Abstract
Proton therapy offers an attractive alternative to conventional photon-based radiotherapy in low grade glioma patients, delivering radiotherapy with equivalent efficacy to the tumour with less radiation exposure to the brain. In the Netherlands, patients with favourable prognosis based on tumour and patient characteristics can be offered proton therapy. Radiation-induced neurocognitive function decline is a major concern in these long surviving patients. Although level 1 evidence of superior clinical outcome with proton therapy is lacking, the Dutch National Health Care Institute concluded that there is scientific evidence to assume that proton therapy can have clinical benefit by reducing radiation-induced brain damage. Based on this decision, proton therapy is standard insured care for selected low grade glioma patients. Patients with other intracranial tumours can also qualify for proton therapy, based on the same criteria. In this paper, the evidence and considerations that led to this decision are summarised. Additionally, the eligibility criteria for proton therapy and the steps taken to obtain high-quality data on treatment outcome are discussed. (C) 2020 The Author(s). Published by Elsevier B.V.
Original language | English |
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Pages (from-to) | 283-290 |
Number of pages | 8 |
Journal | Radiotherapy and Oncology |
Volume | 154 |
DOIs | |
Publication status | Published - 1 Jan 2021 |
Keywords
- Cognitive function
- Low grade glioma
- Neurotoxicity
- Proton therapy
- Radiation-induced brain damage
- Radiotherapy
- LONG-TERM SURVIVORS
- WHITE-MATTER
- CONVENTIONAL RADIOTHERAPY
- EORTC 22033-26033
- COGNITIVE FUNCTION
- RADIATION-THERAPY
- BRAIN RADIOTHERAPY
- NEUROCOGNITIVE FUNCTION
- QUALITY-OF-LIFE
- CEREBRAL-BLOOD-FLOW