Pediatric blood & cancer · 2026
Proton Radiotherapy Decreases Incidence of Radiation-Induced Second Malignant Neoplasms Compared to Photon Radiotherapy in Patients With Retinoblastoma.
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Fattahi Sayeh, Packard Daniel G, Yeap Beow Y, Sethi Roshan V, Shih Helen A, Ioakeim-Ioannidou Myrsini, Gonzalez Efren, Grabowski Eric F, Wiltsie Laura, Kamihara Junne, Yock Torunn I, Tarbell Nancy J, Marcus Karen J, Mukai Shizuo, MacDonald Shannon M, Liu Kevin X
Аннотация
Retinoblastoma is the most common primary intraocular neoplasm in children. Use of radiotherapy has decreased due to the incidence of second malignant neoplasms (SMNs). In our study, photon (n = 42) and proton (n = 66) radiotherapy cohorts had median follow-up of 28.7 and 18.2 years, respectively. The majority of patients (74%) had bilateral disease at diagnosis. Proton radiotherapy is associated with significantly lower cumulative incidence of in-field SMNs (0% vs. 11.1% at 15 years, p = 0.005), with three additional cases occurring > 20 years after photon radiotherapy. These findings suggest that when radiotherapy is indicated for patients with bilateral retinoblastoma, proton radiotherapy should be considered when feasible.