Long-term Outcomes and Prognostic Factors of Skull-base Chondrosarcoma Patients Treated with Pencil-beam Scanning Proton Therapy at the Paul Scherrer Institute

Overview

Journal Neuro Oncol

Publisher Oxford University Press

Specialties Neurology
Oncology

Date 2015 Sep 2

PMID 26323608

Citations 16

Authors

Damien C Weber

Shahed Badiyan

Robert Malyapa

Francesca Albertini

Alessandra Bolsi

Antony J Lomax

Ralf Schneider

Affiliations

Soon will be listed here.

Abstract

Background: Skull-base chondrosarcoma (ChSa) is a rare disease, and the prognostication of this disease entity is ill defined.

Methods: We assessed the long-term local control (LC) results, overall survival (OS), and prognostic factors of skull-base ChSa patients treated with pencil beam scanning proton therapy (PBS PT). Seventy-seven (male, 35; 46%) patients with histologically confirmed ChSa were treated at the Paul Scherrer Institute. Median age was 38.9 years (range, 10.2-70.0y). Median delivered dose was 70.0 GyRBE (range, 64.0-76.0 GyRBE). LC, OS, and toxicity-free survival (TFS) rates were calculated using the Kaplan Meier method.

Results: After a mean follow-up of 69.2 months (range, 4.6-190.8 mo), 6 local (7.8%) failures were observed, 2 of which were late failures. Five (6.5%) patients died. The actuarial 8-year LC and OS were 89.7% and 93.5%, respectively. Tumor volume > 25 cm(3) (P = .02), brainstem/optic apparatus compression at the time of PT (P = .04) and age >30 years (P = .08) were associated with lower rates of LC. High-grade (≥3) radiation-induced toxicity was observed in 6 (7.8%) patients. The 8-year high-grade TFS was 90.8%. A higher rate of high-grade toxicity was observed for older patients (P = .073), those with larger tumor volume (P = .069), and those treated with 5 weekly fractions (P = .069).

Conclusions: This is the largest PT series reporting the outcome of patients with low-grade ChSa of the skull base treated with PBS only. Our data indicate that protons are both safe and effective. Tumor volume, brainstem/optic apparatus compression, and age were prognosticators of local failures.

Citing Articles

A systematic review and meta-analysis of radiotherapy and particle beam therapy for skull base chondrosarcoma: TRP-chondrosarcoma 2024.

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PMID: 38567162 PMC: 10985235. DOI: 10.3389/fonc.2024.1380716.

Skull-Base Chondrosarcoma: A Systematic Review of the Role of Postoperative Radiotherapy.

Ravindran P, Keizer M, Kunst H, Compter I, van Aalst J, Eekers D Cancers (Basel). 2024; 16(5).

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Risk Factors for Radiation Necrosis and Local Recurrence after Proton Beam Therapy for Skull Base Chordoma or Chondrosarcoma.

Takahashi M, Mizumoto M, Oshiro Y, Kino H, Akutsu H, Nakai K Cancers (Basel). 2023; 15(23).

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Proton Therapy for Skull Base Chondrosarcoma.

Tang D, Cutri R, Wu A, Patil C, Zumsteg Z J Neurol Surg Rep. 2023; 84(4):e144-e145.

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The role of particle radiotherapy in the treatment of skull base tumors.

Iannalfi A, Riva G, Ciccone L, Orlandi E Front Oncol. 2023; 13:1161752.

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References

Paganetti H . Relative biological effectiveness (RBE) values for proton beam therapy. Variations as a function of biological endpoint, dose, and linear energy transfer. Phys Med Biol. 2014; 59(22):R419-72. DOI: 10.1088/0031-9155/59/22/R419. View

Lee S, Lim Y, Song M, Seok J, Lee W, Choi E . Chondrosarcoma of the head and neck. Yonsei Med J. 2005; 46(2):228-32. PMC: 2823018. DOI: 10.3349/ymj.2005.46.2.228. View

Halg R, Besserer J, Boschung M, Mayer S, Lomax A, Schneider U . Measurements of the neutron dose equivalent for various radiation qualities, treatment machines and delivery techniques in radiation therapy. Phys Med Biol. 2014; 59(10):2457-68. DOI: 10.1088/0031-9155/59/10/2457. View

DeLaney T, Liebsch N, Pedlow F, Adams J, Weyman E, Yeap B . Long-term results of Phase II study of high dose photon/proton radiotherapy in the management of spine chordomas, chondrosarcomas, and other sarcomas. J Surg Oncol. 2014; 110(2):115-22. DOI: 10.1002/jso.23617. View

Rosenberg A, Nielsen G, Keel S, Renard L, Fitzek M, Munzenrider J . Chondrosarcoma of the base of the skull: a clinicopathologic study of 200 cases with emphasis on its distinction from chordoma. Am J Surg Pathol. 1999; 23(11):1370-8. DOI: 10.1097/00000478-199911000-00007. View

Weber D, Trofimov A, DeLaney T, Bortfeld T . A treatment planning comparison of intensity modulated photon and proton therapy for paraspinal sarcomas. Int J Radiat Oncol Biol Phys. 2004; 58(5):1596-606. DOI: 10.1016/j.ijrobp.2003.11.028. View

Jiang B, Veeravagu A, Feroze A, Lee M, Harsh G, Soltys S . CyberKnife radiosurgery for the management of skull base and spinal chondrosarcomas. J Neurooncol. 2013; 114(2):209-18. DOI: 10.1007/s11060-013-1172-9. View

Oghalai J, Buxbaum J, Jackler R, McDermott M . Skull base chondrosarcoma originating from the petroclival junction. Otol Neurotol. 2005; 26(5):1052-60. DOI: 10.1097/01.mao.0000185076.65822.f7. View

Noel G, Habrand J, Jauffret E, de Crevoisier R, Dederke S, Mammar H . Radiation therapy for chordoma and chondrosarcoma of the skull base and the cervical spine. Prognostic factors and patterns of failure. Strahlenther Onkol. 2003; 179(4):241-8. DOI: 10.1007/s00066-003-1065-5. View

10.

Potluri S, Jefferies S, Jena R, Harris F, Burton K, Prevost A . Residual postoperative tumour volume predicts outcome after high-dose radiotherapy for chordoma and chondrosarcoma of the skull base and spine. Clin Oncol (R Coll Radiol). 2010; 23(3):199-208. DOI: 10.1016/j.clon.2010.09.011. View

11.

Noel G, Feuvret L, Ferrand R, Boisserie G, Mazeron J, Habrand J . Radiotherapeutic factors in the management of cervical-basal chordomas and chondrosarcomas. Neurosurgery. 2004; 55(6):1252-60. DOI: 10.1227/01.neu.0000143330.30405.aa. View

12.

Weber D, Rutz H, Pedroni E, Bolsi A, Timmermann B, Verwey J . Results of spot-scanning proton radiation therapy for chordoma and chondrosarcoma of the skull base: the Paul Scherrer Institut experience. Int J Radiat Oncol Biol Phys. 2005; 63(2):401-9. DOI: 10.1016/j.ijrobp.2005.02.023. View

13.

Iyer A, Kano H, Kondziolka D, Liu X, Niranjan A, Flickinger J . Stereotactic radiosurgery for intracranial chondrosarcoma. J Neurooncol. 2012; 108(3):535-42. DOI: 10.1007/s11060-012-0858-8. View

14.

Bohman L, Koch M, Bailey R, Alonso-Basanta M, Lee J . Skull base chordoma and chondrosarcoma: influence of clinical and demographic factors on prognosis: a SEER analysis. World Neurosurg. 2014; 82(5):806-14. DOI: 10.1016/j.wneu.2014.07.005. View

15.

Bloch O, Jian B, Yang I, Han S, Aranda D, Ahn B . A systematic review of intracranial chondrosarcoma and survival. J Clin Neurosci. 2009; 16(12):1547-51. PMC: 3795514. DOI: 10.1016/j.jocn.2009.05.003. View

16.

Bloch O, Jian B, Yang I, Han S, Aranda D, Ahn B . Cranial chondrosarcoma and recurrence. Skull Base. 2011; 20(3):149-56. PMC: 3037109. DOI: 10.1055/s-0029-1246218. View

17.

Chung C, Yock T, Nelson K, Xu Y, Keating N, Tarbell N . Incidence of second malignancies among patients treated with proton versus photon radiation. Int J Radiat Oncol Biol Phys. 2013; 87(1):46-52. DOI: 10.1016/j.ijrobp.2013.04.030. View

18.

Uhl M, Mattke M, Welzel T, Oelmann J, Habl G, Jensen A . High control rate in patients with chondrosarcoma of the skull base after carbon ion therapy: first report of long-term results. Cancer. 2014; 120(10):1579-85. DOI: 10.1002/cncr.28606. View

19.

Iyer A, Kano H, Kondziolka D, Liu X, Flickinger J, Lunsford L . Postsurgical management strategies in patients with skull base chondrosarcomas. CNS Oncol. 2014; 2(2):203-8. PMC: 6169478. DOI: 10.2217/cns.13.3. View

20.

Ares C, Hug E, Lomax A, Bolsi A, Timmermann B, Rutz H . Effectiveness and safety of spot scanning proton radiation therapy for chordomas and chondrosarcomas of the skull base: first long-term report. Int J Radiat Oncol Biol Phys. 2009; 75(4):1111-8. DOI: 10.1016/j.ijrobp.2008.12.055. View