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Mitigating Radiotoxicity in the Central Nervous System: Role of Proton Therapy.
Winter, Sebastian F; Vaios, Eugene J; Shih, Helen A; Grassberger, Clemens; Parsons, Michael W; Gardner, Melissa M; Ehret, Felix; Kaul, David; Boehmerle, Wolfgang; Endres, Matthias; Dietrich, Jorg.
Afiliación
  • Winter SF; Department of Neurology and MGH Cancer Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. sfwinter@mgh.harvard.edu.
  • Vaios EJ; Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany. sfwinter@mgh.harvard.edu.
  • Shih HA; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Junior Clinician Scientist Program, 10117, Berlin, Germany. sfwinter@mgh.harvard.edu.
  • Grassberger C; Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA.
  • Parsons MW; Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Gardner MM; Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Ehret F; Department of Psychiatry, Psychology Assessment Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Kaul D; Department of Psychiatry, Psychology Assessment Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Boehmerle W; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Junior Clinician Scientist Program, 10117, Berlin, Germany.
  • Endres M; Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353, Berlin, Germany.
  • Dietrich J; Charité - Universitätsmedizin Berlin, Berlin, Germany; German Cancer Consortium (DKTK), partner site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany.
Curr Treat Options Oncol ; 24(11): 1524-1549, 2023 Nov.
Article en En | MEDLINE | ID: mdl-37728819
OPINION STATEMENT: Central nervous system (CNS) radiotoxicity remains a challenge in neuro-oncology. Dose distribution advantages of protons over photons have prompted increased use of brain-directed proton therapy. While well-recognized among pediatric populations, the benefit of proton therapy among adults with CNS malignancies remains controversial. We herein discuss the role of protons in mitigating late CNS radiotoxicities in adult patients. Despite limited clinical trials, evidence suggests toxicity profile advantages of protons over conventional radiotherapy, including retention of neurocognitive function and brain volume. Modelling studies predict superior dose conformality of protons versus state-of-the-art photon techniques reduces late radiogenic vasculopathies, endocrinopathies, and malignancies. Conversely, potentially higher brain tissue necrosis rates following proton therapy highlight a need to resolve uncertainties surrounding the impact of variable biological effectiveness of protons on dose distribution. Clinical trials comparing best photon and particle-based therapy are underway to establish whether protons substantially improve long-term treatment-related outcomes in adults with CNS malignancies.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias del Sistema Nervioso Central / Terapia de Protones Tipo de estudio: Prognostic_studies Límite: Adult / Child / Humans Idioma: En Revista: Curr Treat Options Oncol Asunto de la revista: NEOPLASIAS Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias del Sistema Nervioso Central / Terapia de Protones Tipo de estudio: Prognostic_studies Límite: Adult / Child / Humans Idioma: En Revista: Curr Treat Options Oncol Asunto de la revista: NEOPLASIAS Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos