Fig. 4
From: Early experience with proton craniospinal irradiation in adult patients with leptomeningeal disease

Case example. (A, B) 58-year-old male, KPS of 90%, with the diagnosis of extensive-stage small cell lung cancer and widespread cerebellar leptomeningeal disease on contrast-enhanced magnetic resonance imaging (MRI). He received chemotherapy with carboplatin and etoposide as well as immunotherapy with atezolizumab before and after proton craniospinal irradiation (pCSI) (C) pCSI treatment plan, 30 Gy (RBE) total dose, 10 fractions. (D, E) Three months after pCSI, contrast-enhanced MRI demonstrated complete resolution of LMD