The role of combined ion-beam radiotherapy (CIBRT) with protons and carbon ions in a multimodal treatment strategy of inoperable osteosarcoma
| Autor: | Claudia Blattmann, Jürgen Debus, Andreas Kudak, Hendrik Rathke, Christopher Buesch, Nina Bougatf, Sabine Haufe, Marietta Kirchner, Semi Harrabi, Meinhard Kieser, Klaus Herfarth, Katharina Seidensaal, Andreas E. Kulozik, M. Uhl, Uwe Haberkorn, Susanne Oertel, Matthias Mattke |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_treatment Bone Neoplasms Single Center 030218 nuclear medicine & medical imaging 03 medical and health sciences Young Adult 0302 clinical medicine Positron Emission Tomography Computed Tomography Clinical endpoint Medicine Secondary Acute Myeloid Leukemia Humans Radiology Nuclear Medicine and imaging Progression-free survival Craniofacial Fluorodeoxyglucose Ions Osteosarcoma medicine.diagnostic_test business.industry Hematology Combined Modality Therapy Carbon Radiation therapy Treatment Outcome Oncology Positron emission tomography 030220 oncology & carcinogenesis Protons business Nuclear medicine medicine.drug |
| Zdroj: | Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 159 |
| ISSN: | 1879-0887 |
| Popis: | Background To investigate the role of combined ion-beam radiotherapy (CIBRT) with protons and carbon ions in a multimodal treatment strategy of inoperable osteosarcoma; final analysis of a one-armed, single center phase I/II trial. Methods Between August 2011 until September 2018, 20 patients with primary (N = 18), metastatic (N = 3), or recurrent (N = 2) inoperable pelvic (70%) or craniofacial (30%) osteosarcoma were treated with protons up to 54 Gy (RBE) and a carbon ion boost of 18 Gy (RBE) and followed until May 2019. A Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) was performed before CIBRT in search for a prognostic factor. The primary endpoint was toxicity. Secondary endpoints included treatment response, global, local and distant progression free survival (PFS, LPFS and DPFS) and overall (OS), among others. Results The median age was 20; all patients finished treatment per protocol. LPFS, DPFS, PFS and OS were 73%, 74%, 60% and 75% after one year and 55%, 65% 65.3%, 45% and 68% after two years, respectively. The median clinical target volume (CTV) was 1042 cc and 415 cc for the primary and boost plan, respectively. Craniofacial localization, lower uptake of FDG in PET/CT and boost plan CTV ≤ median were associated with improved overall survival (p = 0.039, p = 0.016 and p = 0.0043, respectively). No acute toxicities > grade III were observed. We observed one case of secondary acute myeloid leukemia (AML) seven months after CIBRT for recurrent disease and one case of hearing loss. Conclusion CIBRT shows a favorable toxicity profile and promising results particularly for patients with inoperable craniofacial osteosarcoma. |
| Databáze: | OpenAIRE |
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