The promise of proton therapy for central nervous system malignancies

Jennifer Vogel, Ruben Carmona, Christopher G. Ainsley, Robert A. Lustig

Research output: Contribution to journalArticle

Abstract

Radiation therapy plays a significant role in management of benign andmalignant diseases of the central nervous system. Patients may be at risk of acute and late toxicity from radiation therapy due to dose deposition in critical normal structures. In contrast to conventional photon delivery techniques, proton therapy is characterized by Bragg peak dose deposition which results in decreased exit dose beyond the target and greater sparing of normal structure which may reduce the rate of late toxicities from treatment. Dosimetric studies have demonstrated reduced dose to normal structures using proton therapy as compared to photon therapy. In addition, clinical studies are being reported demonstrating safety, feasibility, and low rates of acute toxicity. Technical challenges in proton therapy remain, including full understanding of depth of proton penetration and the biological activity in the distal Bragg peak. In addition, longer clinical followup is required to demonstrate reduction in late toxicities as compared to conventional photon-based radiation techniques. In this review, we summarize the current clinical literature and areas of active investigation in proton therapy for adult central nervous system malignancies.

Original languageEnglish (US)
Pages (from-to)1000-1010
Number of pages11
JournalNeurosurgery
Volume84
Issue number5
DOIs
Publication statusPublished - Jan 1 2019
Externally publishedYes

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Keywords

  • Central nervous system
  • Malignancy
  • Proton therapy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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