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dc.contributor.authorConstine, L.S.
dc.contributor.authorRonckers, C.M.
dc.contributor.authorHua, C.-H.
dc.date.accessioned2019-09-13T16:42:00Z
dc.date.available2019-09-13T16:42:00Z
dc.date.issued2019
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85060077068&doi=10.1016%2fj.clon.2019.01.002&partnerID=40&md5=f52125806bf5f8fa2fe5d1eb573762b5
dc.identifier.urihttp://hdl.handle.net/10713/10713
dc.description.abstractWith advances in multimodality therapy, childhood cancer cure rates approach 80%. However, both radiotherapy and chemotherapy can cause debilitating or even fatal late adverse events that are critical to understand, mitigate or prevent. QUANTEC (Quantitative Analysis of Normal Tissue Effects in the Clinic) identified radiation dose constraints for normal tissues in adults and pointed out the uncertainties in those constraints. The range of adverse events seen in children is different from that in adults, in part due to the vulnerability/characteristics of radiation damage to developing tissues, and in part due to the typical body sites affected by childhood cancer that lead to collateral irradiation of somewhat different normal tissues and organs compared with adults. Many childhood cancer survivors have a long life expectancy and may develop treatment-induced secondary cancers and severe organ/tissue injury 10, 20 or more years after treatment. Collaborative long-term observational studies and clinical research programmes for survivors of paediatric and adolescent cancer provide adverse event data for follow-up periods exceeding 40 years. Data analysis is challenging due to the interaction between therapeutic and developmental variables, the lack of radiation dose–volume data and the fact that most childhood malignancies are managed with combined modality therapy. PENTEC (Pediatric Normal Tissue Effects in the Clinic) is a volunteer research collaboration of more than 150 physicians, medical physicists, mathematical modellers and epidemiologists organised into 18 organ-specific working groups conducting a critical review and synthesis of quantitative data from existing studies aiming to: (1) establish quantitative, evidence-based dose/volume/risk guidelines to inform radiation treatment planning and, in turn, improve outcomes after radiation therapy for childhood cancers; (2) explore the most relevant risk factors for toxicity, including developmental status; (3) describe specific physics and dosimetric issues relevant to paediatric radiotherapy; and (4) propose dose–volume outcome reporting standards for publications on childhood cancer therapy outcomes. The impact of other critical modifiers of normal tissue radiation damage, including chemotherapy, surgery, stem cell transplantation and underlying genetic predispositions are also considered. The aims of the PENTEC reports are to provide clinicians with an analysis of the best available data to make informed decisions regarding radiation therapy normal organ dose constraints for planning childhood cancer treatment, and to define future research priorities.en_US
dc.description.urihttps://doi.org/10.1016/j.clon.2019.01.002en_US
dc.language.isoen-USen_US
dc.publisherElsevier Ltden_US
dc.relation.ispartofClinical Oncology
dc.subjectLate effectsen_US
dc.subjectpaediatric canceren_US
dc.subjectPENTECen_US
dc.subjectradiation therapyen_US
dc.subjectsurvivorshipen_US
dc.subjecttreatment guidelinesen_US
dc.titlePediatric Normal Tissue Effects in the Clinic (PENTEC): An International Collaboration to Analyse Normal Tissue Radiation Dose-Volume Response Relationships for Paediatric Cancer Patientsen_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.clon.2019.01.002
dc.identifier.pmid30670336


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