Long term outcome of skull-base chondrosarcoma patients treated with high-dose proton therapy with or without conventional radiation therapy.
Radiother Oncol
; 129(3): 520-526, 2018 12.
Article
em En
| MEDLINE
| ID: mdl-30021697
ABSTRACT
BACKGROUND AND PURPOSE:
Skull-base chondrosarcoma (ChSa) is a rare bone tumor and the outcome of patients with this malignancy has been documented only in a limited number of series with a restricted number of patients.OBJECTIVE:
This study was conducted to assess the outcome and prognostic factors of a large cohort of ChSa patients treated with radiotherapy in two proton therapy centers. MATERIALS ANDMETHODS:
From 1996 to 2015, 251 (male, 43.4%) patients (mean age, 42.0⯱â¯16.2â¯years) were treated with protons with (nâ¯=â¯135; 53.8%) or without photons (nâ¯=â¯116; 46.2%). Median delivered dose was 70.2â¯GyRBE. Failure-free survival (FFS), overall survival (OS) and CTCAE grade ≥3 toxicity free survival (TFS) were calculated using the Kaplan-Meier method.RESULTS:
After a median follow-up of 88.0â¯months for surviving patients, local and distant failures were observed in 12 (4.8%) and 4 (1.6%) patients, respectively. Late failures >6â¯years were observed in 4 (33.3%) patients. The estimated 7-year FFS was 93.1%. Twenty-five (10%) patients died. The estimated 7-year OS was 93.6%. Tumor volume (pâ¯=â¯0.006) and optic pathway compression (pâ¯=â¯0.027) were significantly associated with the risk of treatment failure on univariate analysis. Treatment failure was significantly associated with a higher risk of death (hazard ratioâ¯=â¯126). The estimated 7-year TFS was 84.2%.CONCLUSIONS:
The outcome of skull-base ChSa patients treated with high-dose protons with or without photons is excellent, particularly for patients with small tumors with no optic pathway compression. Treatment failure was however associated with a significantly increased risk of death.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Condrossarcoma
/
Neoplasias da Base do Crânio
/
Terapia com Prótons
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article