{"doi":"10.1093/neuonc/noaa152","title":"Clinical trial of proton craniospinal irradiation for leptomeningeal metastases","abstract":"BACKGROUND: Leptomeningeal 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. METHODS: We 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). RESULTS: We 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. CONCLUSION: Hypofractionated proton CSI using proton therapy is a safe treatment for patients with LM from solid tumors. We saw durable disease control in some patients.","journal":"Neuro-Oncology","year":2020,"id":54668,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":101,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9554,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":281407,"name":"N. Ari Wijetunga","orcid":"0000-0002-8518-4691","position":1,"is_corresponding":false},{"id":283448,"name":"Josh Yamada","orcid":null,"position":2,"is_corresponding":false},{"id":281408,"name":"Suzanne L. 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Gavrilovic","orcid":"0000-0001-9104-6132","position":11,"is_corresponding":false},{"id":281413,"name":"Andrew Lin","orcid":"0000-0003-0659-261X","position":12,"is_corresponding":false},{"id":237603,"name":"Bianca Santomasso","orcid":"0000-0001-9423-4059","position":13,"is_corresponding":false},{"id":281414,"name":"Christian Grommes","orcid":"0000-0002-7485-0441","position":14,"is_corresponding":false},{"id":281415,"name":"Anna F. Piotrowski","orcid":"0000-0003-0058-8476","position":15,"is_corresponding":false},{"id":281416,"name":"Lauren Schaff","orcid":"0000-0002-4664-670X","position":16,"is_corresponding":false},{"id":281417,"name":"Jacqueline Stone","orcid":"0000-0002-0473-279X","position":17,"is_corresponding":false},{"id":281418,"name":"Lisa M. DeAngelis","orcid":"0000-0002-6290-7818","position":18,"is_corresponding":false},{"id":225127,"name":"Adrienne Boire","orcid":"0000-0002-9029-1248","position":19,"is_corresponding":false},{"id":281419,"name":"Elena Pentsova","orcid":"0000-0001-5854-0251","position":20,"is_corresponding":false},{"id":281406,"name":"Jonathan T. Yang","orcid":"0000-0001-9375-7384","position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":null,"created_at":"2026-07-18T21:04:14.743014Z","pmid":"32592583","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}