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A study presented at the ESTRO 38 conference in Milan, Italy, showed that a type of radiation therapy called pencil beam scanning proton therapy offers the best chance of preserving cognitive function in children with craniopharyngioma.
PBS delivers an extremely precise dose of radiotherapy via a very narrow proton beam. In patients with craniopharyngioma, whose tumors are deeply buried in the center of the brain, PBS can be used to administer a relatively low dose of radiation to the temporal lobes and the hippocampus.
Because these two regions of the brain are strongly badociated with the memory function, reducing their exposure to radiation can help maintain the patient's recall capabilities after treatment.
Three types of radiotherapy were evaluated during the study: volume modulated arc therapy (VMAT), dual diffusion proton therapy (DTSP), and PBS. Researchers at the University Hospital Aarhus, Denmark, monitored their use in 10 children diagnosed with craniopharyngioma cancer.
VMAT is a type of intensity modulated radiation therapy (IMRT), which can model the radiation dose on the tumor by modulating the intensity of the radiation beam. Both PTSD and PBS are types of proton therapy, which are more effective at targeting a tumor while protecting surrounding tissues, using high-energy beams to treat tumors that can be more accurately directed than others forms of radiotherapy.
Researchers used previous research on the impact of radiation on the brain of children, including the temporal lobes and the hippocampus, to select 30 structures in the brain of the patient to be studied.
They used CT scanners and MRIs to accurately locate the structures in each of these children's brains, and then compared the three treatment plans for each child to determine which type of treatment was best able to save those 30 structures. radiation. The dosage of each structure was clbadified as low, medium or high.
They found that doses received by the temporal lobe were lower with PBS than with VMAT and DSPT treatments. The study data allowed them to predict that proton therapies, and in particular PBS therapy, would result in less memory impairment for children when using radiotherapy to treat craniopharyngioma.
Laura Toussaint, PhD student at Aarhus University Hospital, said: "We looked at three types of radiotherapy, all of which are aimed at successfully treating brain tumors while minimizing the damage to the children's brains. What we have discovered is that pencil beam scanning proton therapy seems to be by far the best way to avoid important parts of the brain for children's memory. The next step would be to confirm this result with clinical research on patients.
"The use of proton therapy has developed rapidly over the past decade and is becoming increasingly available to cancer patients, especially children. It also means that more research can take place. "
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