Outcomes and hematologic side effects following whole-brain radiotherapy, photon craniospinal irradiation, and proton craniospinal irradiation in patients with solid-tumor leptomeningeal disease: a systematic analysis

By
Mishaal Munir
Kavita Sehrawat
Hanan Hassan
Matthew Hall
Minesh P. Mehta
Jonathan. T. Yang
Rupesh Kotecha
August 29, 2026

Journal Of Neuro-Oncology

1

Leptomeningeal disease (LMD) is a complication of advanced solid tumors, notably breast cancer and non-small cell lung cancer.
2

Management of LMD is complex and may involve systemic agents, intrathecal therapy, and various forms of radiotherapy.
3

Proton craniospinal irradiation (CSI) may reduce radiation exposure to normal tissues compared to conventional photon CSI.
4

Early studies suggest proton CSI may improve CNS progression-free survival and overall survival without increasing serious adverse events.
5

A systematic review is needed to synthesize outcomes of different radiotherapy modalities for solid-tumor LMD due to existing evidence heterogeneity.

Original Source(s)

Journal Of Neuro-Oncology

Survival and hematologic toxicity after whole-brain radiotherapy, photon craniospinal irradiation, and proton craniospinal irradiation for solid-tumor leptomeningeal disease: a systematic review

by Mishaal Munir, Kavita Sehrawat, Hanan Hassan, Matthew Hall, Minesh P. Mehta, Jonathan. T. Yang, Rupesh Kotecha
August 29, 2026

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