Purpose: The purpose of this study was to report the clinical and patient-reported outcomes of children and adolescents with intracranial meningioma treated with pencil beam scanning proton therapy (PBS-PT). Material and methods: Out of a total cohort of 207 intracranial meningioma patients treated with PBS-PT between 1999 and 2022, 10 (4.8%) were children or adolescents aged < 18 years. Median age was 13.9 years (range, 3.2–17.2). Six (60%) children were treated as primary treatment (postoperative PT, n = 4; exclusive PT, n = 2) and four (40%) at the time of tumor recurrence. Acute and late toxicities were registered according to Common Terminology Criteria of Adverse Events (CTCAE). Quality of life (QoL) before PBS-PT was assessed using PEDQOL questionnaires. Educational, functional, and social aspects after PT were assessed through our in-house developed follow-up surveys. Median follow-up time was 71.1 months (range, 2.5–249.7), and median time to last questionnaire available was 37.6 months (range, 5.75–112.6). Results: Five (50%) children developed local failure (LF) at a median time of 32.4 months (range, 17.7–55.4) after PBS-PT and four (80%) were considered in-field. One patient died of T-cell lymphoma 127.1 months after PBS-PT. Estimated 5-year local control (LC) and overall survival (OS) rates were 19.4% and 100.0%, respectively. Except for one patient who developed a cataract requiring surgery, no grade ≥3 late toxicities were reported. Before PT, patients rated their QoL lower than their parents in most domains. During the first year after PT, one child required educational support, one needed to attend to a special school, one had social problems and another three children required assistance for daily basic activities (DBA). Three years after PT, only one child required assistance for DBA. Conclusions: The outcome of children with intracranial meningioma treated with PBS-PT is in line with other centers who have reported results of radiation therapy delivered to this particular patient group. This therapy provides acceptable functional status profiles with no high-grade adverse radiation-induced events.
目的：本研究旨在报告采用笔形束扫描质子治疗（PBS-PT）治疗儿童及青少年颅内脑膜瘤的临床结局及患者报告结局。材料与方法：在1999年至2022年间接受PBS-PT治疗的207例颅内脑膜瘤患者中，10例（4.8%）为年龄＜18岁的儿童或青少年。中位年龄为13.9岁（范围：3.2–17.2岁）。其中6例（60%）儿童接受初次治疗（术后质子治疗4例；单纯质子治疗2例），4例（40%）在肿瘤复发时接受治疗。根据不良事件通用术语标准（CTCAE）记录急性和晚期毒性反应。治疗前生活质量（QoL）采用PEDQOL问卷进行评估。治疗后教育、功能及社会适应方面的情况通过我们内部开发的随访调查进行评估。中位随访时间为71.1个月（范围：2.5–249.7个月），末次问卷评估的中位时间为37.6个月（范围：5.75–112.6个月）。结果：5例（50%）儿童在PBS-PT治疗后中位32.4个月（范围：17.7–55.4个月）出现局部复发（LF），其中4例（80%）为照射野内复发。1例患者在PBS-PT治疗后127.1个月死于T细胞淋巴瘤。估计5年局部控制率（LC）和总生存率（OS）分别为19.4%和100.0%。除1例患者出现需手术的白内障外，未报告≥3级的晚期毒性反应。治疗前，患者在多数维度对生活质量的自我评分低于其父母的评估。治疗后第一年内，1例儿童需教育支持，1例需就读特殊学校，1例存在社交问题，另有3例儿童需辅助完成日常基本活动（DBA）。治疗后三年，仅1例儿童仍需DBA辅助。结论：采用PBS-PT治疗儿童颅内脑膜瘤的结局与其他中心报道的针对该特定患者群体的放射治疗结果一致。该疗法提供了可接受的功能状态谱，且未发生高级别辐射相关不良事件。
肿瘤(癌症)患者之家