Yusuke Demizu1, Reiko Imai2, Hiroki Kiyohara3, Akira Matsunobu4, Masahiko Okamoto5, Tomoaki Okimoto6, Hiroshi Tsuji2, Tatsuya Ohno5, Yoshiyuki Shioyama4, Kenji Nemoto7, Takashi Nakano8, Tadashi Kamada9. 1. Department of Radiation Oncology, Hyogo Ion Beam Medical Center Kobe Proton Center, Kobe, Japan; Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan. 2. QST Hospital, Quantum Medical Science Directorate, National Institute for Quantum and Radiological Sciences and Technology, Chiba, Japan. 3. Department of Radiation Oncology, Japanese Red Cross Maebashi Hospital, Maebashi, Japan. 4. Ion Beam Therapy Center, SAGA-HIMAT Foundation, Tosu, Japan. 5. Gunma University Heavy Ion Medical Center, Maebashi, Japan. 6. Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan. 7. Department of Radiation Oncology, Yamagata University, Faculty of Medicine, Yamagata, Japan. 8. National Institute of Radiological Sciences, Quantum Medical Science Directorate, National Institute for Quantum and Radiological Sciences and Technology, Chiba, Japan. 9. Ion-beam Radiation Oncology Center, Kanagawa Cancer Center, Yokohama, Japan. Electronic address: tkamadakcch2@gmail.com.
Abstract
BACKGROUND AND PURPOSE: Usefulness of carbon ion radiotherapy (CIRT) for sacral chordoma has been reported from single institutions. We conducted a retrospective nationwide multicentre study to evaluate the clinical outcomes of CIRT for sacral chordoma in Japan. MATERIALS AND METHODS: A total of 219 patients who underwent CIRT for sacral chordoma at institutions across Japan between December 2003 and July 2014 were included in this study. RESULTS: Median patient age was 67 years (range, 26-87 years). Most patients had no history of surgical resection (96%). The most frequent planning target volume (PTV) range was 100-500 mL (65%). The most frequently used dose-fractionation was 67.2 Gy (relative biological effectiveness) in 16 fractions (65%). The median follow-up was 56 months (range, 7-132 months). The 5-year overall survival (OS), progression-free survival, and local control rates were 84%, 48%, and 72%, respectively. Frequent sites of out-of-field recurrence included bone (9%) and lung (9%) metastases. The Cox proportional hazards model revealed that both younger age (P = 0.004) and smaller PTV (P = 0.001) were associated with significantly better OS. Acute toxicities of ≥Grade 3 occurred in eight patients (4%). Late toxicities of ≥Grade 3 occurred in 13 patients (6%): skin disorders in six patients (3%), pain in three (1%), myositis in three (1%), etc. CONCLUSION: Our retrospective nationwide multicentre study showed that CIRT for sacral chordoma was effective and safe, and replicated the previously reported data from a representative CIRT institution in Japan demonstrating high local control and low toxicity rates.
BACKGROUND AND PURPOSE: Usefulness of carbon ion radiotherapy (CIRT) for sacral chordoma has been reported from single institutions. We conducted a retrospective nationwide multicentre study to evaluate the clinical outcomes of CIRT for sacral chordoma in Japan. MATERIALS AND METHODS: A total of 219 patients who underwent CIRT for sacral chordoma at institutions across Japan between December 2003 and July 2014 were included in this study. RESULTS: Median patient age was 67 years (range, 26-87 years). Most patients had no history of surgical resection (96%). The most frequent planning target volume (PTV) range was 100-500 mL (65%). The most frequently used dose-fractionation was 67.2 Gy (relative biological effectiveness) in 16 fractions (65%). The median follow-up was 56 months (range, 7-132 months). The 5-year overall survival (OS), progression-free survival, and local control rates were 84%, 48%, and 72%, respectively. Frequent sites of out-of-field recurrence included bone (9%) and lung (9%) metastases. The Cox proportional hazards model revealed that both younger age (P = 0.004) and smaller PTV (P = 0.001) were associated with significantly better OS. Acute toxicities of ≥Grade 3 occurred in eight patients (4%). Late toxicities of ≥Grade 3 occurred in 13 patients (6%): skin disorders in six patients (3%), pain in three (1%), myositis in three (1%), etc. CONCLUSION: Our retrospective nationwide multicentre study showed that CIRT for sacral chordoma was effective and safe, and replicated the previously reported data from a representative CIRT institution in Japan demonstrating high local control and low toxicity rates.
Authors: Yagiz U Yolcu; Jad Zreik; Waseem Wahood; Atiq Ur Rehman Bhatti; Mohamad Bydon; Matthew T Houdek; Peter S Rose; Anita Mahajan; Ivy A Petersen; Michael G Haddock; Safia K Ahmed; Nadia N Laack; Krishan Jethwa; Elizabeth B Jeans; Reiko Imai; Shigeru Yamada; Robert L Foote Journal: JAMA Netw Open Date: 2022-01-04