Clinical outcomes and toxicities of 100 patients treated with proton therapy for chordoma on the proton collaborative group prospective registry.
Radiother Oncol
; 183: 109551, 2023 06.
Article
en En
| MEDLINE
| ID: mdl-36813169
ABSTRACT
BACKGROUND:
We present efficacy and toxicity outcomes among patients with chordoma treated on the Proton Collaborative Group prospective registry.METHODS:
Consecutive chordoma patients treated between 2010-2018 were evaluated. One hundred fifty patients were identified, 100 had adequate follow-up information. Locations included base of skull (61%), spine (23%), and sacrum (16%). Patients had a performance status of ECOG 0-1 (82%) and median age of 58â¯years. Eighty-five percent of patients underwent surgical resection. The median proton RT dose was 74â¯Gy (RBE) (range 21-86â¯Gy (RBE)) using passive scatter proton RT (PS-PBT) (13%), uniform scanning proton RT (US-PBT) (54%) and pencil beam scanning proton RT (PBS-PBT) (33%). Rates of local control (LC), progression-free survival (PFS), overall survival (OS) and acute and late toxicities were assessed.RESULTS:
2/3-year LC, PFS, and OS rates are 97%/94%, 89%/74%, and 89%/83%, respectively. LC did not differ based on surgical resection (pâ¯=â¯0.61), though this is likely limited by most patients having undergone a prior resection. Eight patients experienced acute grade 3 toxicities, most commonly pain (nâ¯=â¯3), radiation dermatitis (nâ¯=â¯2), fatigue (nâ¯=â¯1), insomnia (nâ¯=â¯1) and dizziness (nâ¯=â¯1). No gradeâ¯≥â¯4 acute toxicities were reported. No gradeâ¯≥â¯3 late toxicities were reported, and most common grade 2 toxicities were fatigue (nâ¯=â¯5), headache (nâ¯=â¯2), CNS necrosis (nâ¯=â¯1), and pain (nâ¯=â¯1).CONCLUSIONS:
In our series, PBT achieved excellent safety and efficacy outcomes with very low rates of treatment failure. CNS necrosis is exceedingly low (<1%) despite the high doses of PBT delivered. Further maturation of data and larger patient numbers are necessary to optimize therapy in chordoma.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Cordoma
/
Terapia de Protones
Tipo de estudio:
Etiology_studies
Límite:
Humans
/
Middle aged
Idioma:
En
Año:
2023
Tipo del documento:
Article