TY  - JOUR
AU  - Winter, Sebastian F
AU  - Vaios, Eugene J
AU  - Shih, Helen A
AU  - Grassberger, Clemens
AU  - Parsons, Michael W
AU  - Gardner, Melissa M
AU  - Ehret, Felix
AU  - Kaul, David
AU  - Boehmerle, Wolfgang
AU  - Endres, Matthias
AU  - Dietrich, Jorg
TI  - Mitigating Radiotoxicity in the Central Nervous System: Role of Proton Therapy.
JO  - Current treatment options in oncology
VL  - 24
IS  - 11
SN  - 1527-2729
CY  - Philadelphia, Pa.
PB  - Current Science
M1  - DKFZ-2023-01908
SP  - 1524-1549
PY  - 2023
N1  - 2023 Nov;24(11):1524-1549
AB  - 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.
KW  - Adult patients (Other)
KW  - Complications (Other)
KW  - Neurotoxicity (Other)
KW  - Protons (Other)
KW  - Radiation injury (Other)
KW  - Radiotoxicity (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:37728819
DO  - DOI:10.1007/s11864-023-01131-x
UR  - https://inrepo02.dkfz.de/record/282919
ER  -