Evidence map›Paper›PMID 25128084›Full record

ArticleRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology2014

A comparative study on the risks of radiogenic second cancers and cardiac mortality in a set of pediatric medulloblastoma patients treated with photon or proton craniospinal irradiation.

Rui Zhang, Rebecca M Howell, Phillip J Taddei, Annelise Giebeler, Anita Mahajan, Wayne D Newhauser

Open access · greenAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 3 pooled it
7.0field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 3 syntheses or guidelines pooled it, 97 citations in OpenAlex.

  1. Pooled it
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  3. Neurocognitive impairment following proton therapy for paediatric brain tumour: a systematic review of post-therapy assessments.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021
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  19. Radiation-Induced Heart Disease.Journal of clinical medicine · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Rui ZhangThe University of Texas Graduate School of Biomedical Sciences at Houston, USA; Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, USA.
Rebecca M HowellThe University of Texas Graduate School of Biomedical Sciences at Houston, USA; Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, USA.
Phillip J TaddeiThe University of Texas Graduate School of Biomedical Sciences at Houston, USA; Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Radiation Oncology, American University of Beirut Medical Center, Lebanon.
Annelise GiebelerThe University of Texas Graduate School of Biomedical Sciences at Houston, USA; Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, USA; Current address is: Scripps Proton Therapy Center, San Diego, CA, USA.
Anita MahajanDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
Wayne D NewhauserThe University of Texas Graduate School of Biomedical Sciences at Houston, USA; Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, USA; Medical Physics Program, Department of Physics and Astronomy, Louisiana State University, Baton Rouge, USA. Electronic address: newhauser@lsu.edu.
The University of Texas MD Anderson Cancer Center · USLouisiana State University · USScripps (United States) · US

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Scott Kopetz · 1985 to 2026
$290.8M
Prediction of Second Cancer Risks for Children Treated with Proton - vs. - PhotonR01CA131463 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI NEWHAUSER, WAYNE D · 2008 to 2010
$767k
Radiotherapy outcomes for children in developing versus developed countriesK01TW008409 · FIC · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI TADDEI, PHILLIP J · 2010 to 2013
$447k
FIC NIH HHS K01 TW008409FIC NIH HHS K01TW008409NCI NIH HHS 1R01CA131463-01A1NCI NIH HHS P30 CA016672NCI NIH HHS R01 CA131463
6 · The paper itself

Abstract

purposeTo compare the risks of radiogenic second cancers and cardiac mortality in 17 pediatric medulloblastoma patients treated with passively scattered proton or field-in-field photon craniospinal irradiation (CSI). MATERIAL/

methodsStandard of care photon or proton CSI treatment plans were created for all 17 patients in a commercial treatment planning system (TPS) (Eclipse version 8.9; Varian Medical Systems, Palo Alto, CA) and prescription dose was 23.4 or 23.4 Gy (RBE) to the age specific target volume at 1.8 Gy/fraction. The therapeutic doses from proton and photon CSI plans were estimated from TPS. Stray radiation doses were determined from Monte Carlo simulations for proton CSI and from measurements and TPS for photon CSI. The Biological Effects of Ionization Radiation VII report and a linear model based on childhood cancer survivor data were used for risk predictions of second cancer and cardiac mortality, respectively.

resultsThe ratios of lifetime attributable risk (RLARs) (proton/photon) ranged from 0.10 to 0.22 for second cancer incidence and ranged from 0.20 to 0.53 for second cancer mortality, respectively. The ratio of relative risk (RRR) (proton/photon) of cardiac mortality ranged from 0.12 to 0.24. The RLARs of both cancer incidence and mortality decreased with patient's age at exposure (e), while the RRRs of cardiac mortality increased with e. Girls had a significantly higher RLAR of cancer mortality than boys.

conclusionPassively scattered proton CSI provides superior predicted outcomes by conferring lower predicted risks of second cancer and cardiac mortality than field-in-field photon CSI for all medulloblastoma patients in a large clinically representative sample in the United States, but the magnitude of superiority depends strongly on the patients' anatomical development status.

Indexed as

AdolescentCerebellar NeoplasmsChildChild, PreschoolCraniospinal IrradiationFemaleHeart DiseasesHumansMaleMedulloblastomaMonte Carlo MethodNeoplasms, Radiation-InducedNeoplasms, Second PrimaryPhotonsProton TherapyRadiation DosageCardiac mortalityCraniospinal irradiationMedulloblastomaProton therapySecond cancer

Identifiers

PMID25128084
PMCPMC4256116
OpenAlexW2084873656

What OpenQuestion holds

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LicenceTDM
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.