BACKGROUND: The aim of this study is to evaluate results in terms of local control (LC), overall survival (OS), and toxicity profile and to better identify factors influencing clinical outcome of skull base chordoma treated with proton therapy (PT) and carbon ion radiotherapy (CIRT). METHODS: We prospectively collected and analyzed data of 135 patients treated between November 2011 and December 2018. Total prescription dose in the PT group (70 patients) and CIRT group (65 patients) was 74 Gy relative biological effectiveness (RBE) delivered in 37 fractions and 70.4 Gy(RBE) delivered in 16 fractions, respectively (CIRT in unfavorable patients). LC and OS were evaluated using the Kaplan-Meier method. Univariate and multivariate analyses were performed, to identify prognostic factors on clinical outcomes. RESULTS: After a median follow-up of 44 (range, 6-87) months, 14 (21%) and 8 (11%) local failures were observed in CIRT and PT group, respectively. Five-year LC rate was 71% in CIRT cohort and 84% in PT cohort. The estimated 5-year OS rate in the CIRT and PT group was 82% and 83%, respectively. On multivariate analysis, gross tumor volume (GTV), optic pathways, and/or brainstem compression and dose coverage are independent prognostic factors of local failure risk. High rate toxicity grade ≥3 was reported in 11% of patients. CONCLUSIONS: Particle radiotherapy is an effective treatment for skull base chordoma with acceptable late toxicity. GTV, optic pathways, and/or brainstem compression and target coverage were independent prognostic factors for LC. KEY POINTS: • Proton and carbon ion therapy are effective and safe in skull base chordoma.• Prognostic factors are GTV, organs at risk compression, and dose coverage.• Dual particle therapy and customized strategy was adopted.
BACKGROUND: The aim of this study is to evaluate results in terms of local control (LC), overall survival (OS), and toxicity profile and to better identify factors influencing clinical outcome of skull base chordoma treated with proton therapy (PT) and carbon ion radiotherapy (CIRT). METHODS: We prospectively collected and analyzed data of 135 patients treated between November 2011 and December 2018. Total prescription dose in the PT group (70 patients) and CIRT group (65 patients) was 74 Gy relative biological effectiveness (RBE) delivered in 37 fractions and 70.4 Gy(RBE) delivered in 16 fractions, respectively (CIRT in unfavorable patients). LC and OS were evaluated using the Kaplan-Meier method. Univariate and multivariate analyses were performed, to identify prognostic factors on clinical outcomes. RESULTS: After a median follow-up of 44 (range, 6-87) months, 14 (21%) and 8 (11%) local failures were observed in CIRT and PT group, respectively. Five-year LC rate was 71% in CIRT cohort and 84% in PT cohort. The estimated 5-year OS rate in the CIRT and PT group was 82% and 83%, respectively. On multivariate analysis, gross tumor volume (GTV), optic pathways, and/or brainstem compression and dose coverage are independent prognostic factors of local failure risk. High rate toxicity grade ≥3 was reported in 11% of patients. CONCLUSIONS: Particle radiotherapy is an effective treatment for skull base chordoma with acceptable late toxicity. GTV, optic pathways, and/or brainstem compression and target coverage were independent prognostic factors for LC. KEY POINTS: • Proton and carbon ion therapy are effective and safe in skull base chordoma.• Prognostic factors are GTV, organs at risk compression, and dose coverage.• Dual particle therapy and customized strategy was adopted.
Authors: Brian P Walcott; Brian V Nahed; Ahmed Mohyeldin; Jean-Valery Coumans; Kristopher T Kahle; Manuel J Ferreira Journal: Lancet Oncol Date: 2012-02 Impact factor: 41.316
Authors: R Santoni; N Liebsch; D M Finkelstein; E Hug; P Hanssens; M Goitein; A R Smith; D O'Farrell; J T Efird; B Fullerton; J E Munzenrider Journal: Int J Radiat Oncol Biol Phys Date: 1998-04-01 Impact factor: 7.038
Authors: S Potluri; S J Jefferies; R Jena; F Harris; K E Burton; A T Prevost; N G Burnet Journal: Clin Oncol (R Coll Radiol) Date: 2010-10-25 Impact factor: 4.126
Authors: J Tuan; B Vischioni; P Fossati; A Srivastava; V Vitolo; A Iannalfi; M R Fiore; M Krengli; J E Mizoe; R Orecchia Journal: J Radiat Res Date: 2013-07 Impact factor: 2.724
Authors: Jon Espen Dale; Silvia Molinelli; Barbara Vischioni; Viviana Vitolo; Maria Bonora; Giuseppe Magro; Andrea Mairani; Azusa Hasegawa; Tatsuya Ohno; Olav Dahl; Francesca Valvo; Piero Fossati Journal: Front Oncol Date: 2020-11-24 Impact factor: 6.244