title: The role of image-guided intensity modulated proton therapy in glioma.
abstract: Gliomas represent a broad spectrum of disease with life-expectancy outcomes ranging from months to decades. As our understanding of the molecular profiles of gliomas expands rapidly, practitioners are now better able to identify patients with favorable versus nonfavorable prognoses. Radiation therapy plays a key role in glioma treatment, improving disease control and oftentimes survival. However, for survivors, either long-term or short-term, radiation-induced cognitive impairments may negatively impact their quality of life. For patients with both favorable and unfavorable prognoses, intensity modulated proton therapy (IMPT) may offer significant, yet unproven benefits. IMPT is the newest and most advanced proton delivery technique, one with substantial benefits compared with historical proton techniques. IMPT allows practitioners to maximize the physical benefits of protons, increasing normal tissue sparing and reducing the potential for adverse effects. For more aggressive tumors, the dose conformality and normal tissue sparing afforded by IMPT may also allow for dose escalation to target volumes. However, in order to truly maximize the clinical potential of IMPT, the field of radiation oncology must not only implement the most advanced technologies, but also understand and capitalize on the unique biologic aspects of proton therapy.
authors.affiliation: Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Grosshans
authors.affiliation: Department of Surgical Oncology, New Hope Medical Centre, Kilpauk, Chennai, Tamil Nadu, India.
authors.forename: Radhe
authors.initials: R
authors.lastname: Mohan
authors.affiliation: Northwestern Medicine Chicago Proton Center, Warrenville, Illinois, USA.
authors.forename: Vinai
authors.initials: V
authors.lastname: Gondi
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Helen A
authors.initials: HA
authors.lastname: Shih
authors.affiliation: Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Anita
authors.initials: A
authors.lastname: Mahajan
authors.affiliation: Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Brown
mesh_terms: D001932:Brain Neoplasms / Q000532:radiotherapy*; D060825:Cognitive Dysfunction / Q000209:etiology; D005910:Glioma / Q000532:radiotherapy*; D006801:Humans; D061766:Proton Therapy / Q000009:adverse effects / Q000379:methods*; D011788:Quality of Life; D011879:Radiotherapy Dosage; D061089:Radiotherapy, Image-Guided / Q000009:adverse effects / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
keywords: glioma; intensity modulated proton therapy; proton therapy