Diaphragm and abdominal organ motion during radiotherapy: a comprehensive multicenter study in 189 children

Radiation Oncology

Table 1 Characteristics of the 189 pediatric patients treated between 2010 and 2018 in the six participating centers

	Interfractional position variation	Intrafractional motion
	N (%)	N (%)
Total	189	79
Male/Female	117/72 (61.9/38.1)	54/25 (68.4/31.6)
Age (years) at first RT fraction
Mean (SD) [range]	8.1 (4.9) [0.4–17.9]	8.6 (4.4) [1.0–17.8]
0.4 − 5.4	75 (39.7)	23 (29.1)
5.5–17.9	114 (60.3)	56 (70.9)
Height (cm); mean [range]	127.7 [66.0–196.0]	131.5 [74.0–185.0]
Weight (kg); mean [range]	30.9 [6.0–97.5]	32.1 [9.0–97.5]
Type of primary cancer, N (%)^a
Neuroblastoma	43 (22.8)	8 (10.1)
Renal tumors	37^b (19.6)	6^c (7.6)
Medulloblastoma	22 (11.6)	18 (22.8)
Ewing sarcoma	18 (9.5)	6 (7.6)
Leukemia	17 (9.0)	15 (19.0)
Hodgkin lymphoma	16 (8.5)	-
Rhabdomyosarcoma	5 (2.6)	1 (1.3)
Other^d	26 (13.8)	21 (26.6)
Not reported	5 (2.6)	4 (5.1)
Radiation site
Craniospinal^e	45 (23.8)	30 (38.0)
Thoracic/mediastinal^f	46 (24.3)	14 (17.7)
Abdominal (incl. flank)^f	90 (47.6)	20 (25.3)
Total body irradiation	20 (10.6)	18 (22.8)
General anesthesia
N (%)	40 (21.2)	12 (15.2)
Mean age [range] (years)	2.7 [0.5–5.4]	3.3 [1.6–5.1]
N (%)^a treated in
AMC	60^g (31.7)	42^h (53.2)
Christie	11 (5.8)	8 (10.1)
DRC-PHOI	35 (18.5)	29 (36.7)
UMCG	3^g (1.6)	-
UMCN	35^g (18.5)	-
UMCU	45 (23.8)	-

^aPercentages may not exactly total 100 due to rounding, ^bN=12 patients with diagnosis Wilms’ tumor, ^cAll N = 6 with Wilms’ tumor, ^dOther, including: adenocarcinoma (N = 1), atypical teratoid rhabdoid tumor (N = 1), desmoplastic small round cell tumor (N = 3), ependymoma (N = 3), embryonal rhabdomyosarcoma (N = 1), (pineal) germinoma (N = 5), glioma (N = 2), lymphoma (N = 3), myelofibrosis (N = 1), osteosarcoma (N = 1), primitive neuro-ectodermal tumor (N = 1), pleuropulmonary blastoma, (N = 1), undifferentiated sarcoma (N = 3), ^eN=4 received only spinal irradiation, ^fN=12 (interfractional) and N = 3 (intrafractional) received radiotherapy at the thoracic and abdominal site, ^gInterfractional position variations of diaphragm and kidneys previously reported for 20/60 (33%) AMC, 3/3 (100%) UMCG and 16/35 (46%) UMCN patients (7), ^hPatients were previously reported on [11, 13]
RT, Radiotherapy; N, number of patients; AMC, Amsterdam University Medical Center, location AMC; Christie, The Christie NHS Foundation Trust, Manchester; DRC-PHOI, Dmitry Rogachev National Research Center of Pediatric Oncology, Hematology and Immunology Moscow; UMCG, University Medical Center Groningen; UMCN, Radboud University Medical Center Nijmegen; UMCU, University Medical Center Utrecht

ISSN: 1748-717X