Current state of proton therapy for tumors of the central nervous system in Spain: physical bases, indications, controversies and perspectives.
Eva María Corrales-GarcíaJosé Javier Aristu-MendiorozJuan Castro-NovaisRaúl MatuteMaría Concepción Learra-MartínezPedro David Delgado-LópezPublished in: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico (2024)
The unique biophysical properties of proton therapy (PT), regarding the precise dose distribution, a remarkable better sparing of surrounding normal tissues, and the decreasing costs have promoted the spread of this technique worldwide. In Spain, eleven new PT centers, added to the currently two in function, are expected to be available in the near future. Indications for PT are currently evolving. The suitability of PT in central nervous system tumors of the adult population has been extrapolated from the favorable experience in children and adolescents. Given the lack of appropriate randomized trials, controversies remain regarding its use in lower grade tumors, re-irradiation, and other clinical scenarios in which an a priori dose distribution benefit is expected compared to photon-based radiotherapy. PT is a reasonable option in many brain and spinal tumors associating long life expectancy, in which cognitive decline, and the appearance of radiation-induced neoplasms can be minimized.Estado actual de la terapia con protones en los tumores del sistema nervioso central en España: bases físicas, indicaciones, controversias y perspectivas.
Keyphrases
- radiation induced
- cognitive decline
- radiation therapy
- mild cognitive impairment
- climate change
- early stage
- physical activity
- gene expression
- cerebrospinal fluid
- mental health
- multiple sclerosis
- white matter
- robot assisted
- current status
- resting state
- locally advanced
- brain injury
- spinal cord injury
- minimally invasive
- subarachnoid hemorrhage