{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:49:49Z","timestamp":1792090189974,"version":"4.4.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Heidelberg","id":[{"id":"https:\/\/ror.org\/013czdx64","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurooncol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Progressive adult pilocytic astrocytoma is rare, and management of surgically unfavorable disease remains insufficiently defined. Given the favorable long-term prognosis of WHO grade 1 glioma, local tumor control must be balanced against late toxicity. This study evaluated the efficacy and safety of PRT in adults with pilocytic astrocytoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fourteen adult patients with progressive or surgically unfavorable pilocytic astrocytoma treated with PRT at a single institution were retrospectively analyzed. Patient, tumor, treatment, radiographic, survival, and toxicity data were assessed. Radiographic response was evaluated using bidirectional T2-weighted measurements. Overall survival (OS), progression-free survival (PFS), and radiation-induced contrast enhancement (RICE)-free probability were estimated using Kaplan\u2013Meier analysis. Toxicity was graded according to CTCAE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median prescribed dose was 54.0\u00a0Gy(RBE). PRT was delivered as salvage treatment in 10 patients (71%) or primary therapy in 4 patients (29%). Tumors frequently involved anatomically complex regions, including the posterior fossa, ventricular and midline structures, the optic pathway, and the suprasellar compartment. At last follow-up, radiographic regression included complete response in 3, partial response in 7, and minor response in 2 of 14 patients. Estimated OS at 3 and 5 years was 100%, whereas estimated PFS was 83.3% at both time points. RICE occurred in 3 patients, with 3- and 5-year RICE-free probabilities of 76.2%. Toxicity was predominantly low grade, with no grade 4 or 5 events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PRT was associated with durable tumor control, marked radiographic regression, favorable survival, and acceptable toxicity in selected adults with progressive or surgically unfavorable pilocytic astrocytoma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11060-026-05798-8","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T12:00:04Z","timestamp":1789732804000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of proton radiotherapy for progressive or surgically unfavorable adult pilocytic astrocytoma: a single-center experience"],"prefix":"10.1007","volume":"179","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5826-7707","authenticated-orcid":false,"given":"Fabian J. 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Ethics approval for data collection and research was granted by the Institutional Ethics Review Board (IRB) under project number S-494\/2021.","order":1,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The requirement for informed consent to participate was waived by the Institutional Ethics Review Board (IRB), as the studies conducted under this ethics approval were restricted to a retrospective design.","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The requirement for consent for publication of anonymized images was waived by the Institutional Ethics Review Board (IRB), as all images were fully anonymized and used exclusively within the scope of the approved retrospective study design.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"S.R. received a grant by Accuray. S. M. K. is a consultant for Brainlab (Munich), Ulrich Medical (Ulm) and Need Inc. (Santa Monica), and shareholder of Need Inc. (Santa Monica). J.D. received honoraria from RaySearch Laboratories, Vision RT Limited, Merck Serono, Siemens Healthcare, PTW-Freiburg Dr. Pychlau, and Accuray Incorporated. J.D. is the CEO of the Heidelberg Ion Beam Therapy Center (HIT), and a member of the Board of Directors at the Heidelberg University Hospital.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"89"}}