A Better Way To Irradiate Lethal CNS Metastases? Randomized Trial Makes Case for Proton Craniospinal Irradiation for Leptomeningeal Spread

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Publication: American Society of Clinical Oncology

June 08, 2022

Interim analysis of a Phase II study of patients with metastatic lung and breast cancers indicates that proton craniospinal irradiation therapy can mitigate disease progression in the central nervous system and improve overall survival when used to treat patients whose disease has metastasized into the leptomeningeal space surrounding the brain and spinal cord. Survival for patients with this disease is four to six months with standard irradiation treatments, such as whole-brain radiotherapy (WBRT) or focal spine radiotherapy. While these therapies relieve symptoms, they do not stop progression in the leptomeningeal space or prolong survival. Whereas analysis of the study indicated proton craniospinal irradiation therapy increased survival from six months to 9.9 months. Additionally, results showed that 92 percent of patients receiving standard photon involved-field radiotherapy (IFRT) saw disease progression in the central nervous system at six months – compared to only 22 percent of patients who received proton craniospinal irradiation.