Pencil Beam Proton Therapy Spares Cognition in Craniopharyngioma
No abstract available
To determine the pre-irradiation baseline association of white matter integrity with neurocognitive function and to assess post-treatment changes in pediatric patients with craniopharyngioma treated with proton therapy.
This article reviews current treatment modalities and surgical risks, highlighting differences between endoscopic versus transcranial surgical approaches.
Radiation-induced cerebral vasculopathy (RICV) has been described in paediatric patients after radiation therapy (RT) for tumours of optic tracts, hypothalamus, and suprasellar region [1,2]. Delayed RICV mainly results from an accelerated arteriosclerosis process of small and medium sized vessels within the radiation field [3,4]. This complication can present as moyamoya syndrome, which results from stenosis or occlusion of large and intermediate cerebral arteries . The real incidence of RT-induced stenosis of carotid arteries and intracerebral arteries is however not well established.
CONCLUSIONS: For children with and without RICVs, quantitative analysis showed a significant correlation with LETd average/maximum values in vascular structures, whilst no correlation was found on dosimetric parameters. PMID: 32387488 [PubMed - as supplied by publisher]
Raees Tonse, MP Noufal, Chandrashekhar E Deopujari, Rakesh JalaliNeurology India 2020 68(1):189-191 We recently started India's first proton beam therapy facility. Proton beam therapy because of its unique physical characteristics of minimal exit dose has an unequivocal dosimetric superiority over high-end photon/standard X-ray beam therapy and is particularly advantageous in growing children with curable cancers in view of their very high probability of long-term cures. We hereby report a case of a 7-year-old boy with a craniopharyngioma which had been subtotally resected and was subsequently treated with modern penc...
ConclusionsOur data support the safety and efficacy of proton therapy in the treatment of adult craniopharyngioma as part of primary or salvage treatment. We recommend early consideration of radiotherapy.Trial registrationClinical Trials.gov Identifier: NCT03224767. Accessed December 3, 2019
Study Objectives:Children with craniopharyngioma are at risk for excessive daytime sleepiness (EDS). Multiple Sleep Latency Testing (MSLT) is the gold standard for objective evaluation of EDS; however, it is time and resource intensive. We compared the reliability, sensitivity, and specificity of the modified Epworth Sleepiness Scale (M-ESS) and MSLT in monitoring EDS in children with craniopharyngioma.Methods:Seventy patients (ages 6 to 20 years) with craniopharyngioma completed the M-ESS and were evaluated by polysomnography and MSLT. Evaluations were made after surgery, if performed, and before proton therapy.Results:MS...
CONCLUSION: The irradiated volumes of temporal lobe BSCs were consistently the lowest with PBS, whereas the model-based estimates of cognitive outcomes were less consistent. PMID: 31472997 [PubMed - as supplied by publisher]
Conclusion: For base-of-skull and pediatric craniopharyngioma cases, both physical and biological robustness analyses should be considered for IMPT: these analyses can substantially affect the sparing of OARs and comparisons against VMAT. All proton RBE modeling is subject to high levels of uncertainty, but the clinical community should remain cognizant possible RBE effects. Careful clinical and imaging follow-up, plus further research on end-of-range RBE mitigation strategies such as LET optimization, should be prioritized for these cohorts of proton patients. PMID: 31429359 [PubMed - as supplied by publisher]
Conclusions: Actigraphy was highly sensitive and accurate and was a reliable measure of SE and SL. Although there were differences in TST and WASO measurements by actigraphy and PSG, our findings provide the basis for future studies on the use of actigraphy to monitor treatment response to wakefulness-promoting medications in youth with craniopharyngioma who demonstrate excessive daytime sleepiness. PMID: 31303059 [PubMed - as supplied by publisher]