Proton Therapy For Tumors Of The Central Nervous System

The aim of modern cancer treatment is to provide patients with the maximum chance of cure while minimizing treatment-related side effects. This can be achieved with proton therapy.

Proton radiotherapy is a gentle cancer treatment method with minimal side effects. It allows for accurate targeting of the proton beam to the target area (at the location of the original tumor), thus minimizing exposure of surrounding tissues and organs to radiation.

The Proton Therapy Center in Prague uses unique and innovative treatment procedures that minimize undesirable exposure of the surrounding tissues, such as the optic and auditory nerve, hippocampus, or brain stem to radiation. The benefits of proton radiotherapy for tumors of the central nervous system may already be seen in the course of treatment when the vast majority of patients are able to undergo treatment without hospitalisation.

Proton therapy is exceptional, in particular, because it demonstrably reduces the risk of side effects while also rendering excellent treatment results. It is extremely useful for the treatment of tumors of central nervous system tumours, as it allows for the delivery of the dose required to destroy the tumour with minimum possible irradiation of the surrounding healthy tissues.

Proton therapy is used to treat:

• skull base tumours (chordomas and chondrosarcomas);
• meningiomas;
• low-grade gliomas;
• pituitary adenomas;
• acoustic neuroma;
• craniofaryngeoma;
• medulloblastoma.

You can send your medical documentation for assessment of the suitability of proton therapy by e-mail to patient@ptc.cz. Alternatively, you can contact our treatment coordinators, who are prepared to answer all of your questions related to proton therapy. You can call them at +420 222 999 000.

The only thing YOU need to do is to come to US in time. WE are ready to help you.

In order to select the optimal treatment, it is imperative to get comprehensive and comprehensible information. Ask not only about the most advanced treatment methods but also treatment-related side effects. They may significantly affect the quality of your life during and after treatment.

We are here to help you.

If radiation is considered as part of your treatment, inquire about all the options available. Our physicians have many years of experience in radiotherapy. Moreover, they are experienced in both standard (photon) and proton radiation therapy; therefore, they will be able to answer all your questions pertaining to your decision on your treatment.

• Think about the options you have.
• You don’t have to decide immediately.
• The treatment you choose has a fundamental influence on the quality of life not only during but also after treatment.

Keep in mind that your decision will significantly affect your future life. Our physicians are prepared to answer all of your questions related to PROTON THERAPY; therefore, do not hesitate to contact us immediately.

I Know My Chances Of Healing And Treatment Options

• What treatment has my attending physician recommended?
• Has the physician informed me about the risks and complications associated with currently used treatments?
• Has the physician informed me about proton therapy?
• Has the physician informed me about the risks and complications associated with standard radiation methods?

You can send your medical documentation for assessment of the suitability of proton therapy by e-mail to patient@ptc.cz. Alternatively, you can contact our treatment coordinators, who are prepared to answer all of your questions related to proton therapy. You can call them at +420 222 999 031.

Advantages Of Proton Therapy Over Conventional Radiotherapy

Proton therapy:

• allows to significantly reduce the dose of unwanted radiation to the brain and thus prevent the risk of memory disorders;
• allows to significantly reduce the doses to the optic nerves, thus reducing the risk of vision reduction or loss;
• reduces the risk of hearing impairment or loss, especially in the high frequency range;
• reduces the risk of damage to mental and hormonal functions;
• reduces the likelihood of developing secondary tumors.

Irradiation of the central nervous system is one of the most demanding for both the patient and the doctor. There are many radiation-sensitive structures in this area that can be damaged but, at the same time, high doses are needed to destroy the tumor. Standard radiotherapy is not always able to solve this situation.

The goal is to cure patients in a way, so that they can continue living their life without limitations and health complications. Proton therapy is clearly the most gentle way to irradiate tumors of the central nervous system.

Did you know that the benefits of proton irradiation are based on the physical principles and properties of protons?

Protons target the tumor directly, which allows us to protect healthy tissues and organs from adverse effects.

Unlike conventional radiotherapy, which uses photons for tumor cell irradiation and destruction, proton therapy is more advanced and uses protons.

The commonly used photon beam goes through the body and emits a significant portion of its energy in the regions in front of and behind the tumor. Protons have a certain physical property called the Bragg peak, which means they emit significantly lower amounts of energy on their way to the tumor, thus minimising their impact on healthy tissues behind the tumor. The greatest advantage of proton therapy is that, unlike common radiotherapy, it is precise and able to protect healthy tissues.

The experience of our doctors, our technology, excellent results and professional approach bring you the maximum chance of being cured.

Initial Assessment

In order for our medical team to assess a patient for suitability, we require some medical information from you. Your treatment coordinator will inform you of exactly what information we require. Usually, we will also request to see scans, such as an MRI, CT or PET scan. This information can be requested from the hospital or clinic and is often given to the patient on a CD. We can provide you with login details to upload the CD to our secure server. Alternatively, you can mail it to us.

Any information you already have about your diagnosis and previous treatments is very helpful and it is a good idea to provide us with as much information as possible in your initial enquiry. Your case will then be reviewed by our medical team at the daily indication board meeting. Your treatment coordinator will get back to you with the outcome, or possibly a request for more information if the oncologists require it to make their final decision.

You do not need to travel to Prague for the assessment.

Treatment Planning

When you come to Prague for treatment, you will first have a consultation to discuss the side effects and outcomes of treatment in your specific case, as well as the concrete treatment plan. The doctor also explains what to expect during and after the treatment. Finally, all of your questions are answered.

The first stage of treatment involves the diagnostic scans here at the Proton Therapy Center (MRI and/or CT, preparation of the fixation device, etc.). Precise treatment planning is crucial for treatment success. Therefore, a team of clinical physicists and physicians prepares a radiation plan tailored to each patient according to which proton therapy will take place. The irradiation plan also determines from which directions and with what intensity the proton beam will irradiate the tumor. This process is very complex and it typically takes one week to finalise before treatment can commence.

The treatment is outpatient, and you come to the Proton Therapy Center for radiation and regular check-ups during treatment. One visit takes about 60 minutes while the radiation is a matter of a few minutes. Prior to each radiation session, we carefully check your position using X-ray scans and carry out certain other checks necessary to commence irradiating. At least once a week, you undergo check-ups with the physician who will go through the treatment progress with you and check your condition.

Individual treatment doses are given each day, Monday to Friday. Treatment cannot be interrupted except for serious health reasons.

We Use The Pencil Beam Scanning Technology

Pencil Beam Scanning (PBS) marks the exact distribution of the proton beam dose and is currently the absolute peak in proton therapy technology. PBS irradiates the target area with millimeter accuracy with minimal damage to surrounding healthy tissues and organs.

The treatment is outpatient and, in most cases, takes about 30 business days, according to the regime determined by the physician on the basis of the initial assessment and other diagnostic tests.

Proton therapy is an increasingly recognized and preferred method in the world. The results of the world's proton centers and the Prague Proton Therapy Center clearly confirm that proton therapy opens up completely new possibilities for the treatment of cancer.

Proton therapy is not a new method. Since 1991, the first exclusively clinical (not academic) workplace located at Loma Linda University, California, USA has treated many tens of thousands of cancer patients using proton therapy. Proton therapy is a technologically mature treatment proven by almost three decades of clinical operation. 

Despite many years of proton radiotherapy being used for the treatment of selected types of cancer, some healthcare professionals are still of the opinion that the higher radiation doses used in standard (photon) radiotherapy to which healthy tissues are exposed do not justify the use of proton beam therapy.

New clinical data is available from extensive studies suggesting that the frequency of acute toxicity (complications monitored for 90 days after initiation of treatment) is significantly lower in proton irradiation than in a comparable group of patients treated with photon radiotherapy.

A team of physicians from the University of Washington monitored almost 1,500 patients with various types of cancer, of whom about 400 underwent proton beam therapy while the rest were irradiated with state-of-the-art photon radiotherapy techniques. All the patients from this group were irradiated and at the same time were administered concomitant chemoradiotherapy. The study researchers focused on the emergence of toxicity at grade III and higher, which already requires hospitalisation and intensive medical treatment and care.

The study has shown that the observed toxicity (the complications associated with irradiation) in patients treated with protons is two-thirds lower than in the group treated with photon radiotherapy.

Specifically, serious adverse complications were reported by 11.5% of patients irradiated with protons as compared with 27.6% of patients irradiated with photons.

*Link: medicalnewstoday.com...

CNS Tumors

Tumors of the central nervous system (CNS) are generally divided into primary tumors, which develop from brain tissue cells or surrounding structures (i.e., meninges – meningiomas), and a much larger group of tumors, secondary tumors, that have spread (metastasised), whose original tumor may be anywhere in the body (for example, in a breast, lung, kidney).

Primary brain tumors represent roughly 1–2% of all malignant tumors. In the Czech Republic, brain tumors affect some 800 people each year, with the number of males being slightly higher. The incidence of this disease is more frequent in two age groups: children up to five years of age, and adults over 60 years of age.

Primary brain tumors are a highly varied group. Most commonly, they form from the cells of supportive brain tissue (neuroglia), and these tumors are called gliomas, making up over 50% of all CNS tumors. Simply put, according to certain histological markers and behaviour, gliomas are divided into those with a low level of malignancy (low-grade gliomas), and those with a high level of malignancy (high-grade gliomas).

Low-grade gliomas grow slowly, sometimes even over the course of several years. They are more common in younger age groups (20–40 years of age). The growth of these types of tumors are not clearly demarcated from the surrounding healthy brain tissue, which is why it is difficult to remove them completely using surgery. Over the course of years, they can gradually grow in size or change into malignant gliomas.

High-grade gliomas most often originate in two different ways – either through natural development based on genetic disorders from a low-grade glioma or directly from healthy brain tissue. Rapid, aggressive growth (weeks to months) is typical for these malignant gliomas. They most often affect people over the age of 50. The borders of these tumors are not distinct or clearly defined, which is why complete removal is not possible. Recurrence is common, as is renewed growth at the site or surrounding area after surgery.

Other Types Of Brain Tumors

When addressing common brain tumors, it is important to mention meningiomas, which are typically benign tumors that form from the membranous layers surrounding the brain, and are more common in women and persons over the age of 50. Other types of tumours include cranial nerve tumours (neurinomas), which are typically benign, as well as pituitary adenomas, which manifest in hormonal disorders or visual disorders (visual field defects due to pressure on the optic nerve). Predominantly pediatric tumors generally include medulloblastomas and ependymomas.

Brain Cancer Treatment

The treatment of CNS carcinomas requires a multidisciplinary approach. A comprehensive treatment strategy must be determined by a team of specialists, including a neurosurgeon, radiation or clinical oncologist, pathologist, and radiologist.

In most CNS tumors, their surgical removal is of paramount importance. Surgery, or radiotherapy alone, is sufficient for some patients. For other patients, combined surgery, radiotherapy, and chemotherapy treatment must be used. Radiotherapy plays an irreplaceable role in the comprehensive treatment of CNS cancer.