Academic Journal
Clinical Outcomes Following Dose-Escalated Proton Therapy for Skull-Base Chordoma
| العنوان: | Clinical Outcomes Following Dose-Escalated Proton Therapy for Skull-Base Chordoma |
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| المؤلفون: | Adam L. Holtzman, MD, Ronny L. Rotondo, MD, Michael S. Rutenberg, MD, PhD, Daniel J. Indelicato, MD, Alexandra De Leo, MD, Dinesh Rao, MD, Jeet Patel, MD, Christopher G. Morris, MS, William M. Mendenhall, MD |
| المصدر: | International Journal of Particle Therapy, Vol 8, Iss 1, Pp 179-188 (2021) |
| بيانات النشر: | Elsevier, 2021. |
| سنة النشر: | 2021 |
| المجموعة: | LCC:Medical physics. Medical radiology. Nuclear medicine LCC:Nuclear and particle physics. Atomic energy. Radioactivity |
| مصطلحات موضوعية: | radiation oncology, proton therapy, particle therapy, skull-based tumors, chordoma, head and neck, Medical physics. Medical radiology. Nuclear medicine, R895-920, Nuclear and particle physics. Atomic energy. Radioactivity, QC770-798 |
| الوصف: | Purpose: To evaluate the effectiveness of external-beam proton therapy (PT) on local control and survival in patients with skull-base chordoma. Materials and Methods: We reviewed the medical records of patients with skull-base chordoma treated with definitive or adjuvant high-dose PT and updated their follow-up when feasible. We assessed overall survival, disease-specific survival, local control, and freedom from distant metastasis. Radiotherapy toxicities were scored using the Common Terminology Criteria for Adverse Events, version 4.0. Results: A total 112 patients were analyzed, of whom 105 (94%) received PT and 7 (6%) received combined proton-photon therapy between 2007 and 2019. Eighty-seven patients (78%) underwent a subtotal resection, 22 (20%) a gross total resection, and 3 (3%) a biopsy alone. The median radiotherapy dose was 73.8 Gy radiobiologic equivalent (GyRBE; range, 69.6-74.4). Ninety patients (80%) had gross disease at radiotherapy and 7 (6%) were treated for locally recurrent disease following surgery. Median follow-up was 4.4 years (range, 0.4-12.6); for living patients, it was 4.6 years (range, 0.4-12.6), and for deceased patients, 4.1 years (range, 1.2-11.2). At 5 years after radiotherapy, the actuarial overall survival, disease-specific survival, local control, and freedom from distant metastasis rates were 78% (n = 87), 83% (n = 93), 74% (n = 83), and 99% (n = 111), respectively. The median time to local progression was 2.4 years (range, 0.8-7). Local control and disease-specific survival by resection status was 95% versus 70% (P = 0.28) and 100% versus 80% (P = 0.06) for gross total, versus subtotal, resection or biopsy alone, respectively. There were no serious acute toxicities (grade ≥ 3) related to radiotherapy. Conclusion: High-dose PT alone or after surgical resection for skull-base chordoma reaffirms the favorable 5-year actuarial local control rate compared with conventional techniques with acceptable late-complication–free survival. Outcomes following gross total resection and adjuvant PT were excellent. Further follow-up of this cohort is necessary to better characterize long-term disease control and late toxicities. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2331-5180 |
| Relation: | https://doaj.org/toc/2331-5180 |
| DOI: | 10.14338/IJPT-20-00066.1 |
| URL الوصول: | https://doaj.org/article/cd956fe89c3345049a68cfe17ded6b7f |
| رقم الانضمام: | edsdoj.956fe89c3345049a68cfe17ded6b7f |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 23315180 |
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| DOI: | 10.14338/IJPT-20-00066.1 |