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    Harmonica consensus, controversies, and future directions in radiotherapy for pediatric Wilms tumors

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    Authors
    McAleer, M. F.
    Melchior, P.
    Parkes, J.
    Pater, L.
    Rübe, C.
    Saunders, Daniel
    Paulino, A. C.
    Janssens, G. O.
    Kalapurakal, J.
    Affiliation
    Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
    Issue Date
    2022
    
    Metadata
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    Abstract
    Radiotherapy (RT) is essential for multimodality treatment of pediatric renal tumors, particularly in higher-risk and metastatic disease. Despite decades of use, particularly for Wilms tumor, there remain controversies regarding RT indications, timing, dose, and targets. To align global management, we address these issues in this international HARMONIsation and CollAboration (HARMONICA) project. There are multiple knowledge gaps and opportunities for future research including: (1) utilization of advanced RT technologies, including intensity-modulated RT, proton beam therapy, combined with image-guided RT to reduce target volumes; (2) impact of molecular biomarkers including loss of heterozygosity at 1p, 16q, and 1q gain on RT indications; (3) mitigation of reproductive toxicity following RT; (4) promotion of RT late effects research; and (5) support to overcome challenges in RT utilization in low- and middle-income countries where 90% of the world's children reside. Here, we outline current status and future directions for RT in pediatric renal tumors.
    Citation
    McAleer MF, Melchior P, Parkes J, Pater L, Rübe C, Saunders D, et al. Harmonica consensus, controversies, and future directions in radiotherapy for pediatric Wilms tumors. Pediatric blood & cancer. 2022 Dec 8:e30090. PubMed PMID: 36482883. Epub 2022/12/10. eng.
    Journal
    Pediatric Blood and Cancer
    URI
    http://hdl.handle.net/10541/625889
    DOI
    10.1002/pbc.30090
    PubMed ID
    36482883
    Additional Links
    https://dx.doi.org/10.1002/pbc.30090
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1002/pbc.30090
    Scopus Count
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