Therapeutic Outcomes and Toxicity Mitigation of Proton Beam Therapy in Pediatric Neuro-Oncology: A Systematic Review.

Pediatric brain tumors present unique therapeutic challenges due to their close proximity to critical structures and the vulnerability of the developing brain. Proton beam therapy (PBT) is a modern radiation technique designed to deliver targeted doses to tumors while minimizing exposure to surrounding healthy tissues, offering potential advantages over traditional radiation methods. This systematic review evaluates the efficacy of PBT in treating pediatric brain cancers. A comprehensive search of PubMed was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify relevant studies. Inclusion criteria required original research published within the past 10 years involving patients under 21 years of age with primary brain tumors of any type treated with PBT. Ten studies met the eligibility criteria and were included in the final analysis. PBT demonstrated equivalent tumor control and survival outcomes compared to conventional therapies while offering significantly reduced risks of radiation-induced toxicities. However, most included studies were retrospective in nature, with limited sample sizes and follow-up duration. PBT appears to be a safe and effective treatment modality for pediatric brain tumors, offering meaningful advantages in toxicity reduction. However, further prospective, randomized studies are needed to strengthen the evidence base, assess long-term outcomes, and evaluate cost-effectiveness to guide future clinical practices.