Imaging changes with or without neurological symptoms after proton therapy in pediatric posterior fossa tumors; initial experience of the Dutch national cohort.

Background And Purpose: The incidence of proton therapy (PT)-related imaging changes in the central nervous system, and associated symptoms, varies widely in literature. The aim of this study was to assess imaging changes after implementation of intensity-modulated pencil beam scanning in a national cohort of pediatric posterior fossa (PF) tumors.

Materials And Methods: All pediatric PF tumor patients treated in the XXX with PT between 06-2018 and 12-2022 were analyzed.

The many different clinical faces of acquired hypothalamic dysfunction: a retrospective cohort study in the Netherlands.

Background: Acquired hypothalamic dysfunction, occurring at diagnosis or after treatment for a childhood (supra)sellar brain tumor, can have severe consequences. While morbid obesity and pituitary dysfunction are easily recognized, the other consequences of hypothalamic dysfunction (HD), such as hypothermia, sleep disturbance, or behavioral issues, are less well-known and may be overlooked. In addition, hypothalamic dysfunction may present differently in each patient hampering diagnostic and therapeutic efficacy.

Late toxicity after upper abdominal radiotherapy in pediatric Wilms tumor and neuroblastoma survivors. A systematic review on behalf of SIOPEN and SIOP-RTSG.

Background: Radiotherapy plays a crucial role in the multimodal treatment of Wilms tumor and neuroblastoma subtypes with an increased risk of locoregional failure. Unfortunately, radiotherapy can be associated with late toxicities in survivors. This systematic review provides an overview of the quality of evidence related to late effects following upper abdominal radiotherapy in survivors of Wilms tumor and neuroblastoma.

Gene Expression Analysis of (Paired) Primary and Relapsed Wilms Tumor Samples to Unravel the Underlying Factors Driving Tumor Recurrence.

Purpose: We aimed to unravel underlying factors driving Wilms tumor (WT) recurrence and to build a prediction model for recurrence based on gene expression data of (paired) primary and relapsed WT samples.

Experimental Design: Gene expression levels from seven paired primary and relapsed WT samples from patients treated in the Princess Máxima Center were compared among each other, as well as to matched primary WT samples of patients without recurrence (controls). The differential gene expression analysis results were run through ToppGene for functional enrichment.

European practice on neurovascular late effects after pediatric radiotherapy: considerations on dose planning and follow-up - a HARMONIC/SIOPE ROWG survey.

Background And Purpose: The risk of developing neurovascular late effects after radiotherapy is an area of concern when treating pediatric brain tumor patients. However, knowledge is sparse regarding best practice for clinical management during the radiotherapy (RT) planning process and follow-up examinations. This study therefore aimed at mapping how the risk of neurovascular late effects is considered for pediatric brain or skull base tumor patients treated with radiotherapy in Europe.

Remaining Challenges in the Treatment of Relapsed Wilms Tumor: Children's Oncology Group and International Society of Paediatric Oncology Perspectives.

Wilms tumor (WT) is the most common pediatric renal tumor, and with multidisciplinary treatment overall outcomes are excellent. However, a small subset of patients with WT will relapse. The ideal treatment of relapsed WT is yet to be defined.

Deep learning-based auto-contouring of organs/structures-at-risk for pediatric upper abdominal radiotherapy.

Purposes: This study aimed to develop a computed tomography (CT)-based multi-organ segmentation model for delineating organs-at-risk (OARs) in pediatric upper abdominal tumors and evaluate its robustness across multiple datasets.

Materials And Methods: In-house postoperative CTs from pediatric patients with renal tumors and neuroblastoma (n = 189) and a public dataset (n = 189) with CTs covering thoracoabdominal regions were used. Seventeen OARs were delineated: nine by clinicians (Type 1) and eight using TotalSegmentator (Type 2).

Gross tumor volume increase and need for adaptive radiotherapy in pediatric-type diffuse high-grade glioma of the midline structures.

Introduction: Current pediatric-type diffuse high-grade glioma radiotherapy protocols apply a 1.0 cm clinical target volume (CTV) margin around the gross tumor volume (GTV). However, in adults with glioblastoma, large variations in GTV are observed during radiotherapy.

The incidence and outcome of acute kidney injury during pediatric kidney tumor treatment-a national cohort study.

Background: Acute kidney injury (AKI) is a serious complication of pediatric cancer treatment that is suggested to increase the risk of chronic kidney disease (CKD). Children with a kidney tumor may be at particular risk. This study aimed to determine the incidence and risk factors of AKI and its association with CKD during pediatric kidney tumor treatment.

Prevalence and determinants of diabetes mellitus in 2,338 long-term Dutch childhood cancer survivors (DCCS-LATER2 Study).

Context/objective: Diabetes mellitus (DM), a possible adverse effect of childhood cancer treatment, is strongly associated with cardiovascular disease and early mortality in adult childhood cancer survivors (CCS). Here, we assess the prevalence and determinants of DM in our nationwide CCS cohort.

Design/methods: In this cross-sectional study, the prevalence of DM was assessed in 2,338 CCS, using the Lifelines cohort (n=132,226 adults with no history of cancer) as a reference.

Prevalence and determinants of metabolic syndrome in 2338 childhood cancer survivors: A Dutch Childhood Cancer Survivor LATER 2 study.

Background: Because the occurrence of metabolic syndrome (MetS) might contribute to childhood cancer survivor's excess risk of cardiovascular disease, the authors assessed the prevalence and determinants of MetS in the Dutch Childhood Cancer Survivor Study (DCCSS-LATER2) cohort.

Methods: In total, 2338 adult childhood cancer survivors (CCS) were cross-sectionally assessed for the prevalence of MetS, using the Lifelines cohort (N = 132,226 adults without a history of cancer) as references. The prevalence of MetS was clinically assessed using existing classifications, as well as an alternative method using dual-energy x-ray absorptiometry fat% instead of waist circumference to define abdominal adiposity.

Long-term risk and characteristics of cerebrovascular events after upper body radiotherapy among childhood cancer survivors in the DCCSS-LATER cohort.

Cerebrovascular events (CVEs) are serious late adverse events among childhood cancer survivors. We estimated the incidence and risk factors of symptomatic CVEs and described the clinical characteristics among childhood cancer survivors after upper body radiotherapy. The Dutch Childhood Cancer Survivor Study LATER cohort study includes 5-year childhood cancer survivors diagnosed View Article and Find Full Text PDF

A Retrospective Evaluation of Ototoxicity Monitoring in a Cohort of Pediatric Patients With Solid Tumors, Treated in the Dutch National Cancer Center.

Introduction: Ototoxicity is an adverse effect of childhood cancer treatment with a negative impact on speech-language development and quality of life. This study aimed to retrospectively assess ototoxicity monitoring in a national cohort of pediatric patients with solid tumors, examining the frequency and determinants associated with hearing loss (HL).

Methods: This retrospective cohort study included 305 patients treated between 2015 and 2020 at the Princess Máxima Center.

Treatment-related survival patterns in diffuse intrinsic pontine glioma using a historical cohort: A report from the European Society for Pediatric Oncology DIPG/DMG Registry.

Background: Our aim is to investigate the association of treatment with survival in patients with diffuse intrinsic pontine glioma (DIPG) by examining 6 historical treatment paths.

Methods: We retrospectively analyzed data from 409 patients with radiologically centrally reviewed DIPG, sourced from the German Society of Pediatric Oncology and Hematology HIT-HGG trial database and the SIOPE-DIPG/DMG Registry. Survival outcomes were estimated using the Kaplan-Meier method, and univariable and multivariable Cox proportional hazard models were estimated to study treatment effects.

Long-Term Risk of Subsequent Neoplasms in 5-Year Survivors of Childhood Neuroblastoma: A Dutch Childhood Cancer Survivor Study-LATER 3 Study.

Purpose: Neuroblastoma survivors have an increased risk of developing subsequent malignant neoplasms (SMNs), but the risk of subsequent nonmalignant neoplasms (SNMNs) and risk factors are largely unknown. We analyzed the long-term risks and associated risk factors for developing SMNs and SNMNs in a well-characterized cohort of 5-year neuroblastoma survivors.

Methods: We included 563 5-year neuroblastoma survivors from the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER cohort, diagnosed during 1963-2014.

Increased risk of subsequent neoplasm after hematopoietic stem cell transplantation in 5-year survivors of childhood acute lymphoblastic leukemia.

Acute lymphoblastic leukemia (ALL) survivors are at risk for developing subsequent neoplasms, but there is limited information on long-term risks and risk factors for both subsequent malignant neoplasms (SMNs) and subsequent non-malignant neoplasms (SNMNs). We analyzed long-term risk and risk factors for SMNs and SNMNs among 3291 5-year ALL survivors from the Dutch Childhood Cancer Survivor Study-LATER cohort (1963-2014). We calculated standardized incidence ratios (SIRs) and cumulative incidences and used multivariable Cox proportional hazard regression analyses for analyzing risk factors.

Treatments affecting splenic function as a risk factor for valvular heart disease in Childhood Cancer Survivors: A DCCSS-LATER study.

Purpose: Splenectomy might be a risk factor for valvular heart disease (VHD) in adult Hodgkin lymphoma survivors. As this risk is still unclear for childhood cancer survivors (CCS), the aim of this study is to evaluate the association between treatments affecting splenic function (splenectomy and radiotherapy involving the spleen) and VHD in CCS.

Methods: CCS were enrolled from the DCCSS-LATER cohort, consisting of 6,165 five-year CCS diagnosed between 1963 and 2002.

Surface guided radiotherapy practice in paediatric oncology: a survey on behalf of the SIOPE Radiation Oncology Working Group.

Introduction: Surface guided radiotherapy (SGRT) is increasingly being implemented to track patient's surface movement and position during radiation therapy. However, limited information is available on the SGRT use in paediatrics. The aim of this double survey was to map SIOPE (European Society for Paediatric Oncology)-affiliated centres using SGRT and to gain information on potential indications, observed, or expected benefits.

The organization of care in pediatric radiotherapy across SIOP Europe affiliated centers: A multicenter survey in the framework of the 'Joint Action on Rare Cancers' project.

Background/purpose: To reduce inequalities among SIOPE-affiliated countries, standard and optional levels to deliver 'Good Clinical Practice' compliant treatment in pediatric radiation oncology have been published. The aim of this project was to map the availability of pediatric radiotherapy resources across SIOPE-affiliated radiotherapy departments.

Materials/methods: An online survey with 34 questions was distributed to 246 radiotherapy departments across 35 SIOPE-affiliated countries.

The Value of IgM Memory B-Cells in the Assessment of Splenic Function in Childhood Cancer Survivors at Risk for Splenic Dysfunction: A DCCSS-LATER Study.

Background: Childhood cancer survivors (CCS) who received radiotherapy involving the spleen or total body irradiation (TBI) might be at risk for splenic dysfunction. A comprehensive screening test for examining splenic dysfunction is lacking.

Objective: We investigated whether IgM memory B-cells could be used to assess splenic dysfunction in CCS who received a splenectomy, radiotherapy involving the spleen, or TBI.

Cellular senescence in kidney biopsies is associated with tubular dysfunction and predicts CKD progression in childhood cancer patients with karyomegalic interstitial nephropathy.

Karyomegalic interstitial nephropathy (KIN) has been reported as an incidental finding in patients with childhood cancer treated with ifosfamide. It is defined by the presence of tubular epithelial cells (TECs) with enlarged, irregular, and hyperchromatic nuclei. Cellular senescence has been proposed to be involved in kidney fibrosis in hereditary KIN patients.