Proton radiation therapy for pediatric malignancies: Status report

  • Eugen B. Hug
  • Jerry D. Slater
Clinical Aspects of Hadron Therapy


Proton radiation therapy allows high degrees of conformity of radiation dose around irregular target volumes of variable sizes. Long-term follow-up in adults, and preliminary data for pediatric patients suggest that local control and survival can be improved in histologies requiring high radiation dose, without increased incidence of late toxicities. In the pediatric patient, avoidance of even moderate amounts of irradiation to normal tissues is of paramount importance. Conformal 3-D planned proton irradiation can contribute to this goal. For late effects, one can expect that reduced dose and volume irradiated will reduce radiation effects. However, full expression of late effects may occur in children five to ten years after treatment, or even later. Proton irradiation is therefore also indicated and used at Loma Linda University Medical Center for pediatric solid neoplasms in which conventional dose levels yield satisfactory local control and survival.

Key Words

Proton therapy Brain tumors Pediatric malignancies Radiation therapy 


  1. 1.
    Abramson DH, Notis CM. Visual Acuity After Radiation for Orbital Rhabdomyosarcoma. Am J Ophthalmology 1994;118:808–9.Google Scholar
  2. 2.
    Archambeau JO, Slater JD, Slater JM, et al. Role for proton beam irradiation in treatment of pediatric CNS malignancies. Int J Radiat Oncol Biol Phys 1991;22:287–94.Google Scholar
  3. 3.
    Austin-Seymour M, Munzenrider JE, Goitein M, et al. Fractionated proton radiation therapy of chordoma and low-grade chondrosarcoma of the base of skull. J Neurosurg 1989;70:13–7.PubMedGoogle Scholar
  4. 4.
    Benk V, Liebsch NJ, Munzenrider JE, et al. Base of skull and cervical spine chordomas in children treated by high-dose irradiation. Int J Radiat Oncol Biol Phys 1995;31:577–81.PubMedGoogle Scholar
  5. 5.
    Goitein M, Abrams M. Multidimensional treatment planning: Beam’s eye view, back projection and projection through CT sections. Int J Radiat Oncol Biol Phys 1983;9:789–97.PubMedGoogle Scholar
  6. 6.
    Guyuron B, Dagys AP, Orth D, et al. Long-Term Effects of Orbital Irradiation. Head Neck Surg 1987;10:85–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Heyn R, Ragab A, Raney RB, et al. Late Effects of Therapy in Orbital Rhabdomyosarcoma in Children. A Report from the Intergroup Rhabdomyosarcoma Study. Cancer 1986;57:1738–43.PubMedCrossRefGoogle Scholar
  8. 8.
    Hug EB, Fitzek MM, Liebsch NJ, et al. Locally Challenging Osteo- and Chondrogenic Tumors of the Axial Skeleton: Results of combined Proton and Photon Radiation therapy using Three-Dimensional Treatment Planning. Int J Radiat Oncol Biol Phys 1995;31:467–76.PubMedGoogle Scholar
  9. 9.
    Kun LE, Mulhern RK, Crisco JJ. Quality of life in children treated for brain tumors: Intellectual, emotional and academic functions. J Neurosurg 1983;58:1–6.PubMedCrossRefGoogle Scholar
  10. 10.
    McAllister B, Archambeau JO, Nguyen CM, et al. Proton Therapy for Pediatric Cranial Tumors: Preliminary Report on Treatment and Disease-Related Morbidities. Int J Radiat Oncol Biol Phys 1997;39:455–60.PubMedGoogle Scholar
  11. 11.
    Munzenrider JE, Austin-Seymour M, Blitzer PJ, et al. Proton therapy at Harvard. Strahlenther Onkol 1985;161:756–63.Google Scholar
  12. 12.
    Packer RJ, Meadows AT, Rocke LB, et al. Long-term sequelae of cancer treatment on the central nervous system in childhood. Med Pediatr Oncol 1987;15:241–53.PubMedCrossRefGoogle Scholar

Copyright information

© Urban & Vogel 1999

Authors and Affiliations

  • Eugen B. Hug
    • 1
  • Jerry D. Slater
    • 1
  1. 1.Department of Radiation MedicineLoma Linda University Medical CenterLoma LindaUSA

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