Intensity Modulated Radiation Therapy (IMRT) Versus Intensity Modulated Proton Therapy (IMPT) in Low-Grade Gliomas: A Dosimetric Study

Amelio, Dante; Lorentini, Stefano; Giri, Mariagrazia; Meliadò, Gabriele; Fava, G; Ravanelli, Daniele; Fellin, F.; Cavedon, Carlo; Schwarz, Marco; Amichetti, Maurizio

doi:10.1016/j.ijrobp.2013.06.658

Cited by 3 publications

(3 citation statements)

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“…4 Of these radiation techniques, proton therapy is particularly promising because it allows for reductions in the low and intermediate radiation dose to normal tissue outside of the target volume. 5,6 Accordingly, LGGs in children are considered a "Group 1" indication for proton therapy according to the United States American Society for Radiation Oncology Model Policy, 7 and they have become the third most common pediatric brain tumor type treated with proton therapy worldwide. 8 Nonetheless, only small, heterogeneous studies describing patient outcomes have recently been published.…”

Section: Introductionmentioning

confidence: 99%

Outcomes Following Proton Therapy for Pediatric Low-Grade Glioma

Indelicato

Rotondo

Uezono

et al. 2019

International Journal of Radiation Oncology*Biology*Physics

105

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Our cohort of 174 pediatric patients with low-grade glioma demonstrated progression-free survival and overall survival rates of 84% and 92%, respectively, after proton therapy. These survival rates are similar to those of contemporary photon cohorts. Data from this prospective study inform radiation technique and overall patient management for the most common pediatric brain tumor. Purpose: Dosimetric studies show that proton therapy can reduce the low/intermediate radiation dose to uninvolved tissue in children with low-grade glioma (LGG). For this reason, LGG is the fourth most common pediatric tumor treated with proton therapy, yet clinical outcome data on efficacy and toxicity are limited. Methods and Materials: We reviewed the medical records of 174 children (21 years old) with nonmetastatic LGG enrolled on a prospective protocol and treated with proton therapy between 2007 and 2017. We assessed clinical outcomes and toxicity and analyzed patient, tumor, and treatment-related variables. Results: The median age was 10.2 years (range, 2-21). Fifty-eight percent of tumors were World Health Organization grade 1 and 30% were grade 2; 12% were diagnosed on imaging characteristics alone. The most common histology was pilocytic astrocytoma (47%). The most common tumor subsites were diencephalon/optic pathway (52%), caudal brainstem (16%), and cerebellum (13%). Forty-two percent received chemotherapy before radiation therapy. The median follow-up was 4.4 years. The 5year actuarial rates of local control, progression-free survival, and overall survival were 85% (95% confidence interval [CI], 78%-90%), 84% (95% CI, 77%-89%), and 92% (95% CI, 85%-95%), respectively. On univariate analysis, brainstem/spinal cord tumor location (62% vs 90% elsewhere) and dose <54 GyRBE (67% vs 91% for 54 GyRBE) were associated with inferior local control (P < .01 for both). Twenty-two patients (12.6%) experienced acute nausea or vomiting requiring ondansetron; 2 patients (1.1%) required corticosteroids. Serious toxicities (4% of patients)

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Section: Introductionmentioning

confidence: 99%

Outcomes Following Proton Therapy for Pediatric Low-Grade Glioma

Indelicato

Rotondo

Uezono

et al. 2019

International Journal of Radiation Oncology*Biology*Physics

105

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“…These studies include the prospective analysis of proton therapy, which reduces the amount of radiation delivered to normal developing tissue and potentially resulting in fewer late radiation side effects. 8,17,18 CONCLUSIONS Treatment of children with LGG demands a multimodality team of pediatric brain tumor specialists. The treatment paradigm has shifted over the past few decades but RT remains a critical and effective tool in managing this disease.…”

Section: Discussionmentioning

confidence: 99%

Late Effects After Radiotherapy for Childhood Low-grade Glioma

Williams

Rotondo

Bradley

et al. 2018

American Journal of Clinical Oncology

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“…В ряде исследований [19,26] были предприняты попытки продемонстрировать уменьшение риска развития поздних лучевых реакций у детей при облучении фотонами путем избирательности и выбора объема облучения с применением современных методик лучевой терапии. По данным ряда исследований [31][32][33], протонная терапия благодаря своим дозиметрическим преимуществам способна уменьшить риск лучевой токсичности у данной группы пациентов.…”

Section: протонная терапияunclassified

Comparison of the Effectiveness of Proton and Photon Therapy in Patients With Brain Tumors

2021

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Owing to the development of molecular genetics, the role of radiation therapy and chemotherapy in treatment of patients with glioma (WHO Grade I–IV) has become more understandable. The overall survival among glioma patients has increased. As overall survival increases, oncologists are more likely to detect manifestations of late radiation toxicity that has a huge impact on Quality of Life in patients who have undergone radiation therapy in the past. In this regard, the question of finding more adequate radiation therapy techniques remains relevant. photon radiation therapy is the standard method; however, considering dosimetric advantages of proton therapy over photon therapy, its widespread use can potentially lead to the increased overall survival, decreased number of late radiation-induced complications and improved quality of life in the post-radiation period. This article presents some comparative characteristics of proton and photon radiation therapy in patients with gliomas (WHO Grade I–IV). dosimetry characteristics of protons in tissues were compared, data showing differences in survival of patients treated with photons versus patients treated with protons were presented, and general information on early and late radiation-induced toxicity arising from the treatment by these methods was disclosed.

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Intensity Modulated Radiation Therapy (IMRT) Versus Intensity Modulated Proton Therapy (IMPT) in Low-Grade Gliomas: A Dosimetric Study

Cited by 3 publications

References 0 publications

Outcomes Following Proton Therapy for Pediatric Low-Grade Glioma

Outcomes Following Proton Therapy for Pediatric Low-Grade Glioma

Late Effects After Radiotherapy for Childhood Low-grade Glioma

Comparison of the Effectiveness of Proton and Photon Therapy in Patients With Brain Tumors

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