Oncology · Pediatrics · 1 h ago
Proton Radiotherapy Associated With Fewer In-Field Second Malignancies in Retinoblastoma
A cohort comparison of 108 patients with retinoblastoma found lower cumulative incidence of in-field second malignant neoplasms after proton versus photon radiotherapy. At 15 years, incidence was 0% versus 11.1%, respectively, although median follow-up was shorter in the proton cohort.
- Study compared 66 proton-treated and 42 photon-treated patients.
- In-field second malignancy incidence was 0% versus 11.1% at 15 years.
- Median follow-up was shorter after proton radiotherapy.
- Three additional malignancies occurred beyond 20 years after photon treatment.
An observational cohort comparison published in Pediatric Blood & Cancer examined second malignant neoplasms after radiotherapy for retinoblastoma. The study included 42 patients treated with photon radiotherapy and 66 treated with proton radiotherapy; 74% had bilateral disease at diagnosis. Concern about second malignancies has contributed to declining use of radiotherapy for this childhood intraocular cancer.
The cumulative incidence of in-field second malignant neoplasms at 15 years was 0% after proton radiotherapy versus 11.1% after photon radiotherapy (p = 0.005). Median follow-up was 18.2 years in the proton cohort and 28.7 years in the photon cohort. Three additional second malignancies occurred more than 20 years after photon radiotherapy.
The authors suggest considering proton radiotherapy when radiation is indicated for bilateral retinoblastoma and proton treatment is feasible. The findings show an association rather than establishing causality. Unequal follow-up is an important caveat given the late events in the photon cohort. Only the abstract was available; details of treatment selection, adjustment for potential confounders, and other clinical outcomes could not be assessed.
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Pediatric Blood & Cancer: Proton Radiotherapy Decreases Incidence of Radiation‐Induced Second Malignant Neoplasms Compared to Photon Radiotherapy in Patients With Retinoblastoma ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.