The first single-vault compact proton therapy center opened in 2013, utilizing a gantry-mounted synchrocylotron. The center was placed within a large academic radiation oncology department with a high priority for pediatric cancer care. Here we performed a retrospective study of pediatric (≤21 years) patients treated with proton therapy at our institution between 2013–2022. Patient, tumor, and treatment characteristics were obtained including race, socioeconomic status, insurance type, distance travelled, need for anesthesia, and outside referrals for proton therapy. In total, 250 pediatric patients were treated with proton therapy comprising 18% of our proton patient volume. Median follow-up was 3.1 years, 38.4% were female and 83% were white. The majority of cases were CNS (69.6%) and a large number of patients (80/250, 32%) required craniospinal irradiation. Anesthesia was required for 39.6% of patients. Average distance travelled for treatment was 111 miles and 23% of patients were referred from outside institutions for proton therapy. Insurance type was private/commercial for 61.2% followed by Medicaid for 32%. We found that 23% of patients lived in census tracts with >25% of people living below the national poverty line. Overall survival at 3 years was excellent at 83.7% with better outcomes for CNS patients compared to non-CNS patients. There were no cases of secondary malignancy at this early time point. As the world’s first compact proton therapy center, we found that proton therapy increased our pediatric volume and provided proton therapy to a diverse group of children in our region. These data highlight some of the expected patient and tumor characteristics and necessary resources for providing pediatric proton beam therapy.
首个单室紧凑型质子治疗中心于2013年启用，采用旋转机架同步回旋加速器技术。该中心设立于一家大型学术性放射肿瘤科内，并将儿童肿瘤治疗作为优先重点。本研究对2013年至2022年间在本机构接受质子治疗的儿童（≤21岁）患者进行回顾性分析，收集患者人口学特征、肿瘤信息及治疗参数，包括种族、社会经济状况、保险类型、治疗通勤距离、麻醉需求及外院转诊情况。共250例儿童患者接受质子治疗，占本院质子治疗总量的18%。中位随访时间3.1年，女性占38.4%，白人患者占83%。中枢神经系统肿瘤占比最高（69.6%），其中32%（80/250）需行全脑全脊髓照射。39.6%的患者需要麻醉辅助治疗，平均治疗通勤距离为111英里，23%的患者由外院转诊接受质子治疗。保险类型以商业保险为主（61.2%），医疗补助保险占32%。研究发现23%的患者居住于贫困率超过25%的人口普查区。三年总生存率达83.7%，其中中枢神经系统肿瘤患者预后优于非中枢神经系统肿瘤患者。目前随访期内未发现继发性恶性肿瘤病例。作为全球首个紧凑型质子治疗中心，本研究表明质子治疗显著提升了儿童患者收治量，并为区域内不同背景的儿童群体提供了治疗机会。这些数据揭示了开展儿童质子治疗所需的患者群体特征、肿瘤类型分布及必要资源配置。
Pediatric Experience and Outcomes from the First Single-Vault Compact Proton Therapy Center
肿瘤(癌症)患者之家