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Estimated clinical ...
Estimated clinical benefit of protecting neurogenesis in the developing brain during radiation therapy for pediatric medulloblastoma.
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- Blomstrand, Malin, 1974 (author)
- Gothenburg University,Göteborgs universitet,University of Gothenburg,Sahlgrenska University Hospital,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology
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- Patrik Brodin, N. (author)
- Copenhagen University Hospital,Niels Bohr Institute
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- Munck Af Rosenschld, Per (author)
- Copenhagen University Hospital
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- Vogelius, Ivan R. (author)
- Copenhagen University Hospital
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- Snchez Merino, Gaspar (author)
- Niels Bohr Institute
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- Kiil-Berthlesen, Anne (author)
- Copenhagen University Hospital,Hospital Universitario Araba
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- Blomgren, Klas, 1963 (author)
- Karolinska Institutet,Gothenburg University,Göteborgs universitet,University of Gothenburg,Queen Silvia Children’s Hospital,Karolinska University Hospital,Institutionen för neurovetenskap och fysiologi,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Neuroscience and Physiology,Institute of Clinical Sciences, Department of Pediatrics
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- Lannering, Birgitta, 1948 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics
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- Bentzen, Søren M. (author)
- Copenhagen University Hospital,University of Wisconsin-Madison
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- Björk-Eriksson, Thomas (author)
- Lund University,Lunds universitet,Urologisk cancerforskning, Malmö,Forskargrupper vid Lunds universitet,Urological cancer, Malmö,Lund University Research Groups,Skåne University Hospital
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(creator_code:org_t)
- 2012-05-17
- 2012
- English 8 s.
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In: Neuro-Oncology. - : Oxford University Press (OUP). - 1523-5866 .- 1522-8517. ; 14:7, s. 882-889
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Abstract
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- We sought to assess the feasibility and estimate the benefit of sparing the neurogenic niches when irradiating the brain of pediatric patients with medulloblastoma (MB) based on clinical outcome data. Pediatric MB survivors experience a high risk of neurocognitive adverse effects, often attributed to the whole-brain irradiation that is part of standard management. Neurogenesis is very sensitive to radiation, and limiting the radiation dose to the hippocampus and the subventricular zone (SVZ) may preserve neurocognitive function. Radiotherapy plans were created using 4 techniques: standard opposing fields, intensity-modulated radiotherapy (IMRT), intensity-modulated arc therapy (IMAT), and intensity-modulated proton therapy (IMPT). Mean dose to the hippocampus and SVZ (mean for both sites) could be limited to 88.3% (range, 83.6%-91.0%), 77.1% (range, 71.5%-81.3%), and 42.3% (range, 26.6%-51.2%) with IMAT, IMRT, and IMPT, respectively, while maintaining at least 95% of the prescribed dose in 95% of the whole-brain target volume. Estimated risks for developing memory impairment after a prescribed dose of 23.4 Gy were 47% (95% confidence interval [CI], 21%-69%), 44% (95% CI, 21%-65%), 41% (95% CI, 22%-60%), and 33% (95% CI, 23%-44%) with opposing fields, IMAT, IMRT, and IMPT, respectively. Neurogenic niche sparing during cranial irradiation of pediatric patients with MB is feasible and is estimated to lower the risks of long-term neurocognitive sequelae. Greatest sparing is achieved with intensity-modulated proton therapy, thus making this an attractive option to be tested in a prospective clinical trial.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
Keyword
- CNS
- medulloblastoma
- neurocognitive sparing
- radiotherapy
- risk modeling
Publication and Content Type
- art (subject category)
- ref (subject category)
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Blomstrand, Mali ...
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Patrik Brodin, N ...
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Munck Af Rosensc ...
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Vogelius, Ivan R ...
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Snchez Merino, G ...
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Kiil-Berthlesen, ...
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Blomgren, Klas, ...
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Lannering, Birgi ...
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Bentzen, Søren M ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Pediatrics
- Articles in the publication
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Neuro-Oncology
- By the university
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Lund University
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University of Gothenburg
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Karolinska Institutet