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Publications

Journal Article Multicenter Study Epublish

PubMed: 40764578 DOI: 10.1186/s13014-025-02702-y

Proton therapy for adult type IDH-mutated glioma: Proglio-1, a multicenter retrospective study.

Radiat Oncol 20(1):124

Authors: Nicolas Goliot, Emmanuel Jouglar, Julian Jacob, François Christy, Eva Seutin, Renaud Schiappa, Sarah Dumont, Selim Mohssine, Dinu Stefan, Arthur Leclerc, Evelyne Emery, Cyril Moignier, Jeanne Riverain, Fernand Missohou, Maxime Fontanilles, Samuel Valable, Jacques Balosso, Jérôme Doyen, Paul Lesueur

Affiliations

  • Radiation Oncology Department, François Baclesse Comprehensive Cancer Center, Caen, 14000, France.
  • Université de Caen Normandie, CNRS, ISTCT UMR6030, GIP CYCERON, Caen, 14000, France.
  • Institut Curie, PSL Research University, Department of Radiation Oncology, Paris, 75005, France.
  • Orsay Protontherapy Center, Orsay, 91400, France.
  • Signalisation Radiobiologie et Cancer, Institut Curie, Paris-Saclay University, CNRS UMR3347, Inserm U1021, Orsay, 91400, France.
  • Department of Radiation Oncology, Hôpital Pitié- Salpêtrière Charles Foix, APHP, Paris, 75013, France.
  • Clinical Research Department, Centre François Baclesse, Caen, 14000, France.
  • Department of Epidemiology, Biostatistics and Health Data, Centre Antoine Lacassagne, University of Côte d'Azur, Nice, 06189, France.
  • Gustave-Roussy, Department of Medical Oncology, Université Paris-Saclay, Villejuif, 94805, France.
  • Radiation Oncology Department, François Baclesse Comprehensive Cancer Center, Caen, 14000, France. Université de Caen Normandie, CNRS, ISTCT UMR6030, GIP CYCERON, Caen, 14000, France.
  • Radiation Oncology Department, François Baclesse Comprehensive Cancer Center, Caen, 14000, France.
  • Université de Caen Normandie, CNRS, ISTCT UMR6030, GIP CYCERON, Caen, 14000, France.
  • Neurosurgery Department, CHU Côte de Nacre, Caen, 14000, France.
  • IRON Group, Department of Oncology, Comprehensive Cancer Centre Henri Becquerel, Normandie Univ, UNIROUEN, INSERM U1245 Brain and Cancer Genomics, Rouen, 76000, France.
  • Onco-hematology unit, Le Havre Hospital, Le Havre, 76600, France.
  • Department of Radiation Oncology, Centre Antoine Lacassagne, University of Côte d'Azur, Nice, 06189, France.
  • Centre de radiothérapie Guillaume le conquérant, Le Havre, 76600, France.

Abstract

BACKGROUND

Gliomas with isocitrate dehydrogenase (IDH) mutation affect young adults with a long-life expectancy. While radiotherapy is effective, studies have shown its detrimental effects on cognition and quality of life. Unlike photon radiotherapy, proton therapy better spares healthy tissue. This study aimed to report mid-term survival and toxicities of proton therapy in a multicentric cohort of adults with IDH-mutant gliomas.

METHODS

We retrospectively analyzed 90 patients treated with proton therapy in France since 2016, including 60 with IDH-mutated astrocytomas and 30 with oligodendrogliomas. Overall survival (OS) and progression-free survival (PFS) were estimated by Kaplan-Meier and compared with the log-rank test. Prognostic factors were assessed using univariate Cox models. Toxicities, radiation-induced-contrast-enhancement (RICE) and patterns of recurrence were evaluated.

RESULTS

At the time of proton therapy, World Health Organization (WHO) pathology grades 2, 3, and 4 were observed in 42%, 54%, and 3% of patients, respectively. Protons were delivered as upfront therapy in 41 patients and after recurrence in 49. After a median follow-up of 27.3 months, median OS was not reached, and median PFS was 42.5 months for the whole cohort. WHO grades 3-4 had lower PFS than WHO grade 2 (p = 0.044). Patterns of recurrence were in-field (79%), out-of-field (7%), borderline (4%), and mixed (11%). Proton therapy was well tolerated, with only three grade > 2 toxicities. RICE occurred in 23 patients, but 74% of them did not require any treatment.

CONCLUSIONS

Proton therapy in IDH-mutated gliomas shows a favorable mid-term tolerance and efficacy profile.

MeSH

Radiotherapy, Glioma, Proton Therapy, Radiation Oncology, Retrospective Studies, Therapeutics