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@ARTICLE{Winter:282919,
      author       = {S. F. Winter and E. J. Vaios and H. A. Shih and C.
                      Grassberger and M. W. Parsons and M. M. Gardner and F.
                      Ehret$^*$ and D. Kaul$^*$ and W. Boehmerle and M. Endres and
                      J. Dietrich},
      title        = {{M}itigating {R}adiotoxicity in the {C}entral {N}ervous
                      {S}ystem: {R}ole of {P}roton {T}herapy.},
      journal      = {Current treatment options in oncology},
      volume       = {24},
      number       = {11},
      issn         = {1527-2729},
      address      = {Philadelphia, Pa.},
      publisher    = {Current Science},
      reportid     = {DKFZ-2023-01908},
      pages        = {1524-1549},
      year         = {2023},
      note         = {2023 Nov;24(11):1524-1549},
      abstract     = {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.},
      subtyp        = {Review Article},
      keywords     = {Adult patients (Other) / Complications (Other) /
                      Neurotoxicity (Other) / Protons (Other) / Radiation injury
                      (Other) / Radiotoxicity (Other)},
      cin          = {BE01},
      ddc          = {610},
      cid          = {I:(DE-He78)BE01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37728819},
      doi          = {10.1007/s11864-023-01131-x},
      url          = {https://inrepo02.dkfz.de/record/282919},
}