Normal tissue tolerance amongst paediatric brain tumour patients- current evidence in proton radiotherapy

Author(s):  
Mikaela Dell’Oro ◽  
Michala Short ◽  
Puthenparampil Wilson ◽  
Eva Bezak
BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S47-S47
Author(s):  
Ashy Rengit

AimsIdentify common risk factors for longterm cognitive dysfunction in PBTS (paediatric brain tumour survivors) Examine how various paediatric cancer treatment modalities affect cognitive outcomes Consider baseline features which may increase the risk of cognitive dysfunction in PBTSMethodCurrent research into the neuropsychiatric sequelae of childhood brain tumours is limited, therefore review of the literature was conducted to identify research within this field.DatabasesGoogle Scholar - papers accessed via the University of Brighton or Sussex online libraryNICE HDAS - HMIC, AMED, MEDLINE, BNI, PsycINFO, CINAHL, Pubmed, EMBASE & EMCAREMendeley reference manager - papers for background readingSearch termsPICO(T) method - Population (Cancer Survivors), Intervention (Cancer Treatment), Comparison (Brain tumour), Outcome (Cognitive dysfunction) & Time (Childhood & adolescence) Boolean operators (AND/OR), truncation and wildcard search functions were also utilised.Inclusion criteria; no limits on date, study type or gender, however, study results were limited by age - as the research focus was restricted to children and adolescents.Excluded results; papers which did not meet inclusion criteria, duplicate studies, studies measuring non-cognitive cancer outcomes or investigating non-cortical tumours, non-English language studies with no available English translations.ResultCommon risk factors - certain tumour types (glioneuronal tumours or gliomas) or inner cortical tumour sites e.g. were more vulnerable to epileptogenesis. In particular, seizures which were prolonged and treatment-resistant were associated with a greater degree of cognitive dysfunction.Impact of various cancer treatment modalities - overall results understandably suggested that patients are more likely to develop cognitive deficits following brain tumour treatment. In particular, partial tumour resection (especially if epileptogenic), whole-brain irradiation, cranial radiotherapy and chemotherapy were more likely to impact cognitive function.Baseline features that may increase likelihood of cognitive dysfunction e.g. intellectual disability or education level were not noted in the reviewed literature.ConclusionCancer is one of the leading causes of global child mortality, and younger populations often present to paediatric oncology services with brain tumour involvement. Current childhood brain tumour research has begun to recognise that many young survivors develop into adulthood with cognitive sequelae impacting quality of life measures. However, existing evidence is also limited and requires further research to produce a standardised clinical tool for screening various risk factors which may increase longterm risk of cognitive dysfunction and subsequent difficulties with daily life.


2019 ◽  
pp. 145-164
Author(s):  
Stephen Falk

Chapter 7 discusses the upper gastrointestinal tract, and addresses the technical challenges of these cancersin relation to tumour volumes, anatomical situation, and poor normal tissue tolerance, particularly of the intra-abdominal contents. More contemporaneous treatment techniques such as intensity-modulated radiotherapy and stereotactic ablative radiotherapy have not currently made significant impact in the routine treatment of upper gastrointestinal tumours in the UK.


2020 ◽  
Vol 12 (1) ◽  
pp. 215-220
Author(s):  
E. Onuh ◽  
A.S. Ajuji ◽  
N. Rabiu ◽  
M.S. Anas ◽  
M. Jada

The purpose of this study is to evaluate the impact of Normal Tissue Complication Probability (NTCP) models on radiation treatment plans. We estimated NTCP parameters for the organs at risk (OARs) for cervical cancer radiotherapy. We pooled individual patient data from fifty patients who were treated with External Beam Radiotherapy technique between March 2012 and November 2013 in a part of Northern Nigeria with the exclusion of patients who had other gynaecological malignancies. Three basic methods were followed during the radiotherapy planning of these patients which included the pre-planning stage, planning radiotherapy treatment stage and treatment delivery. Various tests were carried out on these patients which helped to confirm the diagnosis after which they were treated using the linear accelerator, computed tomography simulator and the treatment planning system. We calculated the normal tissue tolerance doses for partial volumes of the organs using the values of the above –said parameters for published data on normal tissue tolerance doses. This article shows a graphical representation of the computed NTCP for left femur, right femur and skin presented and a fairly good correspondence is found between the curves for head of femurs and skin. Keywords: Normal Tissue Tolerance Dose, Normal Tissue Complication Probability, Method of Least Square Fit, Cervical Radiotherapy


2013 ◽  
Vol 40 (6Part22) ◽  
pp. 369-370
Author(s):  
S Lee ◽  
H Kim ◽  
S Han ◽  
M Kim ◽  
H Yoo ◽  
...  

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