Controversies in neuro-oncology: Focal proton versus photon radiation therapy for adult brain tumors

Abstract

Radiation therapy (RT) plays a fundamental role in the treatment of malignant and benign brain tumors. Current state of the art photon- and proton-based RT combines more conformal dose distribution of target volumes and accurate dose delivery while limiting the adverse radiation effects. Several studies have demonstrated that proton therapy (PT) provides reduced dose to healthy brain parenchyma compared with photon-based (xRT) radiation techniques. However, whether dosimetric advantages translate into superior clinical outcomes for different adult brain tumors remains an open question. This review aims at critically reviewing the recent studies on PT in adult patients with brain tumors, including glioma, meningiomas and chordomas, to explore its potential benefits compared with xRT.