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@ARTICLE{Eichkorn:186587,
      author       = {T. Eichkorn and J. W. Lischalk and J. Hörner-Rieber$^*$
                      and M. Deng and E. Meixner and A. Krämer and P. Hoegen and
                      E. Sandrini and S. Regnery and T. Held and S. Harrabi and C.
                      Jungk and K. Herfarth and J. Debus$^*$ and L. König},
      title        = {{A}nalysis of safety and efficacy of proton radiotherapy
                      for {IDH}-mutated glioma {WHO} grade 2 and 3.},
      journal      = {Journal of neuro-oncology},
      volume       = {162},
      number       = {3},
      issn         = {0167-594x},
      address      = {Dordrecht [u.a.]},
      publisher    = {Springer Science + Business Media B.V},
      reportid     = {DKFZ-2023-00023},
      pages        = {489-501},
      year         = {2023},
      note         = {2023 May;162(3):489-501},
      abstract     = {Proton beam radiotherapy (PRT) has been demonstrated to
                      improve neurocognitive sequelae particularly. Nevertheless,
                      following PRT, increased rates of radiation-induced contrast
                      enhancements (RICE) are feared. How safe and effective is
                      PRT for IDH-mutated glioma WHO grade 2 and 3?We analyzed 194
                      patients diagnosed with IDH-mutated WHO grade 2 (n = 128)
                      and WHO grade 3 (n = 66) glioma who were treated with PRT
                      from 2010 to 2020. Serial clinical and imaging follow-up was
                      performed for a median of 5.1 years.For WHO grade 2, $61\%$
                      were astrocytoma and $39\%$ oligodendroglioma while for WHO
                      grade 3, $55\%$ were astrocytoma and $45\%$
                      oligodendroglioma. Median dose for IDH-mutated glioma was 54
                      Gy(RBE) [range 50.4-60 Gy(RBE)] for WHO grade 2 and 60
                      Gy(RBE) [range 54-60 Gy(RBE)] for WHO grade 3. Five year
                      overall survival was $85\%$ in patients with WHO grade 2 and
                      $67\%$ in patients with WHO grade 3 tumors. Overall RICE
                      risk was $25\%,$ being higher in patients with WHO grade 2
                      $(29\%)$ versus in patients with WHO grade 3 $(17\%,$ p =
                      0.13). RICE risk increased independent of tumor
                      characteristics with older age (p = 0.017). Overall RICE was
                      symptomatic in $31\%$ of patients with corresponding CTCAE
                      grades as follows: $80\%$ grade 1, $7\%$ grade 2, $13\%$
                      grade 3, and $0\%$ grade 3 + . Overall need for
                      RICE-directed therapy was $35\%.These$ data demonstrate the
                      effectiveness of PRT for IDH-mutated glioma WHO grade 2 and
                      3. The RICE risk differs with WHO grading and is higher in
                      older patients with IDH-mutated Glioma WHO grade 2 and 3.},
      keywords     = {Efficacy (Other) / IDH-mutation (Other) / Low and
                      intermediate grade glioma (Other) / Proton radiotherapy
                      (Other) / Radiation-induced contrast enhancement (RICE)
                      (Other) / Safety (Other)},
      cin          = {E050 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)E050-20160331 / I:(DE-He78)HD01-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:36598613},
      doi          = {10.1007/s11060-022-04217-y},
      url          = {https://inrepo02.dkfz.de/record/186587},
}