Proton beam therapy reduces the incidence of acute haematological and gastrointestinal toxicities associated with craniospinal irradiation in pediatric brain tumors.

AbstractBackground. The benefits of proton beam craniospinal irradiation (PrBCSI) in children have been extensively reported in dosimetric studies. However, there is limited clinical evidence supporting the use of PrBCSI. We compared the acute toxicity of PrBCSI relative to that of conventional photon beam CSI (PhBCSI) in children with brain tumours.Material and methods. We prospectively evaluated the haematological and gastrointestinal toxicities in 30 patients who underwent PrBCSI between April 2008 and December 2012. As a reference group, we retrospectively evaluated the medical records of 13 patients who underwent PhBCSI between April 2003 and April 2012. The median follow-up time from starting CSI was 22 months (range 2–118 months). The mean irradiation dose was 32.1 Gy (range 23.4–39.6 Gy) and 29.4 CGE (cobalt grey equivalents; range 19.8–39.6), in the PrBCSI and PhBCSI groups, respectively (p = 0.236).Results. There was no craniospinal fluid space relapse after curative therapy in either group of p...