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Radiother Oncol. 2016 Jul;120(1):163-8. doi: 10.1016/j.radonc.2016.05.013. Epub 2016 May 28.

Tumour control and Quality of Life in children with rhabdomyosarcoma treated with pencil beam scanning proton therapy.

Author information

1
Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Switzerland; Center for Proton Therapy, Paul Scherrer Institute, Switzerland.
2
Department of Pediatric Hematology and Oncology, University Hospital Münster, Germany.
3
Center for Proton Therapy, Paul Scherrer Institute, Switzerland.
4
Clinic for Particle Therapy, University Hospital Essen, West German Proton Therapy Center Essen (WPE), Germany.
5
Department of Pediatric Hematology and Oncology, University Hospital Münster, Germany; ETH Zürich, Switzerland.
6
Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Switzerland; Center for Proton Therapy, Paul Scherrer Institute, Switzerland; University of Bern, Switzerland; University of Zürich, Switzerland. Electronic address: damien.weber@psi.ch.

Abstract

PURPOSE:

To assess clinical outcomes in children with rhabdomyosarcoma (RMS) treated with pencil beam scanning (PBS) proton therapy (PT).

METHODS AND MATERIALS:

Eighty-three RMS (embryonal, n=74; 89%) patients treated between January 2000 and December 2014 were included. The median age was 4.5years (range, 0.8-15.5). All patients received systemic chemotherapy according to prospective protocols. Patients had low-, intermediate-, and high-risk disease in 24%, 63%, and 13% of cases, respectively. The median total dose delivered was 54Gy(RBE) (range, 41.4-64.8).

RESULTS:

After a median follow-up time of 55.5 months (range, 0.9-126.3), local failure occurred in 16 patients. The 5-year local-control survival rate was 78.5% [95% confidence interval (CI), 69.5-88.5%]. Significant predictors for local failure were group/stage, tumour location, and size. Fourteen patients (16%) died, all from tumour progression. The 5-year overall survival was 80.6% (95%CI, 71.8-90.0%). The 5-year incidence of grade 3 non-ocular late toxicity was 3.6% (95%CI, 1-12%). No grade 4-5 late toxicities were observed. One radiation-induced malignancy was observed (1.2%). The Quality of Life (QoL) scores increased significantly after PT compared to baseline values.

CONCLUSIONS:

PBS PT led to excellent outcome in children with RMS. Late non-ocular toxicity was minimal and QoL good.

KEYWORDS:

Children; Late toxicity; Pencil beam scanning proton therapy; Quality of Life; Radiation-induced tumours; Rhabdomyosarcoma

PMID:
27247053
DOI:
10.1016/j.radonc.2016.05.013
[Indexed for MEDLINE]

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