2012年10月28-31日，第54届美国放射肿瘤学会（ASTRO）年会在美国波士顿举行。来自世界各地的放射肿瘤学领域的医生及相关人士共计11000多人参会。本届年会的主题是“通过创新改善患者治疗（Advancing Patient Care through Innovation）”。金宝搏网站登录技巧 对本届年会进行了专题报道（http://zt.cmt.com.cn/zt/astro2012/index.html），敬请关注！

　　会上，美国学者报告了一项研究：Proton Therapy for Low-grade Gliomas: A Pilot Study ，其摘要如下：

Purpose/Objective(s)
To evaluate the role of proton therapy in the management of patients with low grade gliomas in regard to toxicity and progression free survival (PFS).

Materials/Methods
WHO grade II glioma patients indicated for radiation therapy were enrolled in a prospective single arm trial of involved field proton therapy receiving a dose of 54 Gy(RBE) in 30 fractions. No prior cranial irradiation was permitted. Comprehensive baseline and regular post treatment evaluations of neuroendocrine function, neurocognitive functions, quality of life (QOL), and PFS were performed.

Results
Of the 20 patients (median age 37.5) enrolled, 13 (65%) were men and 11 (55%) patients were treated at the time of progression. Primary tumor locations were frontal (11), temporal (8), and occipital (1) lobes. All patients tolerated the delivery of proton therapy without difficulty. Median follow-up after proton therapy was 2.7 years among 18 surviving patients with ongoing follow-up. New endocrine dysfunction was detected in 11 patients (55%, 95% CI 33-77%) including 13 new hormonal deficiencies. The axes affected were thyroid (20%), testosterone (23% of men), cortisol (15%), and growth hormone (15%). New neuroendocrine deficits were not associated with direct irradiation to the hypothalamic-pituitary complex (p = 1.00). Baseline level of intellectual functioning on a standardized IQ measure was slightly above the normative mean for the group and remained stable at last follow-up. Executive function as measured on standardized tests of attention, working memory, behavior initiation and cognitive flexibility was also in the average range, though slightly below the normative mean at baseline (range of mean z-scores -0.38 to -0.12) but with improvement at 24 months (range of mean changes -0.03 to 0.82) and at last follow-up (range of mean changes 0.17 to 0.84). On baseline memory measures, learning and retention of verbal and visual information was within normal limits, though below the normative mean (range of mean z-scores -0.91 to -0.70); however, memory scores at last follow-up were improved (range of mean changes -0.03 to 0.66). QOL assessment by FACT-Brain show overall improvement at both 2 and 3 years follow-up with mean increase of 7.7 and 8.7 in total score, respectively. PFS at 2 and 3 years was 94% and 85%, respectively.

Conclusions
Early results demonstrate that low grade glioma patients tolerate proton therapy well and a subset develops neuroendocrine deficiencies. There is no evidence for early decline in intelligence, executive function, memory, or QOL which may be partially attributable to limited integral dose to the brain by use of proton therapy. PFS is equivalent to that of photon based therapy.