Researchers at Children’s Hospital of Philadelphia (CHOP) shared findings from a new retrospective study that found high‑dose proton re‑irradiation can be feasible and well‑tolerated in select children and young adults with recurrent central nervous system tumors. The findings were published in the journal Pediatric Blood & Cancer.
Children’s brain and spinal cord tumors – including medulloblastoma, ependymoma, and gliomas – often respond to surgery, radiotherapy, and chemotherapy, but tumors can still return. Treating a recurrence is difficult because additional treatment with radiation risks damaging the still‑developing brain and spinal cord. Proton therapy can aim radiotherapy more precisely and spare healthy tissue, suggesting this method can treat returning tumors while reducing long‑term harm.
Because there’s limited real‑world data in children, the team analyzed 54 patients treated between 2010 and 2024 who had a second course of proton therapy after initial radiotherapy given at age 20 or younger. They checked tumor control, how much normal brain got exposed to radiotherapy, and short‑ and long‑term side effects.
These findings are encouraging and show why it is important to minimize side effects: after a second round of proton therapy, roughly 7 in 10 children and young adults were alive one year later, and more than half were alive at three years. Of note, patients who did not require a second round of proton therapy for at least 12 months had improved chances of survival.
Given this insight, the authors stress careful precision treatment planning to avoid overlapping high‑dose areas. They also said more prospective studies and longer follow‑up is needed to fully understand long‑term safety and effectiveness of high-dose proton therapy.
“These findings support proton re‑irradiation for the right patients at experienced centers,” said Michael LaRiviere, MD, the study’s corresponding author and an attending physician with the Pediatric Proton Therapy Center at CHOP. “Families and doctors should discuss the potential benefits and risks with their multidisciplinary team.”
Song et al. “Feasibility and Safety of High-Dose Proton Re-Irradiation in Recurrent Pediatric Central Nervous System Tumors: A Single-Institution Retrospective Study.” Pediatric Blood & Cancer. Online May 4, 2026. DOI: 10.1002/1545-5017.70371.
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Researchers at Children’s Hospital of Philadelphia (CHOP) shared findings from a new retrospective study that found high‑dose proton re‑irradiation can be feasible and well‑tolerated in select children and young adults with recurrent central nervous system tumors. The findings were published in the journal Pediatric Blood & Cancer.
Children’s brain and spinal cord tumors – including medulloblastoma, ependymoma, and gliomas – often respond to surgery, radiotherapy, and chemotherapy, but tumors can still return. Treating a recurrence is difficult because additional treatment with radiation risks damaging the still‑developing brain and spinal cord. Proton therapy can aim radiotherapy more precisely and spare healthy tissue, suggesting this method can treat returning tumors while reducing long‑term harm.
Because there’s limited real‑world data in children, the team analyzed 54 patients treated between 2010 and 2024 who had a second course of proton therapy after initial radiotherapy given at age 20 or younger. They checked tumor control, how much normal brain got exposed to radiotherapy, and short‑ and long‑term side effects.
These findings are encouraging and show why it is important to minimize side effects: after a second round of proton therapy, roughly 7 in 10 children and young adults were alive one year later, and more than half were alive at three years. Of note, patients who did not require a second round of proton therapy for at least 12 months had improved chances of survival.
Given this insight, the authors stress careful precision treatment planning to avoid overlapping high‑dose areas. They also said more prospective studies and longer follow‑up is needed to fully understand long‑term safety and effectiveness of high-dose proton therapy.
“These findings support proton re‑irradiation for the right patients at experienced centers,” said Michael LaRiviere, MD, the study’s corresponding author and an attending physician with the Pediatric Proton Therapy Center at CHOP. “Families and doctors should discuss the potential benefits and risks with their multidisciplinary team.”
Song et al. “Feasibility and Safety of High-Dose Proton Re-Irradiation in Recurrent Pediatric Central Nervous System Tumors: A Single-Institution Retrospective Study.” Pediatric Blood & Cancer. Online May 4, 2026. DOI: 10.1002/1545-5017.70371.
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