Treatment of meningioma and glioma with protons and carbon ions
Abstract The rapid rise of particle therapy across the world necessitates evidence to justify its ever-increasing utilization. This narrative review summarizes the current status of these technologies on treatment of both meningiomas and gliomas, the most common benign and malignant primary brain tu...
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| Format: | Article |
| Language: | English |
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BMC
2017-12-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13014-017-0924-7 |
| _version_ | 1819083124262305792 |
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| author | Sebastian Adeberg Semi B. Harrabi Vivek Verma Denise Bernhardt Nicole Grau Jürgen Debus Stefan Rieken |
| author_facet | Sebastian Adeberg Semi B. Harrabi Vivek Verma Denise Bernhardt Nicole Grau Jürgen Debus Stefan Rieken |
| author_sort | Sebastian Adeberg |
| collection | DOAJ |
| description | Abstract The rapid rise of particle therapy across the world necessitates evidence to justify its ever-increasing utilization. This narrative review summarizes the current status of these technologies on treatment of both meningiomas and gliomas, the most common benign and malignant primary brain tumors, respectively. Proton beam therapy (PBT) for meningiomas displays high rates of long-term local control, low rates of symptomatic deterioration, along with the potential for safe dose-escalation in select (but not necessarily routine) cases. PBT is also associated with low adverse events and maintenance of functional outcomes, which have implications for quality of life and cost-effectiveness measures going forward. Data on carbon ion radiation therapy (CIRT) are limited; existing series describe virtually no high-grade toxicities and high local control. Regarding the few available data on low-grade gliomas, PBT provides opportunities to dose-escalate while affording no increase of severe toxicities, along with maintaining appropriate quality of life. Although dose-escalation for low-grade disease has been less frequently performed than for glioblastoma, PBT and CIRT continue to be utilized for the latter, and also have potential for safer re-irradiation of high-grade gliomas. For both neoplasms, the impact of superior dosimetric profiles with endpoints such as neurocognitive decline and neurologic funcionality, are also discussed to the extent of requiring more data to support the utility of particle therapy. Caveats to these data are also described, such as the largely retrospective nature of the available studies, patient selection, and heterogeneity in patient population as well as treatment (including mixed photon/particle treatment). Nevertheless, multiple prospective trials (which may partially attenuate those concerns) are also discussed. In light of the low quantity and quality of available data, major questions remain regarding economic concerns as well. |
| first_indexed | 2024-12-21T20:27:34Z |
| format | Article |
| id | doaj.art-7d34fce37d594f6bb94c431189865d3c |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-21T20:27:34Z |
| publishDate | 2017-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-7d34fce37d594f6bb94c431189865d3c2022-12-21T18:51:19ZengBMCRadiation Oncology1748-717X2017-12-011211710.1186/s13014-017-0924-7Treatment of meningioma and glioma with protons and carbon ionsSebastian Adeberg0Semi B. Harrabi1Vivek Verma2Denise Bernhardt3Nicole Grau4Jürgen Debus5Stefan Rieken6Department of Radiation Oncology, University Hospital of HeidelbergDepartment of Radiation Oncology, University Hospital of HeidelbergDepartment of Radiation Oncology, University of Nebraska Medical CenterDepartment of Radiation Oncology, University Hospital of HeidelbergDepartment of Radiation Oncology, University Hospital of HeidelbergDepartment of Radiation Oncology, University Hospital of HeidelbergDepartment of Radiation Oncology, University Hospital of HeidelbergAbstract The rapid rise of particle therapy across the world necessitates evidence to justify its ever-increasing utilization. This narrative review summarizes the current status of these technologies on treatment of both meningiomas and gliomas, the most common benign and malignant primary brain tumors, respectively. Proton beam therapy (PBT) for meningiomas displays high rates of long-term local control, low rates of symptomatic deterioration, along with the potential for safe dose-escalation in select (but not necessarily routine) cases. PBT is also associated with low adverse events and maintenance of functional outcomes, which have implications for quality of life and cost-effectiveness measures going forward. Data on carbon ion radiation therapy (CIRT) are limited; existing series describe virtually no high-grade toxicities and high local control. Regarding the few available data on low-grade gliomas, PBT provides opportunities to dose-escalate while affording no increase of severe toxicities, along with maintaining appropriate quality of life. Although dose-escalation for low-grade disease has been less frequently performed than for glioblastoma, PBT and CIRT continue to be utilized for the latter, and also have potential for safer re-irradiation of high-grade gliomas. For both neoplasms, the impact of superior dosimetric profiles with endpoints such as neurocognitive decline and neurologic funcionality, are also discussed to the extent of requiring more data to support the utility of particle therapy. Caveats to these data are also described, such as the largely retrospective nature of the available studies, patient selection, and heterogeneity in patient population as well as treatment (including mixed photon/particle treatment). Nevertheless, multiple prospective trials (which may partially attenuate those concerns) are also discussed. In light of the low quantity and quality of available data, major questions remain regarding economic concerns as well.http://link.springer.com/article/10.1186/s13014-017-0924-7Ion beam radiation therapyGliomaProton beam therapyRadiotherapyMeningioma |
| spellingShingle | Sebastian Adeberg Semi B. Harrabi Vivek Verma Denise Bernhardt Nicole Grau Jürgen Debus Stefan Rieken Treatment of meningioma and glioma with protons and carbon ions Radiation Oncology Ion beam radiation therapy Glioma Proton beam therapy Radiotherapy Meningioma |
| title | Treatment of meningioma and glioma with protons and carbon ions |
| title_full | Treatment of meningioma and glioma with protons and carbon ions |
| title_fullStr | Treatment of meningioma and glioma with protons and carbon ions |
| title_full_unstemmed | Treatment of meningioma and glioma with protons and carbon ions |
| title_short | Treatment of meningioma and glioma with protons and carbon ions |
| title_sort | treatment of meningioma and glioma with protons and carbon ions |
| topic | Ion beam radiation therapy Glioma Proton beam therapy Radiotherapy Meningioma |
| url | http://link.springer.com/article/10.1186/s13014-017-0924-7 |
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