{
  "abstract": "Background\n\nLimited data exist regarding the safety and efficacy of photon re-irradiation with whole-brain radiotherapy (WBRT) or craniospinal irradiation (CSI) in children with recurrent or second primary CNS tumors.Materials and methods\n\nIn this retrospective single-institution study, 23 patients < 21 years who underwent photon re-irradiation with WBRT (n = 9) or CSI (n = 14) for CNS tumors between 2013 and 2026 were included. Clinical and treatment characteristics were collected. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Toxicities were graded using CTCAE v5.0.Results\n\nIn our cohort, the median age at diagnosis was 8.5 years (range: 0.2-19.7 years), and medulloblastoma was the most common histology (30%). Median time to the first relapse after initial irradiation was 12.0 months (range: 0.9-92.5 months). Median re-irradiation dose to the whole brain or craniospinal axis was 24.0 Gy (range: 20.0-36.0 Gy). For 15 patients who received involved field boosts, median total dose was 30.6 Gy (range: 20.0-54.0 Gy). With median follow-up after re-RT of 12.2 months (range: 1.0-106.8), 12-month PFS and OS were 24.2% and 67.0%, respectively. Four patients who received curative-intent re-CSI remain alive with median follow-up of 20.4 months (range: 5.8-106.8). The crude rate of grade >2 CNS toxicity was 8.7%. Of 10 patients with new neurologic symptoms before re-irradiation, 7 (70%) had symptomatic improvement after treatment.Conclusions\n\nPhoton re-irradiation with WBRT or CSI was feasible and achieved disease control in a subset of patients and meaningful symptom palliation with acceptable acute toxicity. Careful attention to cumulative dose constraints is essential, and longer follow-up is needed to assess durability and late effects.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiation Oncology, Mass General Brigham Cancer Institute, Harvard Medical School, 55 Fruit St., Boston, MA 02114, USA.",
    "Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston Children's Hospital, Boston, MA 02115, USA.",
    "Department of Neurosurgery, Boston Children's Hospital, Boston, MA 02115, USA.",
    "Department of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA 02115, USA."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Palak P Patel",
      "orcid": "0000-0002-0586-3708"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Hesham Elhalawani"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Karen J Marcus"
    },
    {
      "affs": [
        2
      ],
      "name": "Lissa C Baird"
    },
    {
      "affs": [
        2
      ],
      "name": "Katie P Fehnel"
    },
    {
      "affs": [
        3
      ],
      "name": "Tom Rosenberg",
      "orcid": "0000-0002-9592-2539"
    },
    {
      "affs": [
        3
      ],
      "name": "Ralph Salloum",
      "orcid": "0000-0001-9437-0616"
    },
    {
      "affs": [
        3
      ],
      "name": "Ana Aguilar-Bonilla",
      "orcid": "0000-0002-5327-449X"
    },
    {
      "affs": [
        3
      ],
      "name": "Susan N Chi"
    },
    {
      "affs": [
        3
      ],
      "name": "Karen D Wright"
    },
    {
      "affs": [
        3
      ],
      "name": "Kee Kiat Yeo"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Daphne A Haas-Kogan"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Kevin X Liu",
      "orcid": "0000-0003-2071-5137"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1deq9cyc2hh9j.bib",
  "cited_by": 0,
  "doi": "10.3390/curroncol33100617",
  "fulltext_url": "https://europepmc.org/articles/PMC13703033",
  "id": "1deq9cyc2hh9j",
  "issns": [
    "1198-0052",
    "1718-7729"
  ],
  "landing_url": "https://europepmc.org/article/MED/42930184",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2716|Glioma Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7221773972",
  "pdf_url": "https://europepmc.org/articles/PMC13703033?pdf=render",
  "pmcid": "PMC13703033",
  "pmid": "42930184",
  "published": "2026-10-14",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/1deq9cyc2hh9j.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:22:01Z",
      "native_id": "MED:42930184",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42930184"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2716|Glioma Diagnosis and Treatment",
      "subfield": "human-genetics"
    }
  ],
  "title": "Safety and Efficacy of Photon Re-Irradiation with Whole-Brain Radiotherapy or Craniospinal Irradiation for Recurrent Pediatric Central Nervous System Malignancies.",
  "title_text": "Safety and Efficacy of Photon Re-Irradiation with Whole-Brain Radiotherapy or Craniospinal Irradiation for Recurrent Pediatric Central Nervous System Malignancies.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:01Z",
  "url": "https://research.draconitic.com/paper/1deq9cyc2hh9j",
  "venue": "Current oncology (Toronto, Ont.)",
  "versions": []
}