ArticleNeuro-oncology2021
Clinical trial of proton craniospinal irradiation for leptomeningeal metastases.
Article in Neuro-oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 5 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
71 citing papers in PubMed, 5 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- Survival and hematologic toxicity after whole-brain radiotherapy, photon craniospinal irradiation, and proton craniospinal irradiation for solid-tumor leptomeningeal disease: a systematic review.Journal of neuro-oncology · 2026Pooled it
- Proton beam therapy indications in the Kingdom of Saudi Arabia: A SARO clinical practice guideline.Saudi medical journal · 2025Guideline
- Guidance for Canadian Breast Cancer Practice: National Consensus Recommendations for the Systemic Treatment of Patients with HER2+ Breast Cancer in Both the Early and Metastatic Setting.Current oncology (Toronto, Ont.) · 2024Guideline
- Proton Radiation Therapy: A Systematic Review of Treatment-Related Side Effects and Toxicities.International journal of molecular sciences · 2024Pooled it
- A systematic review of craniospinal irradiation for leptomeningeal disease: past, present, and future.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2021Pooled it
- Tucatinib-trastuzumab-capecitabine for treatment of leptomeningeal metastasis in women with HER2Nature cancer · 2026Trial
- Proton Craniospinal Irradiation for Patients With Leptomeningeal Metastasis: A Randomized Clinical Trial.JAMA oncology · 2025Trial
- Randomized Phase II Trial of Proton Craniospinal Irradiation Versus Photon Involved-Field Radiotherapy for Patients With Solid Tumor Leptomeningeal Metastasis.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2022Trial
- A meta-analysis of dose-volume parameters and treatment efficiency comparing O-ring and C-arm accelerator systems for craniospinal irradiations.Physics and imaging in radiation oncology · 2026Article
- The Use of Radiotherapy in Leptomeningeal Carcinomatosis: A Systematic Review and Random-Effects Proportions Meta-Analysis.Cancers · 2026Review
- Can virtual non-contrast images replace true non-contrast images to calculate dose in children's craniospinal irradiation proton therapy plan?Translational pediatrics · 2026Article
- Crosstalk in the brain tumor microenvironment: mechanisms, therapeutic strategies, and clinical advances.Military Medical Research · 2026Review
- Leptomeningeal metastasis from colon cancer: a case report and review of literature.Frontiers in oncology · 2026Article
- Research progress of anti-angiogenic therapy combined with immunotherapy and radiotherapy for the treatment of brain metastases in non-small cell lung cancer (Review).Oncology letters · 2025Review
- A HER3-targeting antibody-drug conjugate for leptomeningeal metastasis.Nature medicine · 2025Article
- Survival outcomes among patients with breast cancer and leptomeningeal disease.Scientific reports · 2025Article
- Early experience with proton craniospinal irradiation in adult patients with leptomeningeal disease.Radiation oncology (London, England) · 2025Article
- Article
- Leptomeningeal Disease: Current Approaches and Future Directions.Current neurology and neuroscience reports · 2025Review
- Leptomeningeal metastatic disease: new frontiers and future directions.Nature reviews. Clinical oncology · 2025Review
11 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
21 authors at 1 institution in 1 country.
Funding
Abstract
backgroundLeptomeningeal metastases (LM) are associated with limited survival and treatment options. While involved-field radiotherapy is effective for local palliation, it lacks durability. We evaluated the toxicities of proton craniospinal irradiation (CSI), a treatment encompassing the entire central nervous system (CNS) compartment, for patients with LM from solid tumors.
methodsWe enrolled patients with LM to receive hypofractionated proton CSI in this phase I prospective trial. The primary endpoint was to describe treatment-related toxicity, with dose-limiting toxicity (DLT) defined as any radiation-related grade 3 non-hematologic toxicity or grade 4 hematologic toxicity according to the Common Terminology Criteria for Adverse Events that occurred during or within 4 weeks of completion of proton CSI. Secondary endpoints included CNS progression-free survival (PFS) and overall survival (OS).
resultsWe enrolled 24 patients between June 2018 and April 2019. Their median follow-up was 11 months. Twenty patients were evaluable for protocol treatment-related toxicities and 21 for CNS PFS and OS. Two patients in the dose expansion cohort experienced DLTs consisted of grade 4 lymphopenia, grade 4 thrombocytopenia, and/or grade 3 fatigue. All DLTs resolved without medical intervention. The median CNS PFS was 7 months (95% CI: 5-13) and the median OS was 8 months (95% CI: 6 to not reached). Four patients (19%) were progression-free in the CNS for more than 12 months.
conclusionHypofractionated proton CSI using proton therapy is a safe treatment for patients with LM from solid tumors. We saw durable disease control in some patients.
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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.