Proton Therapy Center, Sapporo Teishinkai Hospital, 3-1, East-1, North-33, Higashi-ku, Sapporo, Hokkaido, 065-0033, Japan.
Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan.
Radiat Oncol. 2018 Nov 26;13(1):232. doi: 10.1186/s13014-018-1173-0.
The usefulness of particle therapy for skull base chordoma has not been established. The aim of this retrospective study was to analyse the treatment outcomes of proton therapy (PT) and carbon ion therapy (CIT) in patients with skull base chordoma at a single institution.
All patients who underwent PT or CIT with curative intent between 2003 and 2014 at Hyogo Ion Beam Medical Center were included in this study. Twenty-four patients were enrolled. Eleven (46%) received PT and 13 (54%) received CIT. Overall survival (OS), progression-free survival (PFS) and local control (LC) were calculated using the Kaplan-Meier method. Late toxicities were evaluated according to the Common Terminology Criteria for Adverse Events version 4.0.
The median follow-up was 71.5 months (range, 14-175 months). The five-year LC, PFS and OS rates were 85, 81, and 86%, respectively. The LC (P = 0.048), PFS (P = 0.028) and OS (P = 0.012) were significantly improved in patients who had undergone surgery before particle therapy. No significant differences were observed in the LC rate and the incidence of grade 2 or higher late toxicities between patients who received PT and CIT.
Both PT and CIT appear to be effective and safe treatments and show potential to become the standard treatments for skull base chordoma. To increase the local control, surgery before particle therapy is preferable.
粒子治疗在颅底脊索瘤中的有效性尚未得到证实。本回顾性研究的目的是分析单机构内质子治疗（PT）和碳离子治疗（CIT）治疗颅底脊索瘤患者的治疗结果。
本研究纳入了 2003 年至 2014 年期间在兵库离子束医疗中心接受根治性 PT 或 CIT 的所有患者。共纳入 24 例患者。11 例（46%）接受 PT，13 例（54%）接受 CIT。采用 Kaplan-Meier 法计算总生存率（OS）、无进展生存率（PFS）和局部控制率（LC）。根据通用不良事件术语标准 4.0 评估晚期毒性。
中位随访时间为 71.5 个月（范围 14-175 个月）。5 年 LC、PFS 和 OS 率分别为 85%、81%和 86%。PT 前手术的患者 LC（P=0.048）、PFS（P=0.028）和 OS（P=0.012）均显著改善。PT 和 CIT 患者的 LC 率和 2 级或以上晚期毒性发生率无显著差异。
PT 和 CIT 均为有效且安全的治疗方法，有可能成为颅底脊索瘤的标准治疗方法。为提高局部控制率，PT 前手术是优选。
