Long-term outcomes and late adverse effects of a prospective study on proton radiotherapy for patients with low-grade glioma.
Radiother Oncol
; 137: 95-101, 2019 08.
Article
en En
| MEDLINE
| ID: mdl-31082632
ABSTRACT
BACKGROUND:
Patients with low-grade gliomas (LGG) can survive years with their illness. Proton radiotherapy (PRT) can reduce off-target dose and decrease the risk of treatment-related morbidity. We examined long-term morbidity following proton therapy in this updated prospective cohort of patients with LGG.METHODS:
Twenty patients with LGG were enrolled prospectively and received PRT to 54â¯Gy(RBE) in 30 fractions. Comprehensive baseline and longitudinal assessments of toxicity, neurocognitive and neuroendocrine function, quality of life, and survival outcomes were performed up to 5â¯years following treatment.RESULTS:
Six patients died (all of disease) and six had progression of disease. Median follow-up was 6.8â¯years for the 14 patients alive at time of reporting. Median progression-free survival (PFS) was 4.5â¯years. Of tumors tested for molecular markers, 71% carried the IDH1-R132H mutation and 29% had 1p/19q co-deletion. There was no overall decline in neurocognitive function; however, a subset of five patients with reported cognitive symptoms after radiation therapy had progressively worse function by neurocognitive testing. Six patients developed neuroendocrine deficiencies, five of which received Dmax ≥20â¯Gy(RBE) to the hypothalamus-pituitary axis (HPA). Most long-term toxicities developed within 2â¯years after radiation therapy.CONCLUSIONS:
The majority of patients with LGG who received proton therapy retained stable cognitive and neuroendocrine function. The IDH1-R132H mutation was present in the majority, while 1p/19q loss was present in a minority. A subset of patients developed neuroendocrine deficiencies and was more common in those with higher dose to the HPA.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Traumatismos por Radiación
/
Neoplasias Encefálicas
/
Trastornos Neurocognitivos
/
Terapia de Protones
/
Glioma
/
Sistemas Neurosecretores
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Radiother Oncol
Año:
2019
Tipo del documento:
Article
País de afiliación:
Estados Unidos