ArticleNeuro-oncology2019
Increased risk of pseudoprogression among pediatric low-grade glioma patients treated with proton versus photon radiotherapy.
Article in Neuro-oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Pooled it
- Emerging Outcome Trends From Proton Therapy for Pediatric CNS Tumors: A Systematic Review.International journal of particle therapy · 2026Review
- Decreased T2-signal intensities indicate positive response to front-line radiotherapy in pediatric low-grade gliomas.La Radiologia medica · 2026Article
- Differential synaptic signaling responses in human cortical organoids after photon and proton irradiation.Stem cell reports · 2026Article
- Therapeutic Outcomes and Toxicity Mitigation of Proton Beam Therapy in Pediatric Neuro-Oncology: A Systematic Review.Cureus · 2025Review
- Article
- Case report: Pediatric low-grade gliomas: a fine balance between treatment options, timing of therapy, symptom management and quality of life.Frontiers in oncology · 2024Article
- Analysis of safety and efficacy of proton radiotherapy for IDH-mutated glioma WHO grade 2 and 3.Journal of neuro-oncology · 2023Article
- Recent Updates on Radiation Therapy for Pediatric Optic Pathway Glioma.Brain tumor research and treatment · 2022Review
- Cognitive and Imaging Differences After Proton and Photon Whole Brain Irradiation in a Preclinical Model.International journal of radiation oncology, biology, physics · 2022Article
- Pediatric and Adult Low-Grade Gliomas: Where Do the Differences Lie?Children (Basel, Switzerland) · 2021Review
- Radiation-induced brain injury in patients with meningioma treated with proton or photon therapy.Journal of neuro-oncology · 2021Article
- Paediatric proton therapy.The British journal of radiology · 2020Review
- Pseudoprogression in low-grade glioma.Translational cancer research · 2019Article
- Assembling the brain trust: the multidisciplinary imperative in neuro-oncology.Nature reviews. Clinical oncology · 2019Article
- Proton Radiotherapy for Management of Medulloblastoma: A Systematic Review of Clinical Outcomes.Advances in radiation oncologyReview
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Authors and funding
14 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundPseudoprogression (PsP) is a recognized phenomenon after radiotherapy (RT) for high-grade glioma but is poorly characterized for low-grade glioma (LGG). We sought to characterize PsP for pediatric LGG patients treated with RT, with particular focus on the role of RT modality using photon-based intensity-modulated RT (IMRT) or proton beam therapy (PBT).
methodsSerial MRI scans from 83 pediatric LGG patients managed at 2 institutions between 1998 and 2017 were evaluated. PsP was scored when a progressive lesion subsequently decreased or stabilized for at least a year without therapy.
resultsThirty-two patients (39%) were treated with IMRT, and 51 (61%) were treated with PBT. Median RT dose for the cohort was 50.4 Gy(RBE) (range, 45-59.4 Gy[RBE]). PsP was identified in 31 patients (37%), including 8/32 IMRT patients (25%) and 23/51 PBT patients (45%). PBT patients were significantly more likely to have post-RT enlargement (hazard ratio [HR] 2.15, 95% CI: 1.06-4.38, P = 0.048). RT dose >50.4 Gy(RBE) similarly predicted higher rates of PsP (HR 2.61, 95% CI: 1.20-5.68, P = 0.016). Multivariable analysis confirmed the independent effects of RT modality (P = 0.03) and RT dose (P = 0.01) on PsP incidence. Local progression occurred in 10 patients: 7 IMRT patients (22%) and 3 PBT patients (6%), with a trend toward improved local control for PBT patients (HR 0.34, 95% CI: 0.10-1.18, P = 0.099).
conclusionsThese data highlight substantial rates of PsP among pediatric LGG patients, particularly those treated with PBT. PsP should be considered when assessing response to RT in LGG patients within the first year after RT.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.