Proton Therapy for Skull-Base Chordomas and Chondrosarcomas: Initial Results From the Beaumont Proton Therapy Center

Parzen, Jacob S; Li, Xiaoqiang; Zheng, Weili; Ding, Xuanfeng; Kabolizadeh, Peyman

doi:10.7759/cureus.15278

Cited by 4 publications

(2 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Application of proton therapy with simultaneous integrated boost for these malignancies made possible to deliver radical doses to target volumes while minimizing toxicity for organs at risk. This treatment approach affords excellent local disease control while sparing normal surrounding structures [22].…”

Section: Chordoma Of the Skull Base And Spinementioning

confidence: 99%

Proton beam therapy

et al. 2021

View full text Add to dashboard Cite

Proton beam therapy (PBT) is an advanced type of radiotherapy that shows a dosimetric advantage over photon beam therapy and provides superior dose distribution. PBT may improve patient survival by improving the local disease control while reducing toxicity to normal organs, which may result in fewer treatment related complications. During the last decade technological progress opened up new possibilities in the planning and conducting PBT, so indications were gradually expanded to different cancers. However, many biological aspects of PBT are still unclear, and its role in clinical settings is controversial. Proton therapy is considered to be safe and effective for different types of pediatric cancers, and that it is suitable in treatment of ocular melanomas, chordomas and chondrosarcomas. Future research and more prospective clinical studies with long term follow up are required in order to clearly determine the benefits and proper indications for PBT.

show abstract

Section: Chordoma Of the Skull Base And Spinementioning

confidence: 99%

Proton beam therapy

et al. 2021

View full text Add to dashboard Cite

show abstract

“…To date, medical centers worldwide have gathered more information about the effects of PT used as either radical or adjuvant therapy in skull base chordomas and chondrosarcomas (17)(18)(19). However, access to PT is still limited and much more costly compared with conventional photon therapy; thus, the included patients in some existing systematic reviews were not purely receiving PT.…”

Section: Introductionmentioning

confidence: 99%

Pure proton therapy for skull base chordomas and chondrosarcomas: A systematic review of clinical experience

Nie

Chen²,

Zhang³

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

BackgroundSkull base chordoma and chondrosarcoma are exceptionally rare bone tumors with high propensity for local recurrence. Different postoperative radiation modalities are often used to improve the clinical efficacy. Proton therapy (PT) might be among the most promising ones because of the unique ballistic characteristics of high-energy particles. However, previous meta-analysis often included studies with combined radiation techniques. No systematic review to date has directly analyzed the survival and toxicity of pure PT for these two types of malignancies.MethodsBy following the PRISMA guidelines, a systematic search of three databases was conducted. Articles were screened and data were extracted according to a prespecified scheme. R 4.2.0 software was used to conduct the meta-analysis. Normal distribution test was used for the incidence rate of each subgroup.ResultsA total of seven studies involving 478 patients were included in this analysis. The quality of included articles ranged from moderate to high quality. All patients were histopathologically diagnosed with chordoma or chondrosarcoma, and the follow-up time of the cohort ranged from 21 to 61.7 months. For PT planning, the median target volume ranged from 15 cc to 40 cc, and the administered median dose varied from 63 to 78.4 GyRBE at 1.8–2.0 GyRBE per fraction. The 1-, 2-, 3-, 5-, and 7-year local control and overall survival rates were 100%, 93%, 87%, 78%, and 68%, and 100%, 99%, 89%, 85%, and 68%, respectively. The late grade 3 or higher toxicities were reported in only two involved articles.ConclusionsUntil now, medical centers worldwide have exerted PT to improve outcomes of skull base chordomas and chondrosarcomas. PT not combined with other radiation modalities showed favorable local control and survival with a low incidence of severe radiation-induced toxicities, which manifests promising clinical benefits. However, high-quality evidence is still limited, requiring future clinical trials and prospective studies in selected patients.

show abstract

Robust IMPT and follow-up toxicity in skull base chordoma and chondrosarcoma—a single-institution clinical experience

Miladinovic,

Klaver,

Krol

et al. 2024

Strahlenther Onkol

View full text Add to dashboard Cite

Background Chordomas and chondrosarcomas of the skull base are rare, slowly growing malignant bone neoplasms. Despite their radioresistant properties, proton therapy has been successfully used as an adjunct to resection or as a definitive treatment. Herewith, we present our experience with robustly optimized intensity-modulated proton therapy (IMPT) and related toxicities in skull base chordoma and chondrosarcoma patients treated at HollandPTC, Delft, the Netherlands. Methods Clinical data, treatment plans, and acute toxicities of patients treated between July 2019 and August 2021 were reviewed. CT and 3.0T MRI scans for treatment planning were performed in supine position in a thermoplastic mold. In total, 21 dose optimization and 28 dose evaluation scenarios were simulated. Acute toxicity was scored weekly before and during the treatment according to the CTCAE v4.0. Median follow-up was 35 months (range 12–36 months). Results Overall, 9 chordoma and 3 chondrosarcoma patients with 1–3 resections prior to IMPT were included; 4 patients had titanium implants. Brainstem core and surface and spinal cord core and surface were used for nominal plan robust optimization in 11, 10, 8, and 7 patients, respectively. Middle ear inflammation, dry mouth, radiation dermatitis, taste disorder, and/or alopecia of grades 1–3 were noted at the end of treatment among 6 patients without similar complaints at inclusion; symptoms disappeared 3 months following the treatment. Conclusion Robustly optimized IMPT is clinically feasible as a postoperative treatment for skull base chordoma and chondrosarcoma patients. We observed acceptable early toxicities (grade 1–3) that disappeared within the first 3 months after irradiation.

show abstract

Proton Therapy for Skull-Base Chordomas and Chondrosarcomas: Initial Results From the Beaumont Proton Therapy Center

Cited by 4 publications

References 22 publications

Proton beam therapy

Proton beam therapy

Pure proton therapy for skull base chordomas and chondrosarcomas: A systematic review of clinical experience

Robust IMPT and follow-up toxicity in skull base chordoma and chondrosarcoma—a single-institution clinical experience

Contact Info

Product

Resources

About