Proton therapy for skull-base chondrosarcoma, a single-institution outcomes study

Background We sought to evaluate the effectiveness of definitive or adjuvant external-beam proton therapy on local control and survival in patients with skull-base chondrosarcoma. Methods We reviewed the medical records of 43 patients with a median age of 49 years (range, 23–80 years) treated with d...

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Published in:Journal of neuro-oncology 2019-05, Vol.142 (3), p.557-563
Main Authors: Holtzman, Adam L., Rotondo, Ronny L., Rutenberg, Michael S., Indelicato, Daniel J., Mercado, Catherine E., Rao, Dinesh, Tavanaiepour, Daryoush, Morris, Christopher G., Louis, Debbie, Flampouri, Stella, Mendenhall, William M.
Format: Article
Language:English
Subjects:
Biopsy
Chondrosarcoma
Clinical Study
Disease control
Medical records
Medicine
Medicine & Public Health
Neurology
Oncology
Patients
Radiation therapy
Skull
Surgery
Survival
Toxicity
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Summary:Background We sought to evaluate the effectiveness of definitive or adjuvant external-beam proton therapy on local control and survival in patients with skull-base chondrosarcoma. Methods We reviewed the medical records of 43 patients with a median age of 49 years (range, 23–80 years) treated with double-scattered 3D conformal proton therapy for skull-base chondrosarcomas between January 2007 and February 2016. Proton therapy-related toxicities were scored using CTCAE v4.0. Results The median radiotherapy dose was 73.8 Gy(RBE) (range, 64.5–74.4 Gy[RBE]). Thirty-six (84%) and 7 (16%) patients underwent surgical resection or biopsy alone. Tumor grade distribution included: grade 1, 19 (44%) patients; grade 2, 22 (51%); and grade 3, 2 (5%). Forty patients had gross disease at the time of radiotherapy and 7 patients were treated for locally recurrent disease following surgery. The median follow-up was 3.7 years (range, 0.7–10.1 years). There were no acute grade 3 toxicities related to RT. At 4 years following RT, actuarial rates of overall survival, cause-specific survival, local control, and RT-related grade 3 toxicity-free survival were 95%, 100%, 89%, and 95%. Conclusion High-dose, double-scattered 3D conformal proton therapy alone or following surgical resection for skull-base chondrosarcoma is an effective treatment with a high rate of local control with no acute grade 3 radiation-related toxicity. Further follow-up of this cohort is necessary to better characterize long-term disease control and late toxicities.
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-019-03129-8