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Proton therapy for adult-type diffuse glioma: A systematic review
Nicolas Goliot1, Selim Mohssine1, Dinu Stefan2
1François Baclesse Comprehensive Cancer Center, Radiation Oncology Department, Caen 14000, France; Cyclhad, Normandy Proton Therapy Center, Caen 14000, France; Normandie Univ., UNICAEN, CNRS, ISTCT, GIP CYCERON, Caen 14000, France.
Background:
We conducted a systematic review to evaluate outcomes and toxicities associated with proton therapy in the treatment of adult-type diffuse glioma.
Methods:
Following PRISMA guidelines, we searched PubMed for both prospective and retrospective studies on proton therapy for adult diffuse gliomas, including IDH-mutated gliomas WHO grade 2-3 and glioblastomas. Survival and toxicity outcomes were reported separately for these glioma types.
Results:
Twelve studies from 2013 to 2023 were selected, comprising 3 prospective and 9 retrospective studies. The analysis covered 570 patients with WHO grade 2-3 gliomas and 240 patients with glioblastoma or WHO grade 4 gliomas. Proton therapy was found to be comparable to conventional radiotherapy in terms of survival outcomes. Its main advantage is the ability to minimize radiation exposure to healthy tissues.
Discussion:
Proton therapy offers comparable survival outcomes to conventional radiotherapy for adult diffuse gliomas and may enhance treatment tolerance, especially regarding neurocognitive function. A major limitation of this review is the predominance of retrospective studies. Future research should ensure rigorous patient selection and adhere to the latest WHO 2021 classification.
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