title: Acute toxicity profile of patients with low-grade gliomas and meningiomas receiving proton therapy.
abstract: OBJECTIVE
  Proton therapy is an emerging treatment modality. We studied its acute side effects on patients with low-grade gliomas and meningiomas.
  
  
  METHODS
  Twenty-three patients diagnosed with low-grade gliomas or meningiomas enrolled in an Institutional Review Board-approved prospective proton treatment protocol (NCT01024907) were treated and followed between April 2010 and August 2011. Patients received 54 Gy (relative biological effectiveness) in 1.8 Gy (relative biological effectiveness) per fraction and were assessed at the time of consult, weekly during treatment, and at 1, 3, 6, and 9 months posttreatment. At each clinic visit, nursing completed a "Symptom Assessment/Grading" table. Symptoms were graded based on National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0.
  
  
  RESULTS
  Fatigue: At on-treatment visit (OTV) week 6, 13 patients had grade 1 and 6 patients had grade 2 fatigue. At 1-month follow-up, 3 patients had grade 1 and 1 patient had grade 2 fatigue. At each timepoint, 1 patient had grade 3 fatigue. Nausea: At OTV week 3, 5 patients experienced grade 1 nausea. At OTV week 6, 3 patients experienced grade 1 nausea. Headache: At OTV week 3, 10 patients had grade 1 headaches. At OTV week 6, 4 patients experienced grade 1 headaches and 1 patient by follow-up month 1. One to 2 patients experienced grade 2 headaches at each timepoint. At OTV week 3, 1 patient experienced a grade 3 headache.
  
  
  CONCLUSIONS
  Our results suggest that proton therapy for patients with low-grade gliomas and meningiomas has a favorable acute toxicity profile-most patients experienced mild fatigue, headache, and insomnia that largely resolved by 1-month posttreatment.
authors: Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, PA.
authors: Genevieve
authors: G
authors: Maquilan
authors: Surbhi
authors: S
authors: Grover
authors: Michelle
authors: M
authors: Alonso-Basanta
authors: Robert A
authors: RA
authors: Lustig
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000532:radiotherapy*; D008579:Meningioma / Q000532:radiotherapy*; D008875:Middle Aged; D010414:Pennsylvania; D011446:Prospective Studies; D061766:Proton Therapy / Q000009:adverse effects*; D011832:Radiation Injuries / Q000209:etiology*; D011879:Radiotherapy Dosage; D055815:Young Adult