Acute toxicity profile of patients with low-grade gliomas and meningiomas receiving proton therapy.

Abstract

e12508 Background: Quality of life is not often studied but is an important outcome to measure when evaluating types of radiation treatment. This study attempts to provide data on the treatment effects of proton beam therapy on patients with low grade gliomas and meningiomas, using the National Cancer Institute Common Terminology Criteria (CTCAE) version 4.0 to analyze the severity and frequency of symptoms experienced acutely during and after radiotherapy. Methods: 23 patients diagnosed with low grade gliomas or meningiomas were enrolled in a prospective proton beam radiation treatment protocol (NCT01024907) and were treated and followed between April 2010 and August 2011 in the University of Pennsylvania Radiation Oncology Department. Patients received 54 Gy [relative biologic effectiveness (RBE)] in 1.8 Gy (RBE) per fraction and were assessed at the time of consult, weekly during treatment, and followed up at 1, 3, 6, and 9 months after treatment. Symptoms were graded based on the CTCAE version 4.0. Results: At week 1 of treatment, 4/23 patients experienced Grade 1 anorexia. At week 3, 5/23 patients had Grade 1 nausea, 10/23 patients had Grade 1 headaches, and 1/23 patients had a Grade 3 headache. At the end of treatment at week 6, 13/23 patients had Grade 1 fatigue, 6/23 patients had Grade 2 fatigue, 3/23 patients had Grade 1 nausea, 4/23 patients had Grade 1 headaches, 7/23 patients had Grade 1 insomnia, and 1/23 patients had Grade 2 insomnia. At the 1-month follow-up, 3/23 patients had Grade 1 fatigue, 1/23 patients had Grade 2 fatigue, 2/23 patients had Grade 1 anorexia, 1/23 patients had a Grade 1 headache, and 2/23 patients had Grade 1 insomnia. No patients were reported to have experienced vomiting at any of the 4 time points. Conclusions: Proton therapy has a favorable side effect profile--most patients experienced mild fatigue, headaches, and insomnia that largely resolved by one month after treatment. This study provides a useful starting point for larger-scale studies which could directly compare the acute side effects of proton and conventional radiotherapy.