Evidence map›Paper›PMID 39400662›Full record

ArticleJournal of neuro-oncology2025

Brain volume loss after cranial irradiation: a controlled comparison study between photon vs proton radiotherapy for WHO grade 2-3 gliomas.

Melissa M Gardner, Sebastian F Winter, Franziska Stahl, Elizabeth R Gerstner, Helen A Shih, Janet Sherman, Jorg Dietrich, Michael W Parsons

Abstract readComparative Study
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In one paragraph

Article in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Trial
  2. Review
  3. Article
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  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Melissa M GardnerDivision of Neuro-Oncology, Mass General Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Sebastian F WinterDivision of Neuro-Oncology, Mass General Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Franziska StahlDepartment of Neurology, Schoen Clinic Munich Schwabing, Munich Schwabing, Germany.
Elizabeth R GerstnerDivision of Neuro-Oncology, Mass General Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Helen A ShihDepartment of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Janet ShermanDepartment of Psychiatry, Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Jorg Dietrich *Division of Neuro-Oncology, Mass General Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Michael W Parsons *Division of Neuro-Oncology, Mass General Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. mwparsons@mgh.harvard.edu.ORCID http://orcid.org/0000-0001-8619-9564

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRadiation therapy (RT) is an integral treatment component in patients with glioma but associated with neurotoxicity. Proton RT (PRT), as compared with photon RT (XRT), reduces excess radiation to nontarget tissue. We used a retrospective method to evaluate brain imaging metrics of neurotoxicity after treatment with PRT and XRT for glioma.

methodsWe analyzed brain volume change in thirty-four patients with WHO grade 2-3 gliomas treated with either PRT (n = 17) or XRT (n = 17). Both groups were carefully matched by demographic/clinical criteria and assessed longitudinally for two years post-radiotherapy. Brain volume change was measured as ventricular volume expansion in the tumor free hemisphere (contralateral to RT target) as a proxy indicator of brain volume loss. We further assessed the impact of volumetric changes on cognition in PRT patients, who completed neuropsychological testing as part of an outcome study.

resultsWe found significant ventricular volume increases in the contralesional hemisphere in both groups at two years post-RT (F(1, 31) = 18.45, p < 0.000, partial η2 = 0.373), with greater volume change observed in XRT (26.55%) vs. PRT (12.03%) (M = 12.03%, SD = 16.26; F(1,31) = 4.26, p = 0.048, partial η2 = 0.121). Although, there was no group-level change on any cognitive test in PRT treated patients, individual changes on cognitive screening, working memory, processing speed and visual memory tasks correlated with contralesional brain volume loss.

conclusionThis study suggests progressive brain volume loss following cranial irradiation, with greater severity after XRT vs. PRT. Radiation-induced brain volume loss appears to be associated with measurable cognitive changes on an individual level. Prospective studies are warranted to validate these findings and their impacts on long-term cognitive function and quality of life. An improved understanding of the structural and functional consequences of cranial radiation is essential to develop neuroprotective strategies.

Indexed as

BrainBrain NeoplasmsCranial IrradiationGliomaProton TherapyAdultAgedFemaleFollow-Up StudiesHumansMagnetic Resonance ImagingMaleMiddle AgedNeoplasm GradingNeuropsychological TestsOrgan SizeCognitionGliomaMagnetic resonance imagingNeurotoxicityRadiation therapy

Identifiers

PMID39400662

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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.