Proton therapy for low-grade gliomas: Results from a prospective trial.

Abstract:

BACKGROUND:In this prospective study, the authors evaluated potential treatment toxicity and progression-free survival in patients with low-grade glioma who received treatment with proton radiation therapy. METHODS:Twenty patients with World Health Organization grade 2 glioma who were eligible for radiation therapy were enrolled in a prospective, single-arm trial of proton therapy. The patients received proton therapy at a dose of 54 Gy (relative biological effectiveness) in 30 fractions. Comprehensive baseline and regular post-treatment evaluations of neurocognitive function, neuroendocrine function, and quality of life (QOL) were performed. RESULTS:All 20 patients (median age, 37.5 years) tolerated treatment without difficulty. The median follow-up after proton therapy was 5.1 years. At baseline, intellectual functioning was within the normal range for the group and remained stable over time. Visuospatial ability, attention/working memory, and executive functioning also were within normal limits; however, baseline neurocognitive impairments were observed in language, memory, and processing speed in 8 patients. There was no overall decline in cognitive functioning over time. New endocrine dysfunction was detected in 6 patients, and all but 1 had received direct irradiation of the hypothalamic-pituitary axis. QOL assessment revealed no changes over time. The progression-free survival rate at 3 years was 85%, but it dropped to 40% at 5 years. CONCLUSIONS:Patients with low-grade glioma tolerate proton therapy well, and a subset develops neuroendocrine deficiencies. There is no evidence for overall decline in cognitive function or QOL.

journal_name

Cancer

journal_title

Cancer

authors

Shih HA,Sherman JC,Nachtigall LB,Colvin MK,Fullerton BC,Daartz J,Winrich BK,Batchelor TT,Thornton LT,Mancuso SM,Saums MK,Oh KS,Curry WT,Loeffler JS,Yeap BY

doi

10.1002/cncr.29237

subject

Has Abstract

pub_date

2015-05-15 00:00:00

pages

1712-9

issue

10

eissn

0008-543X

issn

1097-0142

journal_volume

121

pub_type

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