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Identifier

000438622

Title

Νεότερες τεχνικές ακτινοθεραπείας σε όγκους κεντρικού νευρικού συστήματος σε παιδιά και εφήβους

Alternative Title

Newer radiotherapy techniques in central nervous system tumors in children and adolescents

Author

Βαρβέρης, Αντώνης Χ

Thesis advisor

Τόλια, Μαρία

Reviewer

Στειακάκη, Ευτυχία
Μαζωνάκης, Μιχαήλ

Abstract

Introduction: Cancer is the second leading cause of death in children aged 1-14 years, with 11,000 cases by 2020. Central Nervous System (CNS) tumors are the most common solid tumors in the pediatric population (1). They are usually located in the brain, either as a solitary lesion or as a primary tumor that extends through the CNS to the nevraxis. Advanced imaging exams, neurosurgery, new systemic treatments (chemotherapy, immunotherapy) as well as modern radiotherapy techniques (ACT), have led to an increase in local disease control and overall survival (OS) of pediatric patients. Purpose: In the present work, we reviewed the current literature regarding the application of all modern radiotherapy techniques and the potential clinical benefit in pediatric oncology patients suffering from CNS malignancies. At the same time, the clinical experience of the Radiotherapy Department of University Hospital of Herakleion was described, using the advanced linear accelerator machines"Infinity", donated by the Stavros Niarchos Foundation, during the period 2017-2019. Material and Methods: We reviewed the current published international literature. We included publications with clinical data for pediatric patients suffering from CNS tumors, who underwent advanced ACTH techniques. The databases we used were PubMed, Cochrane Database of Controlled Trials and SCOPUS until 2020. We used only works in English. Studies that do not use our search entry criteria will be excluded. Results: Newer radiotherapy techniques such as 3DCRT, IMRT, VMAT, protons can improve the distribution as well as the radiation dose escalation to the target tumor. Critical brain structures such as eyes, optic chiasm, stem and hippocampus can be protected in pediatric brain tumors. The use of protons reduces the acute hematological and gastrointestinal side effects, as well as the distant neurological, vascular and developmental radiation-induced side effects. Conclusions: Newer radiotherapy techniques ensure better radiotherapy dose delivery based on the size and shape of the tumor. Proton therapy minimizes the development rates of chronic toxicity because it deposits the maximum dose in the target tumor and reduces the exit dose to adjacent healthy tissues. At the same time, protons reduce the exposure to low doses of radiotherapy located in front of the nevraxis. This reduces the development of second future malignancies.

Language

Greek

Subject

Brain radiotherapy

CNS tumors

Pediatric patient

Issue date

2021-03-29

Collection

School/Department--School of Medicine--Department of Medicine--Post-graduate theses

Type of Work--Post-graduate theses

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