Early axial growth outcomes of pediatric patients receiving proton craniospinal irradiation Journal Article
| Authors: | De, B.; Cahlon, O.; Sine, K.; Mah, D.; Hug, E. B.; Wolden, S. L. |
| Article Title: | Early axial growth outcomes of pediatric patients receiving proton craniospinal irradiation |
| Abstract: | Guidelines on proton craniospinal irradiation (p-CSI) target volume selection in children are lacking. We examined the impact of target volume selection on growth of children receiving p-CSI at a institution. Records of 58 patients who received p-CSI were reviewed. Median age at treatment initiation was 8 years (range, 2 to 18 y). Spinal target volumes included whole vertebral body (WVB) in 67% and partial vertebral body (PVB) in 33%. Height z-scores before and after p-CSI were assessed using Centers for Disease Control and Prevention stature-for-age charts. Maximal Cobb angle and height z-score change were compared for WVB versus PVB p-CSI using a t test. Among 93% of patients with detailed data, median follow-up was 19 months (range, 2 to 58 mo) after radiation therapy initiation. Quantitative growth evaluations were available for 64% of patients. Median change in height z-score was -0.5 (range, -2.1 to +0.7) after treatment, representing a decrease (P<0.001) in age-adjusted height. WVB patients had significantly greater reduction in height z-score versus PVB patients (P=0.004) but no difference in Cobb angle change (P>0.05). Despite reluctance surrounding its use in younger patients, PVB p-CSI was associated with similar spinal curvature and less growth suppression as compared with WVB p-CSI; a trial comparing WVB versus PVB in children may be warranted. © 2018 Wolters Kluwer Health, Inc. All rights reserved. |
| Keywords: | pediatric oncology; craniospinal irradiation; proton therapy; central nervous system tumors; growth outcomes |
| Journal Title: | Journal of Pediatric Hematology/Oncology |
| Volume: | 40 |
| Issue: | 8 |
| ISSN: | 1077-4114 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2018-11-01 |
| Start Page: | 574 |
| End Page: | 579 |
| Language: | English |
| DOI: | 10.1097/mph.0000000000001242 |
| PUBMED: | 29889805 |
| PROVIDER: | scopus |
| PMCID: | PMC6197896 |
| DOI/URL: | |
| Notes: | Conference Paper -- Export Date: 3 December 2018 -- Source: Scopus |
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