Combination of photon and proton radiation therapy for chordomas and chondrosarcomas of the skull base: the Centre de Protonthérapie D’Orsay experience

Noël, Georges; Habrand, Jean‐Louis; Mammar, Hamid; Pontvert, D.; Haie-Méder, Christine; Hasboun, Dominique; Moisson, P; Ferrand, R.; Beaudré, A.; Boisserie, G.; Gaboriaud, G.; Mazal, A.; Kérody, Katia; Schlienger, M.; Mazeron, Jean‐Jacques

doi:10.1016/s0360-3016(01)01634-0

Cited by 141 publications

(69 citation statements)

References 40 publications

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“…45 Those results are in keeping with other published series. 16,46,47 Thus, it appears that the risk of local recurrence and subsequent death is more neutral with regard to sex than initially assumed. In the previous SEER analysis, the impact on outcomes from various clinical and therapeutic characteristics was assessed.…”

Section: Sex and Survivalmentioning

confidence: 99%

Incidence and relative survival of chordomas

Smoll

Gautschi

Radovanović

et al. 2013

Cancer

167

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BACKGROUND: Chordomas are rare bone tumors arising from remnants of the embryonic notochord. METHODS: Data for this study were obtained from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute to calculate the incidence, relative survival (RS), and standardized mortality ratio (SMR) of patients diagnosed with intracranial and extracranial chordomas and to assess the effects of age and sex on this disease. RESULTS: The overall incidence of extracranial and intracranial chordomas was 8.4 per 10 million population. The median overall survival of patients with chordoma patients was 7.7 years. The median survival was 7.7 years for male patients and 7.8 years for female patients. Younger patients (aged <40 years) survived longer compared with older patients (10-year RS, 68% vs 43%). The estimated age-standardized 5-year, 10-year, and 20-year RS rates was 72%, 48%, and 31%, respectively. The SMR in the overall cohort was 4.6 (95% confidence interval, 4.22-5.0) or 21.0 (95% confidence interval, 16.6-27.2) in young adult patients and 3.0 (95% confidence interval, 2.6-3.4) in elderly patients. CONCLUSIONS: The elderly had a more aggressive form of this disease; and, other than the incidence, sex did not influence outcome in this disease. The study of chordomas presents a good case for the contribution that the SMR can have on measuring the impact of a disease on a population of patients. Although the younger population has better survival rates, the impact (SMR) in the younger age groups is much higher than in older populations.

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Section: Sex and Survivalmentioning

confidence: 99%

Incidence and relative survival of chordomas

Smoll

Gautschi

Radovanović

et al. 2013

Cancer

167

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“…24 It is also important to remember that RN can occur when the total dose is ,60 Gy. 15 Furthermore, the risk of RN can be higher when the structures are located at the distal end of the proton beams, as the relative biological effectiveness of proton beams is reported to be .1.1 at the distal end of the Bragg peak. 25 Although we experienced one case of temporal lobe RN, the lesion was fortunately stabilized with conservative medical treatment.…”

Section: Discussionmentioning

confidence: 99%

“…4,[6][7][8] Specifically, the proton beam therapy (PBT), with its excellent dose localization properties, has been reported to be effective in achieving both local control and improved overall survival when compared with the conventional radiotherapy treatment. 4,[11][12][13][14][15][16][17][18][19] We have previously reported the early clinical results from 12 patients with clival chordomas and 1 patient with chondrosarcoma treated using PBT. 13 After treating a total of 17 patients, including these 12 patients, with the conventional dose-per-fraction scheme, we initiated hyperfractionated PBT after surgical tumour removal for minimizing complications while maintaining a high tumour control rate.…”

Section: Introductionmentioning

confidence: 99%

Hyperfractionated high-dose proton beam radiotherapy for clival chordomas after surgical removal

Hayashi¹,

Mizumoto²,

Akutsu³

et al. 2016

BJR

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Yasutaka Hayashi and Masashi Mizumoto contributed equally to this article.Objective: To evaluate the hyperfractionated high-dose proton beam therapy (PBT) for patients with clival chordomas. Methods: Records for 19 patients with pathologically verified clival chordomas treated with surgery followed by hyperfractionated PBT were retrospectively reviewed. The first 9 consecutive patients were treated with 77.44 cobalt gray equivalents (CGEs) in 64 fractions, and the latter 10 patients were treated with 78.4 CGE in 56 fractions. Results: The median follow-up period of all 19 cases was 61.7 months with a range from 31.5 to 115.4 months. At 5 years, the local control, cause-specific and overall survival rates for all 19 cases were 75%, 94% and 83.2%, respectively. Whereas the 5-year local control, cause-specific and over all survival rates of the latter 10 cases were 100%, 100% and 88.9%, respectively, with a median follow-up period of 59.5 months. One of the first nine patients demonstrated bilateral temporal lobe radiation necrosis, who were successfully treated conservatively. In the latter cohort, two cases showed transient neurological symptoms probably due to brain stem ischaemia, but both cases recovered completely with conservative treatment. Conclusion: The hyperfractionated high-dose scheme combined with maximum surgical removal was shown to be efficient for patients with clival chordomas. Advances in knowledge: High-dose proton beam radiotherapy using a hyperfractionation scheme yielded a more favourable outcome than previous reports.

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“…There is an impressive literature in particular with regard to treatment of chordoma/chondrosarcoma [12,21,22,32,80,84,92,95,105,107], meningiomas [59,114] and choroidal melanoma [24,28,29,34,48,89,92]. Combinations of photons with a proton boost have been shown to offer an exceptional chance of cure at the price of an acceptable toxicity [83]. Few detailed reports of late morbidities following proton therapy [113] have been reported.…”

Section: Proton and Helium Radiation Therapymentioning

confidence: 99%

“…At issue is the fact that operating technology for accelerators in the laboratory can be underestimated in the transition to the clinic. However, recent reports of overall higher local control and cure rates following hadron therapy [24,30,32,38,70,72,80,81,83,98,101,107] have drawn attention to these modalities, and justify a consideration of potential late radiation effects in surviving patients. The goal of this paper is to summarize the few clinical and experimental data that are available, and to suggest areas of need for further study.…”

Section: Introductionmentioning

confidence: 99%

Late effects from hadron therapy

Blakely

Chang

2004

Radiotherapy and Oncology

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Successful cancer patient survival and local tumor control from hadron radiotherapy warrant a discussion of potential secondary late effects from the radiation. The study of late-appearing clinical effects from particle beams of protons, carbon, or heavier ions is a relatively new field with few data. However, new clinical information is available from pioneer hadron radiotherapy programs in the USA, Japan, Germany and Switzerland. This paper will review available data on late tissue effects from particle radiation exposures, and discuss its importance to the future of hadron therapy.Potential late radiation effects are associated with irradiated normal tissue volumes at risk that in many cases can be reduced with hadron therapy. However, normal tissues present within hadron treatment volumes can demonstrate enhanced responses compared to conventional modes of therapy. Late endpoints of concern include induction of secondary cancers, cataract, fibrosis, neurodegeneration, vascular damage, and immunological, endocrine and hereditary effects. Low-dose tissue effects at tumor margins need further study, and there is need for more acute molecular studies underlying late effects of hadron therapy.2

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Combination of photon and proton radiation therapy for chordomas and chondrosarcomas of the skull base: the Centre de Protonthérapie D’Orsay experience

Cited by 141 publications

References 40 publications

Incidence and relative survival of chordomas

Incidence and relative survival of chordomas

Hyperfractionated high-dose proton beam radiotherapy for clival chordomas after surgical removal

Late effects from hadron therapy

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