Long-term outcomes and prognostic factors of skull-base chondrosarcoma patients treated with pencil-beam scanning proton therapy at the Paul Scherrer Institute

Weber, Damien Charles; Badiyan, Shahed; Malyapa, Robert; Albertini, Francesca; Bolsi, Alessandra; Lomax, Antony J; Schneider, Ralf (2016). Long-term outcomes and prognostic factors of skull-base chondrosarcoma patients treated with pencil-beam scanning proton therapy at the Paul Scherrer Institute. Neuro-Oncology, 18(2), pp. 236-243. Oxford University Press 10.1093/neuonc/nov154

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology

UniBE Contributor:

Weber, Damien Charles

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1523-5866

Publisher:

Oxford University Press

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

07 Apr 2016 09:17

Last Modified:

05 Dec 2022 14:51

Publisher DOI:

10.1093/neuonc/nov154

PubMed ID:

26323608

Uncontrolled Keywords:

chondrosarcoma; pencil beam scanning; prognostic factors; proton therapy; skull-base tumors

URI:

https://boris.unibe.ch/id/eprint/75362

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