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Radiother Oncol. 2019 Mar;132:155-161. doi: 10.1016/j.radonc.2018.10.022. Epub 2018 Nov 7.

Patterns of proton therapy use in pediatric cancer management in 2016: An international survey.

Author information

1
INSERM U1018, Centre for Research in Epidemiology and Population Health, Cancer & Radiations Group, Gustave Roussy Cancer Campus, Villejuif, France. Electronic address: neige.journy@gustaveroussy.fr.
2
University of Florida, Department of Radiation Oncology, Jacksonville, United States.
3
Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, United States.
4
National Cancer Center Hospital East, Kashiwa, Japan.
5
Institut Curie Proton therapie Centre (ICPO), Orsay, France.
6
Aizawa Hospital Proton Therapy Center, Nagano, Japan.
7
California Protons, San Diego, United States.
8
Northwestern Medicine Chicago Proton Center, Warrenville, United States; Vanderbilt University Medical Center, Department of Radiation Oncology, Nashville, United States.
9
ProCure Proton Therapy Center, United States.
10
ProCure Proton Therapy Center, Oklahoma City, United States.
11
Hyogo Ion Beam Medical Center, Tatsuno, Japan.
12
Department of Radiation Oncology, Centre Antoine-Lacassagne, 227 avenue de la Lanterne, University of Côte d'Azur, Nice, France.
13
SCCA Proton Therapy, Seattle, United States.
14
Universitäts Protonentherapie Dresden, Universitätsklinikum Carl Gustav Carus, Germany.
15
Children's Hospital of Philadelphia and University of Pennsylvania, Roberts Proton Therapy Center, Philadelphia, United States.
16
Nagoya Proton Therapy Center (Nagoya City West Medical Center), Nagoya-city, Japan.
17
ProtonTherapy Center, National Cancer Center, Goyang-si, South Korea.
18
Departement of Radiation Oncology, University of Maryland School of Medicine, Baltimore, United States.
19
Department of Radiation Oncology, Mayo Clinic, Rochester, United States.
20
Samsung Proton Therapy Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
21
Loma Linda University Medical Center, United States.
22
Texas Center for Proton Therapy, Irving, United States.
23
University Hospitals Proton Therapy Center, Seidman Cancer Center, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, United States.
24
Southern TOHOKU Proton Therapy Center, Koriyama, Japan.
25
Shizuoka Cancer Center, Japan.
26
Medipolis Proton Therapy and Research Center, Kaghosima, Japan.
27
Proton Therapy Center Czech s.r.o, Praha, Czech Republic.
28
Rutgers Cancer Institute of New Jersey, New Brunswick, United States.
29
The University of Texas M.D Anderson Cancer Center, Department of Radiation Oncology, Houston, United States.
30
S. Lee Kling Proton Therapy Center, Washington University in St. Louis, United States.
31
Orlando Health UF Health Cancer Center, United States.
32
Rinecker Proton Therapy Center, Muenchen, Germany.
33
Proton Therapy Center, Trento, Italy.
34
Proton Therapy Center, Fukui Prefectural Hospital, Japan.
35
Department of Radiation Oncology, Hokkaido University, Faculty of Medicine, Sapporo, Japan.
36
Department of Particle Therapy, University Hospital Essen, West German Proton Therapy Center Essen (WPE), West German Cancer Center (WTZ), German Cancer Consortium (DKTK), Essen, Germany.
37
Mayo Clinic Arizona, Phoenix, United States.
38
Willis-Knighton Proton Center, Shreveport, United States.
39
Center for Proton Therapy, Paul Scherrer Institute, Switzerland.
40
Provision Cares Proton Therapy Center, Knoxville, United States.
41
The Skandion Clinic, Uppsala, Sweden; Danish Centre for Particle Therapy, Aarhus, Denmark.
42
Francis H Burr Proton Therapy Center, Massachusetts General Hospital, Boston, United States.

Abstract

PURPOSE:

To facilitate the initiation of observational studies on late effects of proton therapy in pediatric patients, we report on current patterns of proton therapy use worldwide in patients aged less than 22 years.

MATERIALS & METHODS:

Fifty-four proton centers treating pediatric patients in 2016 in 11 countries were invited to respond to a survey about the number of patients treated during that year by age group, intent of treatment, delivery technique and tumor types.

RESULTS:

Among the 40 participating centers (participation rate: 74%), a total of 1,860 patients were treated in 2016 (North America: 1205, Europe: 432, Asia: 223). The numbers of patients per center ranged from 1 to 206 (median: 29). Twenty-four percent of the patients were <5 years of age, and 50% <10 years. More than 30 pediatric tumor types were identified, mainly treated with curative intent: 48% were CNS, 25% extra-cranial sarcomas, 7% neuroblastoma, and 5% hematopoietic tumors. About half of the patients were treated with pencil beam scanning. Treatment patterns were broadly similar across the three continents.

CONCLUSION:

To our knowledge, this survey provides the first worldwide assessment of proton therapy use for pediatric cancer management. Since previous estimates in the United States and Europe, CNS tumors remain the cancer types most commonly treated with protons in 2016. However, the proportion of extra-cranial tumors is growing worldwide. The typically low numbers of patients treated in each center indicate the need for international research collaborations to assess long-term outcomes of proton therapy in pediatric patients.

KEYWORDS:

Patterns of care; Pediatrics; Proton therapy; Survey

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