Brainstem Injury in Pediatric Patients with Posterior Fossa Tumors Treated with Proton Beam Therapy and Associated Dosimetric Factors

Controversy exists as to whether proton radiotherapy has been associated with higher rates of symptomatic brainstem injury in pediatric patients with CNS tumors. This study includes the highest risk patients with posterior fossa tumors treated with tri-modality therapy. The 5-year cumulative incidence of injury is 2%, comparable to patients treated in the photon setting. Symptomatic brainstem injury is rare when the Dmax and V55 are kept below 55.8 GyRBE and 6%, respectively

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