{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T02:37:46Z","timestamp":1789094266688,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Proton beam therapy (PT) offers a targeted approach to treating pediatric tumors by minimizing radiation exposure to surrounding healthy tissue. However, the specific toxicity profile associated with it remains underexplored. This study aims to investigate the incidence and risk factors of acute and late treatment\u2010related toxicities following PT in pediatric patients with pelvic tumors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using data from the Pediatric Proton Consortium Registry (PPCR), we analyzed 126 pediatric patients who underwent PT for pelvic tumors. We assessed the incidence of gastrointestinal (GI), genitourinary (GU), and musculoskeletal (MSK) toxicities at baseline, during treatment, and across follow\u2010up intervals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Acute toxicities were observed in 61.9% of patients posttreatment, with new GI, GU, and MSK toxicities occurring in 54.3%, 9.7%, and 7.0% of baseline toxicity\u2010free patients, respectively. Follow\u2010up indicated that 20.6%, 22.2%, and 13.5% of patients developed late GI, GU, and MSK toxicities, respectively. Use of passive scattering proton therapy and radiation to the abdomen were significant predictors of GI toxicity development, while higher radiation dose was associated with MSK toxicity development.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings demonstrate the safety profile of PT among pediatric patients while identifying specific risk factors, such as passive scattering proton therapy and abdominal irradiation, that contribute to increased GI toxicity. While proton therapy appears to be a well\u2010tolerated treatment option, the observed toxicity rates highlight the need for continued monitoring and long\u2010term follow\u2010up.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31811","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T04:48:31Z","timestamp":1752554911000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Assessing Acute and Long\u2010Term Toxicities of Proton Radiation Therapy in Pediatric Pelvic Tumors: Findings From the Pediatric Proton Consortium Registry"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5055-674X","authenticated-orcid":false,"given":"Jamil","family":"Almohtasib","sequence":"first","affiliation":[{"name":"Department of Urology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5765-1873","authenticated-orcid":false,"given":"Daniel J.","family":"Indelicato","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Florida  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0269-3045","authenticated-orcid":false,"given":"Arnold C.","family":"Paulino","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Mihalcik","sequence":"additional","affiliation":[{"name":"Northwestern Medicine Chicago Proton Center  Warrenville Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology ProCure Proton Therapy Center  Franklin Township New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7514-0943","authenticated-orcid":false,"given":"Ralph","family":"Ermoian","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2059-6599","authenticated-orcid":false,"given":"John Hah\u2010Chih","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology The Oklahoma Proton Center and University of Oklahoma Health Science Center  Oklahoma City Oklahoma USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young","family":"Kwok","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Maryland Medical Center  Baltimore Maryland 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