Comparison of risks of late effects from radiation therapy in children versus adults: Insights from the QUANTEC, HyTEC, and PENTEC efforts Review
| Authors: | Milano, M. T.; Marks, L. B.; Olch, A. J.; Yorke, E. D.; Jackson, A.; Bentzen, S. M.; Constine, L. S. |
| Review Title: | Comparison of risks of late effects from radiation therapy in children versus adults: Insights from the QUANTEC, HyTEC, and PENTEC efforts |
| Abstract: | Pediatric Normal Tissue Effects in the Clinic (PENTEC) seeks to refine quantitative radiation dose-volume relationships for normal-tissue complication probabilities (NTCPs) in survivors of pediatric cancer. This article summarizes the evolution of PENTEC and compares it with similar adult-focused efforts (eg, Quantitative Analysis of Normal Tissue Effects in the Clinic [QUANTEC] and Hypofractionated Treatment Effects in the Clinic [HyTEC]) with respect to content, oversight, support, scope, and methodology of literature review. It then summarizes key organ-specific findings from PENTEC in an attempt to compare NTCP estimates in children versus adults. In brief, select normal-tissue risks within developing organs and tissues (eg, maldevelopment of musculoskeletal tissue, teeth, breasts, and reproductive organs) are primarily relevant only in children. For some organs and tissues, children appear to have similar (eg, brain for necrosis, optic apparatus, parotid gland, liver), greater (eg, brain for neurocognition, cerebrovascular, breast for lactation), less (ovary), or perhaps slightly less (eg, lung) risks of toxicity versus adults. Similarly, even within the broad pediatric age range (including adolescence), for some endpoints, younger children have greater (eg, hearing and brain for neurocognition) or lesser (eg, ovary, thyroid) risks of radiation-associated toxicities. NTCP comparisons in adults versus children are often confounded by marked differences in treatment paradigms that expose normal tissues to radiation (ie, cancer types, prescribed radiation therapy dose and fields, and chemotherapy agents used). To add to the complexity, it is unclear if age is best analyzed as a continuous variable versus with age groupings (eg, infants, young children, adolescents, young adults, middle-aged adults, older adults). Further work is needed to better understand the complex manner in which age and developmental status affect risk. © 2023 Elsevier Inc. |
| Keywords: | adolescent; adult; child; preschool child; child, preschool; review; hypertension; comparative study; chemotherapy; neoplasm; neoplasms; cell death; breast; kidney disease; radiotherapy; age factors; radiation injury; histology; ovary insufficiency; radiation response; late effects; age; cancer survivor; risk assessment; radiation effects; probability; cerebrovascular disease; heart death; cardiotoxicity; radiation injuries; xerostomia; cognition; retinopathy; liver disease; medical literature; therapy effect; radiation hazard; hypothyroidism; toxicity; normal tissue; brain necrosis; hearing impairment; diseases; radiation pneumonia; tissue; spinal cord disease; acute disease; pediatrics; hypofractionated; cancer survivors; radiation induced neoplasm; normal tissue complication probabilities; audition; pediatric cancer; dose-volume; tooth; organs at risk; treatment effects; optic nerve disease; young children; hypofractionated radiotherapy; humans; human; male; female; cataractogenesis; neurocognition; literature reviews; radiation dose hypofractionation |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 119 |
| Issue: | 2 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2024-06-01 |
| Start Page: | 387 |
| End Page: | 400 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2023.08.066 |
| PUBMED: | 38069917 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Review -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- Source: Scopus |
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