[Radiotherapy using a combination of photons and protons for locally aggressive intracranial tumors. Preliminary results of protocol CPO 94-C1].
OBJECTIVE
From October 1993 through July 1998, 48 assessable adult patients with non-resectable aggressive intracranial tumors were treated by a combination of high dose photon + proton therapy at the Centre de Protonthérapie d'Orsay.


METHODS
Grade 1 and 4 gliomas were excluded. Patients benefited from a 3D dose calculation based on high-definition CT and MRI, a stereotactic positioning using implanted fiducial markers and a thermoplastic mask. Mean tumor dose ranged between 63 and 67 Gy delivered in five weekly sessions of 1.8 Gy in most patients, according to the histological types (doses in Co Gy Equivalent, with a mean proton-RBE of 1.1).


RESULTS
With a median 18-month follow-up (range: four-58 months), local control in tumors located in the envelopes and in the skull base was 97% (33/34), and in parenchymal tumors, 43% (6/14) only. Two patients (5%) presented with a clinically severe radiation-induced necrosis (temporal lobe and chiasm).


CONCLUSIONS
In our experience, high-dose radiation combining photons and protons is a safe and highly efficient procedure in selected malignancies of the skull base and envelopes.
Habrand
J L
JL
Centre de protonthérapie d'Orsay, France.
Haie-Meder
C
C
Rey
A
A
Mammar
H
H
Pontvert
D
D
Gaboriaud
G
G
Couanet
D
D
Lenir
C
C
Valinta
D
D
Ferrand
R
R
Boisserie
G
G
Beaudré
A
A
Kerody
K
K
Mazal
A
A
Dupouy
N
N
Bonomi
M
M
Mazeron
J J
JJ
D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000532:radiotherapy*; D016371:Cranial Irradiation / Q000009:adverse effects / Q000379:methods*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011522:Protons; D011832:Radiation Injuries; D016896:Treatment Outcome
D011522:Protons