Patterns of proton therapy use in pediatric cancer management in 2016: An international survey

Neige Journy, Daniel J. Indelicato, Diana R. Withrow, Tetsuo Akimoto, Claire Alapetite, Masayuki Araya, Andrew Chang, John Han Chih Chang, Brian Chon, Michael E. Confer, Yusuke Demizu, Rémi Dendale, Jérôme Doyen, Ralph Ermoian, Kristin Gurtner, Christine Hill-Kayser, Hiromitsu Iwata, Joo Young Kim, Young Kwok, Nadia N. LaackChoonsik Lee, Do Hoon Lim, Lilia Loredo, Victor S. Mangona, David B. Mansur, Masao Murakami, Shigeyuki Murayama, Takashi Ogino, Barbora Ondrová, Rahul R. Parikh, Arnold C. Paulino, Stephanie Perkins, Naren R. Ramakrishna, Ronald Richter, Barbara Rombi, Satoshi Shibata, Shinichi Shimizu, Beate Timmermann, Tamara Vern-Gross, Chiachien J. Wang, Damien C. Weber, John Ben Wilkinson, Petra Witt Nyström, Torunn I. Yock, Ruth A. Kleinerman, Amy Berrington de Gonzalez

Research output: Contribution to journalArticlepeer-review

40 Scopus citations


Purpose: To facilitate the initiation of observational studies on late effects of proton therapy in pediatric patients, we report on current patterns of proton therapy use worldwide in patients aged less than 22 years. Materials & methods: Fifty-four proton centers treating pediatric patients in 2016 in 11 countries were invited to respond to a survey about the number of patients treated during that year by age group, intent of treatment, delivery technique and tumor types. Results: Among the 40 participating centers (participation rate: 74%), a total of 1,860 patients were treated in 2016 (North America: 1205, Europe: 432, Asia: 223). The numbers of patients per center ranged from 1 to 206 (median: 29). Twenty-four percent of the patients were <5 years of age, and 50% <10 years. More than 30 pediatric tumor types were identified, mainly treated with curative intent: 48% were CNS, 25% extra-cranial sarcomas, 7% neuroblastoma, and 5% hematopoietic tumors. About half of the patients were treated with pencil beam scanning. Treatment patterns were broadly similar across the three continents. Conclusion: To our knowledge, this survey provides the first worldwide assessment of proton therapy use for pediatric cancer management. Since previous estimates in the United States and Europe, CNS tumors remain the cancer types most commonly treated with protons in 2016. However, the proportion of extra-cranial tumors is growing worldwide. The typically low numbers of patients treated in each center indicate the need for international research collaborations to assess long-term outcomes of proton therapy in pediatric patients.

Original languageEnglish
Pages (from-to)155-161
Number of pages7
JournalRadiotherapy and Oncology
StatePublished - Mar 2019


  • Patterns of care
  • Pediatrics
  • Proton therapy
  • Survey


Dive into the research topics of 'Patterns of proton therapy use in pediatric cancer management in 2016: An international survey'. Together they form a unique fingerprint.

Cite this