Table 4.
Literature review of cerebral necrosis for proton therapy
| Author [ref] | Year | Tumor type | # pts | Median Age [years] |
Median Dose [GyRBE] (range) |
Time to RN [months] |
Toxicity | Prognostic Factors |
|---|---|---|---|---|---|---|---|---|
| Sabin et al.82 | 2013 | EP,CPC,PNET, MB, ATRT |
8/17 | 2.5 | 54 | 3.9 | 47% pseudoprogression | PT after chemotherapy |
| Indelicato et al.83 | 2014 | EP,CF,LGG, MB,PNET,PMRh | 11/313 | 5.9 | 54 | 3 | 3.8% Gr < 3@2y 2.1% Gr 3 @2y |
Age < 5y; PF; V55Gy, Dmax |
| McGovern et al.84 | 2014 | ATRT | 5/31 | 19 | Local PT 50.4 CSI 54 |
4 | 16% @2y Gr1-2 | Age < 5y; intensive Cht prior PT |
| Gunther et al.85 | 2015 | EP | 72 16/37 PT 6/35 IMRT |
4.4 PT 6.9 IMRT |
59.4 PT 54 IMRT |
3.8 PT 5.3 IMRT |
43%PT 17% IMRT 3PT persistent neurological deficits |
PTvsIMRT higher rate of imaging changes Age > 3 y BS |
| Giantsoudi et al.86 | 2016 | MB | 4/111 | 10.5 | 54 | 9 | 3.6%@5y 2.7%@5y (grade3+) |
WPF vs IF |
| Bojaxhiu et al.87 | 2018 | EP,CF,LGG, MB,PNET,other | 29/171 | 3.3 | 54 | 5 | 17%RN; 11%WMLs | Cht, EP, hydrocephalus |
| Gentile et al.88 | 2018 | MB,EP,ATRT | 5/216 | 6.6 | 54 | 8.5 | 2.0%@5y (grade ≥ 2) | Dmax < 55.8 Gy,V55 ≤ 6% |
GyRBE, Gray in relative biological effectiveness; ATRT, atypical teratoid rhabdoid tumor; CF, craniopharyngioma; CPC, choroid plexus carcinoma; CSI, craniospinal irradiation; Cht, chemotherapy; EP, ependymoma; IF, involved field; IMRT, intensity modulated radiation therapy; LGG, low grade glioma; MB, medulloblastoma; PF, posterior fossa; PMRh, parameningeal rhabdomyosarcoma; PNET, primitive neuroectodermal tumor; RN, radiation necrosis; WML, white matter lesion; WPF, whole posterior fossa; pts, patients.