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A single-center experience of the upright proton therapy for skull-base chordomas and chondrosarcomas: Updated results.
Lemaeva, Alyona; Gulidov, Igor; Smyk, Daniil; Agapova, Yuliya; Koryakin, Sergey; Eremina, Irina; Gantsova, Elena; Fatkhudinov, Timur; Kaprin, Andrey; Gordon, Konstantin.
Afiliação
  • Lemaeva A; A. Tsyb Medical Radiological Research Center - Branch of the National Medical Radiological Research Center, Obninsk, Russia.
  • Gulidov I; A. Tsyb Medical Radiological Research Center - Branch of the National Medical Radiological Research Center, Obninsk, Russia.
  • Smyk D; A. Tsyb Medical Radiological Research Center - Branch of the National Medical Radiological Research Center, Obninsk, Russia.
  • Agapova Y; Obninsk Institute for Nuclear Power Engineering, National Research Nuclear University MEPhI, Obninsk, Russia.
  • Koryakin S; A. Tsyb Medical Radiological Research Center - Branch of the National Medical Radiological Research Center, Obninsk, Russia.
  • Eremina I; Medical Institution, P. Lumumba People's Friendship University of Russia, Moscow, Russia.
  • Gantsova E; Medical Institution, P. Lumumba People's Friendship University of Russia, Moscow, Russia.
  • Fatkhudinov T; Medical Institution, P. Lumumba People's Friendship University of Russia, Moscow, Russia.
  • Kaprin A; A. Tsyb Medical Radiological Research Center - Branch of the National Medical Radiological Research Center, Obninsk, Russia.
  • Gordon K; Medical Institution, P. Lumumba People's Friendship University of Russia, Moscow, Russia.
Clin Transl Radiat Oncol ; 48: 100814, 2024 Sep.
Article em En | MEDLINE | ID: mdl-39044782
ABSTRACT

Aim:

To access efficacy and safety of the upright proton therapy for the skull-base chordomas and chondrosarcomas. Materials and

methods:

The study encompasses single-center experience of proton therapy in chordomas (CA) and chondrosarcomas (CSA) of skull-base localization. We evaluate overall survival, local control and toxicity. Tumor response was assessed in accordance with RANO criteria. Treatment-related toxicity was evaluated with the help of CTCAE v 5.0 scale.

Results:

Proton therapy in the upright position was utilized for 51pts (patients) with CA-CSA (40 pts with chordoma and 11pts with chondrosarcoma) at the A. Tsyb Medical Radiological Research Center in 2016-2023. Median tumor volume constituted 30 cm3 (IQR (interquartile range) 15-41 cm3). Median total dose was 70 GyRBE. Median number of fractions was 35. Overall survival (OS) at 1-, 2- and 3-year rates reached 98.0 %, 88.6 % and 82.7 %, respectively. Median follow-up time was 36 months. The 1-, 2- and 3-year local control (LC) rates constituted, respectively, 98 %, 78.6 % and 66.3 %. Prior surgery showed statistically significant association with better prognosis (p = 0.023). Brainstem-to-tumor dose coverage compromise became the major pattern of LC failure (p = 0.03). The late radiation toxicity reactions included temporal lobe necrosis grade 2 in 2 pts, xerostomia grade 1 in 1pt, radiation cataract grade 2 in 1pt and persistent headache grade 2 in 4 pts. Severe late toxicity reactions were observed in 2 cases (4 %) 1 myelitis grade 3 and brainstem damage grade 5 in 1pt.

Conclusion:

Local control was achieved in the majority of patients receiving the scanning-beam upright proton therapy for skull-base CA-CSA. The LC rates after a surgery-radiotherapy combination treatment were higher compared with irradiation alone. Pattern of failure is mostly brainstem-tumor dose compromise. The high OS and LC rates were accompanied by low toxicity incidence. Even in complex case of the skull base CA-CSA upright proton therapy shows promising clinical outcomes.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Clin Transl Radiat Oncol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Federação Russa

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Clin Transl Radiat Oncol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Federação Russa
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