Loïc Feuvret1, Stefano Bracci2, Valentin Calugaru3, Stéphanie Bolle4, Hamid Mammar3, Ludovic De Marzi3, Damien Bresson5, Jean-Louis Habrand6, Jean-Jacques Mazeron7, Rémi Dendale3, Georges Noël8. 1. Department of Radiation Oncology, Groupe Hospitalier La Pitié-Salpêtrière-Charles Foix (Assistance Publique-Hôpitaux de Paris), Paris, France; Department of Radiation Oncology, Institut Curie-Centre de protonthérapie d'Orsay (CPO), Orsay, France. Electronic address: loic.feuvret@psl.aphp.fr. 2. Institute of Radiation Oncology, Sapienza University, Sant'Andrea Hospital, Rome, Italy. 3. Department of Radiation Oncology, Institut Curie-Centre de protonthérapie d'Orsay (CPO), Orsay, France. 4. Department of Radiation Oncology, Gustave Roussy, Villejuif, France. 5. Department of Neurosurgery, Hôpital Lariboisière (Assistance Publique-Hôpitaux de Paris), Paris, France. 6. Department of Radiation Oncology, Centre François Baclesse, Caen, France. 7. Department of Radiation Oncology, Groupe Hospitalier La Pitié-Salpêtrière-Charles Foix (Assistance Publique-Hôpitaux de Paris), Paris, France. 8. Department of Radiation Oncology, Centre Paul Strauss, Strasbourg, France.
Abstract
PURPOSE: Chondrosarcoma is a rare malignant tumor of the cartilage affecting young adults. Surgery, followed by charged-particle irradiation, is considered the reference standard for the treatment of patients with grade I to II skull base chondrosarcoma. The present study was conducted to assess the effect of the quality of surgery and radiation therapy parameters on local control (LC) and overall survival (OS). METHODS AND MATERIALS: From 1996 to 2013, 159 patients (median age 40 years, range 12-83) were treated with either protons alone or a combination of protons and photons. The median total dose delivered was 70.2 Gy (relative biologic effectiveness [RBE]; range 67-71). Debulking and biopsy were performed in 133 and 13 patients, respectively. RESULTS: With a median follow-up of 77 months (range 2-214), 5 tumors relapsed based on the initial gross tumor volume. The 5- and 10-year LC rates were 96.4% and 93.5%, respectively, and the 5- and 10-year OS rates were 94.9% and 87%, respectively. A total of 16 patients died (13 of intercurrent disease, 3 of disease progression). On multivariate analysis, age <40 years and primary disease status were independent favorable prognostic factors for progression-free survival and OS, and local tumor control was an independent favorable predictor of OS. In contrast, the extent of surgery, dosimetric parameters, and adjacent organs at risk were not prognostic factors for LC or OS. CONCLUSIONS: Systematic high-dose postoperative proton therapy for skull base chondrosarcoma can achieve a high LC rate with a low toxicity profile. Maximal safe surgery, followed by high-dose conformal proton therapy, is therefore recommended.
PURPOSE:Chondrosarcoma is a rare malignant tumor of the cartilage affecting young adults. Surgery, followed by charged-particle irradiation, is considered the reference standard for the treatment of patients with grade I to II skull base chondrosarcoma. The present study was conducted to assess the effect of the quality of surgery and radiation therapy parameters on local control (LC) and overall survival (OS). METHODS AND MATERIALS: From 1996 to 2013, 159 patients (median age 40 years, range 12-83) were treated with either protons alone or a combination of protons and photons. The median total dose delivered was 70.2 Gy (relative biologic effectiveness [RBE]; range 67-71). Debulking and biopsy were performed in 133 and 13 patients, respectively. RESULTS: With a median follow-up of 77 months (range 2-214), 5 tumors relapsed based on the initial gross tumor volume. The 5- and 10-year LC rates were 96.4% and 93.5%, respectively, and the 5- and 10-year OS rates were 94.9% and 87%, respectively. A total of 16 patients died (13 of intercurrent disease, 3 of disease progression). On multivariate analysis, age <40 years and primary disease status were independent favorable prognostic factors for progression-free survival and OS, and local tumor control was an independent favorable predictor of OS. In contrast, the extent of surgery, dosimetric parameters, and adjacent organs at risk were not prognostic factors for LC or OS. CONCLUSIONS: Systematic high-dose postoperative proton therapy for skull base chondrosarcoma can achieve a high LC rate with a low toxicity profile. Maximal safe surgery, followed by high-dose conformal proton therapy, is therefore recommended.
Authors: Adam L Holtzman; James E Bates; Christopher G Morris; Michael S Rutenberg; Daniel J Indelicato; Daryoush Tavanaiepour; William M Mendenhall Journal: J Neurol Surg B Skull Base Date: 2021-03-09
Authors: J D Palmer; M E Gamez; K Ranta; H Ruiz-Garcia; J L Peterson; D M Blakaj; D Prevedello; R Carrau; A Mahajan; K L Chaichana; D M Trifiletti Journal: J Neurooncol Date: 2020-08-12 Impact factor: 4.130