TY - JOUR
T1 - Osteoradionecrosis in Pediatric Patients Treated with Proton Therapy for Head and Neck Malignancies
AU - Grippin, Adam J.
AU - Kim, Andrew
AU - Liu, Yufei
AU - Copling, Sage
AU - Nalin, Ansel P.
AU - Crabtree, Katina
AU - Cheng, Hunter
AU - Kui, Naishu
AU - Zhang, Zhe
AU - McAleer, Mary Frances
AU - Grosshans, David
AU - McGovern, Susan
AU - Sun, Ryan
AU - Paulino, Arnold C.
N1 - Publisher Copyright:
© 2025
PY - 2025/5/1
Y1 - 2025/5/1
N2 - Purpose: Osteoradionecrosis (ORN) is a feared complication after head and neck (H/N) radiation, but the incidence and radiation therapy risk factors for ORN in children are unknown. In this retrospective analysis of a prospectively collected data set, we evaluated the incidence and factors associated with the development of ORN in children treated with proton therapy (PT) for H/N malignancies. Materials and Methods: We reviewed records from patients treated at a single institution between December 2006 and February 2020, including demographic data, tumor, treatment details, ORN occurrence, and dosimetry. Results: We identified 117 pediatric patients treated with PT for H/N malignancies. The most common histology was rhabdomyosarcoma (46%), and the most common involved sites were the parameningeal sites (44%) and the orbit (32%). The majority received passive scatter (n = 81, 69%) and the remainder intensity modulated PT (n = 36, 31%). Only 2 (1.7%) developed ORN. Both patients had previous dental work and high radiation doses to the affected bone. Patient 1 had a maximum and mean dose to the affected bone of 68 and 42 Gy, while patient 2 received 64.2 and 56.4 Gy, respectively. Conclusions: ORN was uncommon in our large, single institution cohort, occurring in only 1.7% of pediatric patients treated with PT for H/N malignancies.
AB - Purpose: Osteoradionecrosis (ORN) is a feared complication after head and neck (H/N) radiation, but the incidence and radiation therapy risk factors for ORN in children are unknown. In this retrospective analysis of a prospectively collected data set, we evaluated the incidence and factors associated with the development of ORN in children treated with proton therapy (PT) for H/N malignancies. Materials and Methods: We reviewed records from patients treated at a single institution between December 2006 and February 2020, including demographic data, tumor, treatment details, ORN occurrence, and dosimetry. Results: We identified 117 pediatric patients treated with PT for H/N malignancies. The most common histology was rhabdomyosarcoma (46%), and the most common involved sites were the parameningeal sites (44%) and the orbit (32%). The majority received passive scatter (n = 81, 69%) and the remainder intensity modulated PT (n = 36, 31%). Only 2 (1.7%) developed ORN. Both patients had previous dental work and high radiation doses to the affected bone. Patient 1 had a maximum and mean dose to the affected bone of 68 and 42 Gy, while patient 2 received 64.2 and 56.4 Gy, respectively. Conclusions: ORN was uncommon in our large, single institution cohort, occurring in only 1.7% of pediatric patients treated with PT for H/N malignancies.
UR - https://www.scopus.com/pages/publications/85219571149
UR - https://www.scopus.com/pages/publications/85219571149#tab=citedBy
U2 - 10.1016/j.ijrobp.2024.12.001
DO - 10.1016/j.ijrobp.2024.12.001
M3 - Article
C2 - 39674326
AN - SCOPUS:85219571149
SN - 0360-3016
VL - 122
SP - 159
EP - 163
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 1
ER -