A New Tool in the Arsenal

Innovations in Pediatrics Winter 2016 - Download PDF

Young cancer patients to benefit from Ohio’s first Proton Therapy Center 

 David Mansur, MD

Patients at University Hospitals Rainbow Babies & Children’s Hospital will soon have access to the distinct dosimetric advantages of proton therapy, thanks to a new Proton Therapy Center scheduled to open in summer 2016. Expected to be the first in Ohio and regionally, the Proton Therapy Center between University Hospitals Rainbow Babies & Children’s Hospital and UH Seidman Cancer Center will accommodate patients from a multi-state region. While the Proton Therapy Center will treat adult patients also, pediatric, adolescent and young adult cancer patients at the Angie Fowler Adolescent and Young Adult Cancer Institute at UH Rainbow Babies & Children’s Hospital stand to benefit most from this advanced treatment.

“UH Seidman Cancer Center’s Proton Therapy Center will be located on the same campus as a nationally ranked children’s hospital ­-- one of the only places in the country to achieve that distinction,” says David Mansur, MD, Division Chief, Radiation Oncology, UH Rainbow Babies & Children’s Hospital and Associate Professor of Pediatrics and Radiation Oncology, Case Western Reserve University School of Medicine, who is overseeing the launch of the Proton Therapy Center. “Proton therapy is uniquely suited for treating pediatric and young adult population.

“While the targeted dose is the same with proton therapy as traditional radiation treatment, proton therapy eliminates potentially significant doses to uninvolved tissues. It eliminates a lot of unnecessary low and intermediate doses, which is especially significant for pediatric patients, many of whom have curable malignancies.”

An advanced form of radiation therapy, proton therapy targets tumors more directly and spares much of the surrounding tissue from the side effects of radiation. This targeted therapy can provide advantages for treatment of certain tumors, such as those in the brain, base of skull and in the head and neck. Proton therapy also is effective in treating sarcomas, or cancer of the soft tissue, connective tissue or bone, such as Ewing’s sarcoma and Rhabdomyosarcoma.

With greater power and precision, however, comes an enhanced focus on patient selection and risk management. “Proton therapy is a more unforgiving treatment,” says Dr. Mansur. “With proton therapy, changes in density and tumor motion have a greater potential to introduce uncertainty in the radiation dose than in photon beam cases. We will be exercising caution in proper selection of patients who will benefit the most.”

For patients, the differences between traditional radiation therapy and proton therapy are largely invisible. Proton therapy may minimize typical radiation therapy side effects, but patients typically undergo the same number of treatments. While patients may still experience hair loss, fatigue, and skin irritation, there is potential to spare patients some adverse side effects. For example, nausea may be reduced in a treating a spine tumor because the beam penetrates and stops, rather than exiting out the front of the body and through the stomach, causing nausea.

Participation in clinical trials is expected to be an important component of care for patients treated with proton therapy at UH Seidman Cancer Center. A registry will track outcomes, and the vast majority of patients will be enrolled in a clinical trial. 

Dr. Mansur says he’s looking forward to the enhanced treatment that proton therapy will offer his pediatric patients, as well as the convenient way they’ll be able to access this innovative care. While traditional proton therapy systems cost hundreds of millions of dollars to build and can be as large as a football field, the compact, gantry-mounted design of the Mevion S250 superconducting synchrocyclotron accelerator being built at UH Seidman Cancer Center requires less space, fewer staff and significantly less energy to operate. 

“When you cure a 10-year-old, the hope is that you will have 70 to 80 years of life expectancy,” says Dr. Mansur. “It’s not magic, but if you can limit the number of patient years of late effects of treatment, it is worth it.”

For more information about UH Seidman Cancer Center’s new Proton Therapy Center, contact David.Mansur@UHhospitals.org.