ESTRO 2024 - Abstract Book

S2024

Clinical - Paediatric

ESTRO 2024

Keywords: paediatric, protontherapy; distractive method

References:

[1] Dendale R, Thariat J, Doyen J, Balosso J, Stefan D, Bolle S, Feuvret L, Poortmans P, Hannoun-Lévi JM, Bondiau PY, Micaud M, Alapetite C, Calugaru V, Habrand JL, Mahé MA. État des lieux de la protonthérapie en France en 2019 [Proton therapy in France in 2019]. Cancer Radiother. 2019 Oct;23(6-7):617-624. French. doi: 10.1016/j.canrad.2019.07.129.

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Dose-Volume predictors of acute hematologic toxicity during pediatric cranio-spinal irradiation

Andrada Turcas 1,2 , Bianca Homorozeanu 1,2 , Daniel Leucuta 3 , Cristina Balan 1,4 , Rodica Cosnarovici 5 , Oana Diaconu 1,4 , Zsolt Fekete 1,2 , Cristina Gheara 1,4 , Emilia Mihut 5 , Diana Olteanu 5 , Paula Pruteanu 5 , Adrian Turcas 6 , Dana Cernea 1 , Patriciu Achimas-Cadariu 7,2 1 The Oncology Institute “Prof. Dr. Ion Chiricuta”, Radiotherapy Department, Cluj-Napoca, Romania. 2 The University of Medicine and Pharmacy “Iuliu Hatieganu”, Oncology Department, Cluj-Napoca, Romania. 3 The University of Medicine and Pharmacy “Iuliu Hatieganu”, Department of Medical Informatics and Biostatisticsology Department, Cluj-Napoca, Romania. 4 Babes-Bolyai” University, Faculty of Physics, Cluj-Napoca, Romania. 5 The Oncology Institute “Prof. Dr. Ion Chiricuta”, Paediatric Oncology Department, Cluj-Napoca, Romania. 6 The Oncology Institute “Prof. Dr. Ion Chiricuta”, Oncology Department, Cluj-Napoca, Romania. 7 The Oncology Institute “Prof. Dr. Ion Chiricuta”, Surgical Oncology Department, Cluj-Napoca, Romania

Purpose/Objective:

Craniospinal irradiation (CSI) is a complex radiotherapy (RT) technique often required for treating specific pediatric brain tumors, also having limited indications in some hematologic malignancies. Due to irradiation of a large volume of hematogenous bone marrow (BM), CSI often causes acute hematologic toxicity, which could lead to treatment interruptions or severe complications. The aim of this study is to report on the dynamics and dose/volume predictors of hematologic toxicity in pediatric patients undergoing photon CSI.

Material/Methods:

This study was approved by the local ethics committee, and consent was obtained from all patients/parents. All pediatric patients (≤18 years) undergoing CSI between 2011-2023 in a tertiary cancer center were included. Medical records were retrospectively reviewed for clinical data. CBC results were collected at baseline (before starting RT) and weekly, until one week after end of RT. The BM, defined as the entire spine and pelvic bones (PB), was manually contoured, and dose-volume parameters were extracted from the RT treatment planning systems. We used Wilcoxon rank-sum test to compare quantitative data, the Chi square test for qualitative data, and ROC curves for dose/volume thresholds.

Results: