Temporally modulated pulsed proton re-irradiation (TMPPR) for recurrent high-grade gliomas

We present the first known case of a multi-recurrent highgrade glioma patient, which after multiple salvage strategies, was treated with a novel radiation therapy technique, "temporally modulated pulsed proton re-irradiation" (TMPPR). This proton therapy (PT) technique has the radiobiological property to allow an enhanced tumor cell death and an increased normal cell sublethal repair by splitting the radiation dose into smaller subfractions delivered as pulses, with the novelty of using PT for its administration. The response to the treatment was impressive, as a complete response (CR) was achieved, minimal treatment-related toxicities were seen, and no deterioration in neurocognitive function was observed.