Fuji Hiroshi, Nakasu Yoko, Ishida Yuji, Horiguchi Satoshi, Mitsuya Koichi, Kashiwagi Hiroya, Murayama Shigeyuki
Skull Base. 2011 May;21(3):201-6. doi: 10.1055/s-0031-1275636.
We explored the general feasibility of proton beam therapy for chordoma and chondrosarcoma of the skull base. Clinical records and treatment-planning data of patients with the pathological diagnosis of chordoma or chondrosarcoma were examined. Proton beam therapy was administered for gross tumor mass as well as microscopic residual disease after surgery. The prescribed dose was determined to maximize the coverage of the target and to not exceed predefined constraints for the organs at risk. Eight cases of chordoma and eight cases of chondrosarcoma were enrolled. The median tumor volume was 40 cm(3) (range, 7 to 546 cm(3)). The prescribed dose ranged from 50 to 70 Gy (relative biological effectiveness [RBE]), with a median of 63 Gy RBE. The median follow-up duration was 42 months (range 9 to 80 months). The overall survival rate was 100%, and the local control rate at 3 years of chordoma and chondrosarcoma were 100% and 86%. None of the patients developed radiation-induced optic neuropathy, brain stem injury, or other severe toxicity. Proton beam therapy is generally feasible for both chordoma and chondrosarcoma of the skull base, with excellent local control and survival rates.
我们探讨了质子束治疗颅底脊索瘤和软骨肉瘤的总体可行性。对经病理诊断为脊索瘤或软骨肉瘤患者的临床记录和治疗计划数据进行了检查。质子束治疗用于治疗肉眼可见的肿瘤块以及术后显微镜下的残留病灶。规定剂量的确定是为了最大程度覆盖靶区，且不超过对危及器官的预定义限制。纳入了8例脊索瘤和8例软骨肉瘤患者。肿瘤体积中位数为40 cm³（范围为7至546 cm³）。规定剂量范围为50至70 Gy（相对生物效应[RBE]），中位数为63 Gy RBE。中位随访时间为42个月（范围为9至80个月）。总生存率为100%，脊索瘤和软骨肉瘤3年局部控制率分别为100%和86%。没有患者发生放射性视神经病变、脑干损伤或其他严重毒性反应。质子束治疗对于颅底脊索瘤和软骨肉瘤总体可行，局部控制率和生存率良好。
