Clinical Outcomes Following Dose-Escalated Proton Therapy for Skull-Base Chordoma
| Autor: | Michael S. Rutenberg, Adam L. Holtzman, Jeet Patel, Daniel J. Indelicato, William M. Mendenhall, Dinesh S. Rao, Alexandra N. De Leo, Christopher G. Morris, Ronny L Rotondo |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment R895-920 QC770-798 head and neck 03 medical and health sciences Clinical Medical physics. Medical radiology. Nuclear medicine 0302 clinical medicine Nuclear and particle physics. Atomic energy. Radioactivity Biopsy proton therapy Medicine Radiology Nuclear Medicine and imaging Proton therapy chordoma medicine.diagnostic_test business.industry Medical record Common Terminology Criteria for Adverse Events radiation oncology medicine.disease Atomic and Molecular Physics and Optics Surgery Radiation therapy Skull Base Chordoma particle therapy 030220 oncology & carcinogenesis Cohort Chordoma skull-based tumors business 030217 neurology & neurosurgery |
| Zdroj: | International Journal of Particle Therapy, Vol 8, Iss 1, Pp 179-188 (2021) International Journal of Particle Therapy |
| ISSN: | 2331-5180 |
| DOI: | 10.14338/IJPT-20-00066.1 |
| Popis: | Purpose To evaluate the effectiveness of external-beam proton therapy (PT) on local control and survival in patients with skull-base chordoma. Materials and Methods We reviewed the medical records of patients with skull-base chordoma treated with definitive or adjuvant high-dose PT and updated their follow-up when feasible. We assessed overall survival, disease-specific survival, local control, and freedom from distant metastasis. Radiotherapy toxicities were scored using the Common Terminology Criteria for Adverse Events, version 4.0. Results A total 112 patients were analyzed, of whom 105 (94%) received PT and 7 (6%) received combined proton-photon therapy between 2007 and 2019. Eighty-seven patients (78%) underwent a subtotal resection, 22 (20%) a gross total resection, and 3 (3%) a biopsy alone. The median radiotherapy dose was 73.8 Gy radiobiologic equivalent (GyRBE; range, 69.6-74.4). Ninety patients (80%) had gross disease at radiotherapy and 7 (6%) were treated for locally recurrent disease following surgery. Median follow-up was 4.4 years (range, 0.4-12.6); for living patients, it was 4.6 years (range, 0.4-12.6), and for deceased patients, 4.1 years (range, 1.2-11.2). At 5 years after radiotherapy, the actuarial overall survival, disease-specific survival, local control, and freedom from distant metastasis rates were 78% (n = 87), 83% (n = 93), 74% (n = 83), and 99% (n = 111), respectively. The median time to local progression was 2.4 years (range, 0.8-7). Local control and disease-specific survival by resection status was 95% versus 70% (P = 0.28) and 100% versus 80% (P = 0.06) for gross total, versus subtotal, resection or biopsy alone, respectively. There were no serious acute toxicities (grade ≥ 3) related to radiotherapy. Conclusion High-dose PT alone or after surgical resection for skull-base chordoma reaffirms the favorable 5-year actuarial local control rate compared with conventional techniques with acceptable late-complication–free survival. Outcomes following gross total resection and adjuvant PT were excellent. Further follow-up of this cohort is necessary to better characterize long-term disease control and late toxicities. |
| Databáze: | OpenAIRE |
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