Systematic review of effects of proton therapy on cognition in adult patients with brain tumors

Proton therapy (PT) is increasingly employed in treating of intracranial neoplasms due to its ability to spare surrounding healthy tissue. However, its effects on cognitive function remain unclear. Systematic review of 8 studies (247 patients) evaluated the evidence on neurocognitive outcomes in adults treated with PT for primary intracranial tumors (gliomas, meningiomas, craniopharyngiomas, and others). Overall, PT was associated with stable or improved outcomes in global cognition, memory, language, executive function, attention, working memory, and visuospatial abilities. No study reported progressive decline. Improvements were often observed over long-term follow-up, particularly in patients without treatment-induced toxicity. The authors conclude that PT appears to be a cognitive function sparing modality for treating intracranial neoplasms in adult patients.