open access publication

Article, 2024

Radiation Therapy Technology Advances and Mitigation of Subsequent Neoplasms in Childhood Cancer Survivors

International Journal of Radiation Oncology • Biology • Physics, ISSN 1879-355X, 0360-3016, Volume 119, 2, Pages 681-696, 10.1016/j.ijrobp.2024.01.206

Contributors

Stokkevåg, Camilla Hanquist 0000-0001-6352-4571 (Corresponding author) [1] [2] Journy, Neige [3] Vogelius, Ivan Richter 0000-0002-8877-1218 [4] Howell, Rebecca Maureen [5] Hodgson, David C 0000-0003-4687-4582 [6] Bentzen, Søren Møller 0000-0002-7444-7564 [7]

Affiliations

  1. [1] Haukeland University Hospital
    2. [NORA names: Norway; Europe, Non-EU; Nordic; OECD];
  2. [2] University of Bergen
    3. [NORA names: Norway; Europe, Non-EU; Nordic; OECD];
  3. [3] Centre for Research in Epidemiology and Population Health
    4. [NORA names: France; Europe, EU; OECD];
  4. [4] University of Copenhagen
    5. [NORA names: KU University of Copenhagen; University; Denmark; Europe, EU; Nordic; OECD];
  5. [5] The University of Texas MD Anderson Cancer Center
    6. [NORA names: United States; America, North; OECD];

Abstract

PURPOSE: In this Pediatric Normal Tissue Effects in the Clinic (PENTEC) vision paper, challenges and opportunities in the assessment of subsequent neoplasms (SNs) from radiation therapy (RT) are presented and discussed in the context of technology advancement. METHODS AND MATERIALS: The paper discusses the current knowledge of SN risks associated with historic, contemporary, and future RT technologies. Opportunities for research and SN mitigation strategies in pediatric patients with cancer are reviewed. RESULTS: Present experience with radiation carcinogenesis is from populations exposed during widely different scenarios. Knowledge gaps exist within clinical cohorts and follow-up; dose-response and volume effects; dose-rate and fractionation effects; radiation quality and proton/particle therapy; age considerations; susceptibility of specific tissues; and risks related to genetic predisposition. The biological mechanisms associated with local and patient-level risks are largely unknown. CONCLUSIONS: Future cancer care is expected to involve several available RT technologies, necessitating evidence and strategies to assess the performance of competing treatments. It is essential to maximize the utilization of existing follow-up while planning for prospective data collection, including standardized registration of individual treatment information with linkage across patient databases.

Keywords

PENTEC, Pediatric Normal Tissue Effects, RT technology, SN risk, Sn, advances, age, age considerations, assessment, biological mechanisms, cancer, cancer care, cancer survivors, carcinogenesis, care, challenges, childhood, childhood cancer survivors, clinic, clinical cohort, cohort, collection, considerations, context, context of technological advances, data collection, database, dose response, dose-rate, effect, evidence, experiments, follow-up, fraction, fractionation effects, gap, genetic predisposition, individual treatment information, information, knowledge, knowledge gaps, linkage, mechanism, mitigation, mitigation strategies, neoplasms, normal tissue effects, opportunities, paper, patient database, patient-level risk, patients, pediatric patients, performance, population, predisposition, prospective data collection, quality, radiation, radiation carcinogenesis, radiation quality, radiation therapy, research, risk, scenarios, standard registration, strategies, survivors, susceptibility, technological advances, technology, therapy, tissue, tissue effects, treatment, treatment information, utilization, vision, vision paper, volume, volume effect

Funders

  • National Cancer Institute
  • Norwegian Cancer Society

Data Provider: Digital Science

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