UF Research Advances Care for Children with Low‑Grade Gliomas

Each research study published is one step forward to better understanding cancer and the effectiveness of cancer treatment options. Below are the latest publications by our physicians, either as primary investigators or coauthors with oncology experts from around the world.

The UF Health Proton Therapy Institute physicians, physicists and contributing staff members are indicated in bold.

Read our full research portfolio here.

Pediatric Cancer

Article Title:
Selection of the Most Appropriate Radiation Treatment Modality for Children's Cancers: A Paediatric Radiation Oncology Society (PROS) Position Paper on the Ethical Utilization of Proton Therapy.  November 2025

Authors:
Natia Esiashvili, Daniel J Indelicato, MD, Anita Mahajan, Jeannette Parkes, Arnold C Paulino, Guillaume Beljoudi, Ingrid Kristensen, Anne Laprie, Yasmin Lassen, Pauline Njoki Njiraini, Bilal Mazhar Qureshi, Beatriz Garcia Robles, Klaus Seiersen, Beate Timmermann, Mark N Gaze

Why this is important:
This article, published by leaders of the international Paediatric Radiation Oncology Society, discusses the clinical rationale and ethical considerations for selecting radiation treatment modalities, with a focus on the utilization of proton therapy in pediatric cancer care. Proton therapy offers dosimetric advantages over conventional photon-based radiotherapy in reducing radiation exposure to healthy tissues, but its broad implementation raises important ethical, logistical and equity concerns. While proton therapy has shown clinical benefits for certain pediatric cancers, high-quality photon-based treatments like IMRT and VMAT remain effective and widely accessible alternatives. The referral and evaluation process for proton therapy can introduce treatment delays and travel/financial burdens can exacerbate disparities. 

The article advocates for an evidence-informed, equitable approach to radiotherapy modality selection, with local pediatric radiation oncologists playing a central role in counseling families. It also calls for balanced communication from providers and industry stakeholders.

Article Title:
Factors Associated with Primary Site Local Therapy in Patients with Non-Metastatic Ewing Sarcoma Treated with Interval Compressed Chemotherapy: A Report from the Children's Oncology Group.   November 2025

Authors:
Safia K. Ahmed, MD, Odion Binitie, MD, Mark Krailo, PhD, Daniel J. Indelicato, MD, Alexandra K. Callan, MD, Natalie DelRocco, PhD, Allen Buxton, MS, Paul Chuba, MD, PhD, Alexander Christ, MD, Robert Lor Randall, MD, Helen Nadel, MD, Bruce Pawel, MD, Damon R. Reed, MD, Richard G. Gorlick, MD, Steven G. DuBois, MD, Katherine A. Janeway, MD, Patrick J. Leavey, MD, Leo Mascarenhas, MD, MS, Nadia N.I. Laack, MD, MS

Why this is important:
This article, written by the Children’s Oncology Group Ewing Sarcoma steering committee, reports on a study that evaluated clinical and treatment variables associated with local failure (LF) risk for patients with nonmetastatic Ewing sarcoma treated with interval-compressed chemotherapy on the AEWS1031 trial. Key findings include the 5-year cumulative incidence of local failure was 6%, the lowest reported to date for Ewing sarcoma trials. There was no significant difference in local failure incidence by local therapy modality (surgery, radiation or surgery plus radiation). Many of the children on this study were treated with proton radiation therapy. The researchers also found that increasing tumor size at diagnosis, increasing patient age and axial tumor subsite were associated with higher local failure incidence. Tumors ≥200 mL had an 11.3% local failure incidence compared to 3.9% for tumors <200 mL.

Head and Neck Cancer

Article Title:
RBE-Guided Treatment Planning, LET Optimization, and Implications of Proton Arc Therapy for the Sparing of Nervous Tissue in Head and Neck Proton Therapy.   November 2025

Authors:
Keaton Reiners, MS, Mark Artz, PhD, MBA, DABR, Curtis M Bryant, MD, MPH, Roi Dagan, MD, MS, Hardev S Grewal, PhD, Perry B Johnson, PhD, Zuofeng Li, DSc, DABMP, FAAPM, Jiyeon Park, PhD, Michael Vieceli, PhD, Yawei Zhang, PhD

Why this is important:
This publication is adding to our knowledge of optimizing proton therapy treatment plans using pencil beam scanning with proton arc therapy. The UF Health Proton Therapy Institute is part of a committee to define best practices in the implementation of proton arc therapy. To deliver proton arc therapy effectively, we need to take into account what is known about the linear energy transfer (LET) of protons and how that affects the radiobiological effectiveness (RBE) of the proton treatments. Using treatment plans that optimize the linear energy transfer, we can build more effective treatments for patients with cancers in the head and neck.

Article Title:  Proton versus photon radiotherapy for patients with oropharyngeal cancer in the USA: a multicentre, randomised, open-label, non-inferiority phase 3 trial  January 2026

Authors:
Prof Steven J Frank, MD, Prof Paul M Busse, MD PhD, Prof J Jack Lee, PhD, Prof David I Rosenthal, MD, Mike Hernandez, MS, David M Swanson, PhD, Prof Adam S Garden, MD, Prof G Brandon Gunn, MD, Prof Samir H Patel, MD, James W Snider, MD, Prof Daniel J Ma, MD, Jason K Molitoris, MD PhD, Nancy Y Lee, MD, Prof Upendra Parvathaneni, MD, Prof Mark W McDonald, MD, Noah S Kalman, MD, Prof Alexander Lin, MD, Nasiruddin Mohammed, MD, Christina Henson, MD, Christian Hyde, MD, Gopal K Bajaj, MD, Sanford R Katz, MD, Roi Dagan, MD, Prof William H Morrison, MD, Jay P Reddy, MD PhD, Prof C David Fuller, MD PhD, Prof Shalin J Shah, MD, Prof Jack Phan, MD PhD, Prof Gregory M Chronowski, MD, Lauren Mayo, MD, Prof Erich M Sturgis, MD, Prof Renata Ferrarotto, MD, Prof Xiaorong R Zhu, PhD, Prof Xiaodong Zhang, PhD, Li Wang, PhD, Prof Katherine A Hutcheson, PhD, Prof Adel K El-Naggar, MD, Amy C Moreno, MD, Anna Lee, MD, Michael T Spiotto, MD PhD, Prof Neil D Gross, MD, Prof Stephen Y Lai, MD PhD, Jay J Liao, MD, Jonathan Paly, DO, Prof Zhongxing Liao, MD, Prof Robert L Foote, MD on behalf of The University of Texas MD Anderson Cancer Center Clinical Trial Consortium

Why this is important:
A recent publication in The Lancet, a leading peer-reviewed journal, shared exciting news for cancer patients. Proton therapy for head‑and‑neck cancer showed the 5‑year survival rate to be 90.9 % vs 81 % with traditional radiation. The study also revealed that proton therapy cuts side effects (fewer issues with dry mouth, feeding‑tube use and immune suppression). Led by Dr. Steven Frank, MD Anderson, this largest Phase III trial for head and neck cancer treated with proton therapy, confirms protons offer patients improved quality of life and recovery after treatment. UF Health Proton Therapy Institute is continuing the push, studying who benefits most, including HPV‑related oropharyngeal cancer.