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Technology Insight: proton beam radiotherapy for treatment in pediatric brain tumors

A Corrigendum to this article was published on 01 April 2005

Abstract

Tumors of the central nervous system are the most common solid tumor in childhood. Treatment options for childhood brain tumors include radiation therapy, surgery and chemotherapy, often given in combination. Radiation therapy regularly has a pivotal role in treatment, and technological advancements during the past quarter of a century have dramatically improved the ability to deliver radiation in a more focused manner. Improvements in imaging and computing ability led to better targeting of tumor tissue using conventional X-ray therapy. These advances have been harnessed for proton radiation therapy. Proton radiotherapy has special physical characteristics that allow normal tissues to be spared better than even the most conformal photon radiation, and it will reduce the complications from treatment. This review discusses the characteristics of proton radiation, and describes examples of pediatric brain tumor patients who would benefit most from this form of treatment.

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Figure 1: Depth dose distribution in tissue of a single Bragg peak (grey), a spread-out Bragg peak (black), which consists of multiple Bragg peaks of different energy added together, and a 10 MV X-ray beam (dashed).
Figure 2: Differences in dose conformality using protons, conventional 3D planned photons and IMRT.
Figure 3: Differences in doses delivered to the spine and body using photons (X-rays) and protons.
Figure 4: Dose distributions to an optic glioma using (A) proton radiation, (B) stereotactic radiotherapy and (C) IMRT.

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Acknowledgements

We would like to thank Judith Adams, Kevin Beaudette, Jong Kung and Tim Padera for their assistance in providing the figures.

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Correspondence to Torunn I Yock.

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Yock, T., Tarbell, N. Technology Insight: proton beam radiotherapy for treatment in pediatric brain tumors. Nat Rev Clin Oncol 1, 97–103 (2004). https://doi.org/10.1038/ncponc0090

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