{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T16:50:12Z","timestamp":1754153412456,"version":"3.41.2"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Little is known about pseudoprogression after proton therapy (PT) for pediatric spinal tumors. Clinical consequences are significant if it is not appropriately identified. We report the incidence of pseudoprogression in pediatric spinal pilocytic astrocytoma (sPA) and myxopapillary ependymoma (MPE) after PT at our institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>Medical charts were retrospectively reviewed for patients &lt;18 years old who received PT from 2007 to 2019 for sPA or MPE. Patients with gross disease at the time of PT and at least 6 months of follow\u2010up were included. Demographic, tumor, and treatment characteristics were tabulated. Two neuroradiologists scored pre\u2010 and post\u2010PT magnetic resonance images to assess for pseudoprogression, and the incidence of pseudoprogression was determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifteen patients were included (nine with sPA, six with MPE). Median age of patients with sPA was 10.1 years and 12.7 years for patients with MPE. Median prescribed dose was 45.0\u00a0cobalt\u201060\u00a0Gy equivalents (GyRBE) (range, 39.6\u201350.4) for sPA and 50.4\u00a0GyRBE for MPE (range, 45.0\u201354.0). Within 6 months post\u2010PT, pseudoprogression occurred in six of nine patients (67%) with sPA, and three were symptomatic. No patients with MPE developed pseudoprogression (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pseudoprogression may occur within 6 months after PT for sPA but is not likely for MPE, even with a higher median PT dose. As pseudoprogression can be clinically challenging, clinicians should be aware of this possibility to provide appropriate guidance for patients and families.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31873","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:25:56Z","timestamp":1750897556000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pseudoprogression in Pediatric Spinal Pilocytic Astrocytoma and Myxopapillary Ependymoma after Proton Therapy: A Case Series"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5552-5988","authenticated-orcid":false,"given":"Kamaria L.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology MD Anderson Cancer Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason M.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Imaging Yale University New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen F.","family":"Kralik","sequence":"additional","affiliation":[{"name":"Department of Radiology Texas Children's Hospital Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sof\u00eda V.","family":"Ram\u00edrez Mateo","sequence":"additional","affiliation":[{"name":"Medical School, Universidad Central del Caribe Bayam\u00f3n Puerto Rico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R.","family":"Grosshans","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology MD Anderson Cancer Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0585-1712","authenticated-orcid":false,"given":"Mary Frances","family":"McAleer","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology MD Anderson Cancer Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wafik","family":"Zaky","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, MD Anderson Cancer Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia A.","family":"Baxter","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank Y.","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2686-6737","authenticated-orcid":false,"given":"Murali","family":"Chintagumpala","sequence":"additional","affiliation":[{"name":"Texas Children's Cancer Center, Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0269-3045","authenticated-orcid":false,"given":"Arnold C.","family":"Paulino","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology MD Anderson Cancer Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5286-0649","authenticated-orcid":false,"given":"Susan L.","family":"McGovern","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology MD Anderson Cancer Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms150711832"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noz042"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-016-2151-8"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2019.07.013"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-018-3841-7"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noaa296"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noab062"},{"key":"e_1_2_8_9_1","article-title":"Primary Spinal Astrocytomas: A Literature Review","volume":"11","author":"Ogunlade J.","year":"2019","journal-title":"Cureus"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-019-01109-0"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000479323"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/1817-1745.85718"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2012.05.001"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.3171\/2013.12.PEDS13383"},{"key":"e_1_2_8_15_1","unstructured":"F.LimaiemandJ. 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