Igaki Hiroshi, Tokuuye Koichi, Okumura Toshiyuki, Sugahara Shinji, Kagei Kenji, Hata Masaharu, Ohara Kiyoshi, Hashimoto Takayuki, Tsuboi Koji, Takano Shingo, Matsumura Akira, Akine Yasuyuki
Proton Medical Research Center, University Hospital, University of Tsukuba, Ibaraki, Japan.
Int J Radiat Oncol Biol Phys. 2004 Nov 15;60(4):1120-6. doi: 10.1016/j.ijrobp.2004.05.064.
To evaluate clinical results of proton beam therapy for patients with skull base chordoma.
Thirteen patients with skull base chordoma who were treated with proton beams with or without X-rays at the University of Tsukuba between 1989 and 2000 were retrospectively reviewed. A median total tumor dose of 72.0 Gy (range, 63.0-95.0 Gy) was delivered. The patients were followed for a median period of 69.3 months (range, 14.6-123.4 months).
The 5-year local control rate was 46.0%. Cause-specific, overall, and disease-free survival rates at 5 years were 72.2%, 66.7%, and 42.2%, respectively. The local control rate was higher, without statistical significance, for those with preoperative tumors <30 mL. Partial or subtotal tumor removal did not yield better local control rates than for patients who underwent biopsy only as the latest surgery.
Proton beam therapy is effective for patients with skull base chordoma, especially for those with small tumors. For a patient with a tumor of <30 mL with no prior treatment, biopsy without tumor removal seems to be appropriate before proton beam therapy.
评估质子束治疗颅底脊索瘤患者的临床疗效。
回顾性分析了1989年至2000年间在筑波大学接受质子束治疗（有或无X射线辅助）的13例颅底脊索瘤患者。中位总肿瘤剂量为72.0 Gy（范围63.0 - 95.0 Gy）。对患者进行了中位时长69.3个月（范围14.6 - 123.4个月）的随访。
5年局部控制率为46.0%。5年的病因特异性生存率、总生存率和无病生存率分别为72.2%、66.7%和42.2%。术前肿瘤体积<30 mL的患者局部控制率较高，但无统计学意义。部分或次全肿瘤切除后的局部控制率并不比仅接受活检作为最新手术的患者更高。
质子束治疗对颅底脊索瘤患者有效，尤其是对肿瘤较小的患者。对于肿瘤体积<30 mL且未接受过先前治疗的患者，在质子束治疗前，仅进行活检而不切除肿瘤似乎是合适的。
