. J Clin Oncol, 2018, 36(21):2160-2168. DOI:10.1200/JCO.2017.76.3839. [32] Rao AD, Ladra M, Dunn E, et al. A road map for important centers of growth in the pediatric skeleton to consider during radiation therapy and associated clinical correlates of radiation-induced growth toxicity[J]. Int J Radiat Oncol Biol Phys, 2019, 103(3):669-679. DOI:10.1016/j.ijrobp.2018.10.026. [33] Dörr W, Kallfels S, Herrmann T. Late bone and soft tissue sequelae of childhood radiotherapy. Relevance of treatment age and radiation dose in 146 children treated between 1970 and 1997[J]. Strahlenther Onkol, 2013, 189(7):529-534. DOI:10.1007/s00066-013-0361-y. [34] Lockney NA, Friedman DN, Wexler LH, et al. Late toxicities of intensity-modulated radiation therapy for head and neck rhabdomyosarcoma[J]. Pediatr Blood Cancer, 2016, 63(9):1608-1614. DOI:10.1002/pbc.26061. [35] Friedman DL, Whitton J, Leisenring W, et al. Subsequent neoplasms in 5-year survivors of childhood cancer:the childhood cancer survivor study[J]. J Natl Cancer Inst, 2010, 102(14):1083-1095. DOI:10.1093/jnci/djq238. [36] Armstrong GT, Liu Q, Yasui Y, et al. Late mortality among 5-year survivors of childhood cancer:a summary from the childhood cancer survivor study[J]. J Clin Oncol, 2009, 27(14):2328-2338. DOI:10.1200/JCO.2008.21.1425. [37] Bhatti P, Veiga LH, Ronckers CM, et al. Risk of second primary thyroid cancer after radiotherapy for a childhood cancer in a large cohort study:an update from the childhood cancer survivor study[J]. Radiat Res, 2010, 174(6):741-752. DOI:10.1667/RR2240.1. [38] Lee CY, Chen YW, Lee YY, et al. Irradiation-induced secondary tumors following pediatric central nervous system tumors:experiences of a single institute in taiwan (1975-2013)[J]. Int J Radiat Oncol Biol Phys, 2018, 101(5):1243-1252. DOI:10.1016/j.ijrobp.2018.04.032. [39] Armstrong GT, Liu W, Leisenring W, et al. Occurrence of multiple subsequent neoplasms in long-term survivors of childhood cancer:a report from the childhood cancer survivor study[J]. J Clin Oncol, 2011, 29(22):3056-3064. DOI:10.1200/JCO.2011.34.6585. [40] Chung CS, Yock TI, Nelson K, et al. Incidence of second malignancies among patients treated with proton versus photon radiation[J]. Int J Radiat Oncol Biol Phys, 2013, 87(1):46-52. DOI:10.1016/j.ijrobp.2013.04.030. [41] Kaste SC, Goodman P, Leisenring W, et al. Impact of radiation and chemotherapy on risk of dental abnormalities:a report from the childhood cancer survivor study[J]. Cancer, 2009, 115(24):5817-5827. DOI:10.1002/cncr.24670. [42] Weil BR, Madenci AL, Liu Q, et al. Late infection-related mortality in asplenic survivors of childhood cancer:a report from the childhood cancer survivor study[J]. J Clin Oncol, 2018, 36(16):1571-1578. DOI:10.1200/JCO.2017.76.1643. [43] Weber DC, Habrand JL, Hoppe BS, et al. Proton therapy for pediatric malignancies:fact, figures and costs. A joint consensus statement from the pediatric subcommittee of PTCOG, PROS and EPTN[J]. Radiother Oncol, 2018, 128(1):44-55. DOI:10.1016/j.radonc.2018.05.020. [44] Journy N, Indelicato DJ, Withrow DR, et al. Patterns of proton therapy use in pediatric cancer management in 2016:an international survey[J]. Radiother Oncol, 2019, 132:155-161. DOI:10.1016/j.radonc.2018.10.022.
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