Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany.
Cancer. 2014 May 15;120(10):1579-85. doi: 10.1002/cncr.28606. Epub 2014 Feb 5.
The current study was performed to evaluate the safety and effectiveness of irradiation with carbon ions using raster scanning as well as prognostic factors in patients with skull base chondrosarcomas.
Between 1998 and 2008, 79 patients with chondrosarcoma of the skull base were treated using carbon ions in raster scanning. The applied median total dose was 60 gray equivalent (GyE) at 3 GyE per fraction. Local control and overall survival (OS) were evaluated using the Kaplan-Meier method. Long-term toxicity was quantitatively assessed using questionnaires.
The median follow-up after irradiation was 91 months (range, 3 months-175 months). Within the follow-up, 10 patients developed local disease recurrence. The 3-year, 5-year, and 10-year local control rates were 95.9%, 88%, and 88%, respectively; the corresponding OS rates were 96.1%, 96.1%, and 78.9%, respectively. With a median follow-up of 110 months after first diagnosis, the corresponding 3-year, 5-year, and 10-year OS rates were 97.5%, 97.5%, and 91.5%, respectively. Age ≤ 45 years and boost volume ≤ 55 mL were associated with significantly better local control rates. We observed a clinically relevant improvement in cranial nerve deficits 7 to 10 years after treatment (range, 45.5%-53.3%) compared with the baseline (73.4%). During follow-up, none of the patients in the current study developed a secondary malignancy.
Carbon ion therapy is a safe and effective treatment in patients with chondrosarcoma of the skull base. For further evaluation, a prospective randomized phase 3 trial comparing protons versus carbon ions has been recruiting patients with low-grade and intermediate-grade chondrosarcoma of the skull base since 2009.
本研究旨在评估使用光栅扫描进行碳离子照射的安全性和有效性，以及颅底软骨肉瘤患者的预后因素。
1998 年至 2008 年间，79 例颅底软骨肉瘤患者接受碳离子光栅扫描治疗。应用的中位总剂量为 60 格雷等效（GyE），每次 3 GyE。采用 Kaplan-Meier 法评估局部控制率和总生存率（OS）。采用问卷调查定量评估长期毒性。
放疗后中位随访时间为 91 个月（范围 3 个月-175 个月）。随访期间，10 例患者出现局部疾病复发。3 年、5 年和 10 年局部控制率分别为 95.9%、88%和 88%；相应的 OS 率分别为 96.1%、96.1%和 78.9%。首次诊断后中位随访 110 个月，相应的 3 年、5 年和 10 年 OS 率分别为 97.5%、97.5%和 91.5%。年龄≤45 岁和增强体积≤55 mL 与局部控制率显著提高相关。与基线（73.4%）相比，治疗后 7 至 10 年（范围 45.5%-53.3%）颅神经缺损有明显改善。在随访期间，本研究中没有患者发生继发性恶性肿瘤。
碳离子治疗是颅底软骨肉瘤患者安全有效的治疗方法。为了进一步评估，自 2009 年以来，一项比较质子与碳离子的低级别和中级别颅底软骨肉瘤的前瞻性随机 3 期临床试验正在招募患者。
