Proton Radiotherapy Decreases Incidence of Radiation-Induced Second Malignant Neoplasms Compared to Photon Radiotherapy in Patients With Retinoblastoma.

Authors

Sayeh Fattahi, Daniel G Packard, Beow Y Yeap, Roshan V Sethi, Helen A Shih, Myrsini Ioakeim-Ioannidou, Efren Gonzalez, Eric F Grabowski, Laura Wiltsie, Junne Kamihara, Torunn I Yock, Nancy J Tarbell, Karen J Marcus, Shizuo Mukai, Shannon M MacDonald, Kevin X Liu

Published in

Pediatric blood & cancer. Pages e70754. Oct 12, 2026. Epub Oct 12, 2026.

Abstract

Retinoblastoma is the most common primary intraocular neoplasm in children. Use of radiotherapy has decreased due to the incidence of second malignant neoplasms (SMNs). In our study, photon (n = 42) and proton (n = 66) radiotherapy cohorts had median follow-up of 28.7 and 18.2 years, respectively. The majority of patients (74%) had bilateral disease at diagnosis. Proton radiotherapy is associated with significantly lower cumulative incidence of in-field SMNs (0% vs. 11.1% at 15 years, p = 0.005), with three additional cases occurring > 20 years after photon radiotherapy. These findings suggest that when radiotherapy is indicated for patients with bilateral retinoblastoma, proton radiotherapy should be considered when feasible.

PMID:
42861579
Bibliographic data and abstract were imported from PubMed on 12 Oct 2026.

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