Proton and Carbon Ion Therapy of Intracranial Gliomas.

In comparison to photon irradiation, particle therapy of cancer performed either with protons or with carbon ions, offers the advantage of their distinct physical characteristics, and through delivery of high linear energy transfer (LET) particles, exploits greater relative biological effectiveness (RBE). There is strong rationale for applying such treatment in patients with intracranial gliomas. In cases of low-grade tumors, the main benefits may be related to potential decrease of long-term morbidity, whereas in cases of high-grade neoplasms, the use of modalities with greater RBE may lead to better tumor control and improve patient survival. Nevertheless, to date, there are no convincing data that confirm the superior effects of particle therapy (either with protons or carbon ions) in comparison to advanced photon fractionated radiotherapy (FRT) in patients with either newly diagnosed or recurrent intracranial gliomas. Therefore, the real clinical benefit of such treatment should be evaluated further in prospective clinical trials.