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Do you still recommend protons for grade 2 and grade 3 glioma, following the Soprano study results showing a survival detriment?

Recently presented in abstract form at SNO 2025. Nagtegaal et al., SNO 2025
3 Answers
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Radiation Oncology · Icahn School of Medicine at Mount Sinai
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I should start by saying that I generally do not recommend proton therapy for grade 2-3 gliomas in adults unless there is a clear and specific indication. Modern photon techniques such as VMAT are highly conformal, efficient, and safe, and they form the backbone of the evidence base that guides our ...

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Radiation Oncology · University of Arizona
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Proton therapy is generally considered less deleterious (harmful) than traditional photon radiation for brain tumors. In this non-randomized study from the Netherlands and Belgium, 373 consecutive patients (256 with WHO grade 2 IDHm gliomas and 117 with WHO grade 3 IDH gliomas) were treated postoper...

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Radiation Oncology · The Christie Hospital
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The APPROACH study in the UK, which is a randomised study for grade 2 and 3 oligodendroglioma looking at neurocognitive effects with PBT vs X-rays, has temporarily closed accrual to the grade 3 arm of the trial following publication of this abstract.

However, as outlined above by Dr. @Dr. First Last,...

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