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100 1 _ |a Eichkorn, Tanja
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245 _ _ |a Analysis of safety and efficacy of proton radiotherapy for IDH-mutated glioma WHO grade 2 and 3.
260 _ _ |a Dordrecht [u.a.]
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500 _ _ |a 2023 May;162(3):489-501
520 _ _ |a 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.
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650 _ 7 |a Efficacy
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650 _ 7 |a IDH-mutation
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650 _ 7 |a Low and intermediate grade glioma
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650 _ 7 |a Proton radiotherapy
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650 _ 7 |a Radiation-induced contrast enhancement (RICE)
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650 _ 7 |a Safety
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700 1 _ |a Lischalk, Jonathan W
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700 1 _ |a Hörner-Rieber, Juliane
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700 1 _ |a Deng, Maximilian
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700 1 _ |a Meixner, Eva
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700 1 _ |a Krämer, Anna
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700 1 _ |a Hoegen, Philipp
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700 1 _ |a Sandrini, Elisabetta
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700 1 _ |a Regnery, Sebastian
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700 1 _ |a Held, Thomas
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700 1 _ |a Harrabi, Semi
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700 1 _ |a Jungk, Christine
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700 1 _ |a Herfarth, Klaus
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700 1 _ |a Debus, Jürgen
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700 1 _ |a König, Laila
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