Proton Therapy and Gliomas: A Systematic Review

Chambrelant, Isabelle; Eber, Jordan; Antoni, D.; Burckel, Hélène; Noël, Georges; Auvergne, Romane

doi:10.3390/radiation1030019

Cited by 14 publications

(15 citation statements)

References 44 publications

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“…Further, the use of CTV expansions in SRT protocols are being evaluated for safety and efficacy, with mixed results; however, if shown to be clinically beneficial, this approach could be considered in the future for canine glioma patients. [36][37][38] Despite the variability reported outcomes in previous and more recent studies, there is emerging evidence that radiation therapy is a viable treatment option for canine glioma, with more promising durability of tumour control.…”

Section: Discussionmentioning

confidence: 99%

“…This would be challenging to evaluate in prospective, randomized clinical trial for the reasons mentioned above for why clinicians and clients may be more inclined to treated their dog with SRT instead of a prolonged fractionated radiotherapy treatment course, but the results of such study would likely provide valuable information for the field. Further, the use of CTV expansions in SRT protocols are being evaluated for safety and efficacy, with mixed results; however, if shown to be clinically beneficial, this approach could be considered in the future for canine glioma patients 36–38 . Despite the variability reported outcomes in previous and more recent studies, there is emerging evidence that radiation therapy is a viable treatment option for canine glioma, with more promising durability of tumour control.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of stereotactic radiation therapy for the treatment of confirmed or presumed canine glioma

Trageser,

Martin,

Burdekin

et al. 2023

Vet Comparative Oncology

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Intracranial gliomas are the second most common brain tumour in dogs. Radiation therapy provides a minimally invasive treatment option for this tumour type. Earlier publications reporting on the use of non‐modulated radiation therapy suggested a poor prognosis for dogs with glioma, with median survival times ranging between 4 and 6 months; more recent literature utilizing stereotactic radiation therapy (SRT) demonstrates that the prognosis for canine gliomas may be more promising, with survival times closer to 12 months. A single institution retrospective study was performed between 2010 and 2020 investigating the outcomes of dogs with biopsy‐confirmed glioma or a presumptive diagnosis of intra‐cranial glioma based on MRI characteristics that were treated with SRT. Twenty‐three client‐owned dogs were included. Brachycephalic breeds were overrepresented, totalling 13 dogs (57%). SRT protocols included 16 Gy single fraction (n = 1, 4%), 18 Gy single fraction (n = 1, 4%), 24 Gy in 3 daily fractions (n = 20, 91%), or 27 Gy in four daily fractions (n = 1, 4%). Twenty‐one dogs (91%) had improvement of their presenting clinical signs following SRT. Median overall survival time (MST) was 349 days (95% CI, 162–584). Median disease specific survival time was 413 days (95% CI, 217–717). When SRT is incorporated into the management plan for dogs with confirmed or presumed intracranial glioma, a median survival time of approximately 12 months may be achievable.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of stereotactic radiation therapy for the treatment of confirmed or presumed canine glioma

Trageser,

Martin,

Burdekin

et al. 2023

Vet Comparative Oncology

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“…A potential margin for dose escalation with PBT in GBM is an area of future research (80)(81)(82)(83)(84)(85). In a National Cancer Data Base (NCDB) analysis, PBT was associated with improved outcomes in OS in adult patients either with low-grade or high-grade gliomas.…”

Section: Studies' Limitations and New Perspectivesmentioning

confidence: 99%

Hyperbaric Oxygen Therapy as a Complementary Treatment in Glioblastoma—A Scoping Review

et al. 2022

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Glioblastoma (GBM) is the most common and aggressive malignant brain tumor in adults. The mainstay of management for GBM is surgical resection, radiation (RT), and chemotherapy (CT). Even with optimized multimodal treatment, GBM has a high recurrence and poor survival rates ranging from 12 to 24 months in most patients. Recently, relevant advances in understanding GBM pathophysiology have opened new avenues for therapies for recurrent and newly diagnosed diseases. GBM's hypoxic microenvironment has been shown to be highly associated with aggressive biology and resistance to RT and CT. Hyperbaric oxygen therapy (HBOT) may increase anticancer therapy sensitivity by increasing oxygen tension within the hypoxic regions of the neoplastic tissue. Previous data have investigated HBOT in combination with cytostatic compounds, with an improvement of neoplastic tissue oxygenation, inhibition of HIF-1α activity, and a significant reduction in the proliferation of GBM cells. The biological effect of ionizing radiation has been reported to be higher when it is delivered under well-oxygenated rather than anoxic conditions. Several hypoxia-targeting strategies reported that HBOT showed the most significant effect that could potentially improve RT outcomes, with higher response rates and survival and no serious adverse events. However, further prospective and randomized studies are necessary to validate HBOT's effectiveness in the ‘real world' GBM clinical practice.

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“…With the use of Magnetic Resonance Imaging (MRI) or X-Ray to detect a specific location, a stereotactic biopsy decreases the risk of affecting nearby areas of the brain (26). Some physicians, however, concluded that due to the risk of hemorrhage and other complications, biopsies are just as dangerous as surgical removal of a glioma (27).…”

Section: Challenges Of Treatmentmentioning

confidence: 99%

The Molecular, Neurological, and Clinical Features of Diffuse Intrinsic Pontine Glioma

Denniston¹,

Dickson²,

Fitzsimmons³

et al. 2022

Preprint

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Diffuse intrinsic pontine glioma (DIPG) is recognized as a pediatric brainstem cancer with a 0% survival rate. On a molecular basis, DIPG commonly results from mutations in histone H3, specifically a mutation in the H3K27M gene, that promotes tumorigenesis and results in presentation of this fatal brainstem tumor. DIPG is challenging to treat, as surgical intervention is inefficacious due to the location where the glioma resides. To date, traditional treatments such as radiation, chemotherapy, and immunotherapy have not increased survival rates and have only been successful at relieving symptoms. Future therapeutic approaches such as proton beam radiation, Chimeric Antigen Receptor T Cell (CAR-T) immunotherapy, and alternative epigenetic pharmaceuticals are under investigation for potential benefits. Various clinical trials have also explored these treatment procedures to discover potential increases in survival rates in both animal and human studies. In this review, we will evaluate the pathology and molecular characteristics of DIPG, the current and future approaches to DIPG treatment; and, lastly, we will discuss clinical trials that have been completed to develop successful treatment options.

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Proton Therapy and Gliomas: A Systematic Review

Cited by 14 publications

References 44 publications

Efficacy of stereotactic radiation therapy for the treatment of confirmed or presumed canine glioma

Efficacy of stereotactic radiation therapy for the treatment of confirmed or presumed canine glioma

Hyperbaric Oxygen Therapy as a Complementary Treatment in Glioblastoma—A Scoping Review

The Molecular, Neurological, and Clinical Features of Diffuse Intrinsic Pontine Glioma

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