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碳离子放疗治疗颅外脊索瘤或软骨肉瘤患者——来自上海质子重离子中心的初步经验

Carbon Ion Radiotherapy for Patients with Extracranial Chordoma or Chondrosarcoma - Initial Experience from Shanghai Proton and Heavy Ion Center.

作者信息

Wu Shuang, Li Ping, Cai Xin, Hong Zhengshan, Yu Zhan, Zhang Qing, Fu Shen

机构信息

Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201321, China.

Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China.

出版信息

J Cancer. 2019 Jun 2;10(15):3315-3322. doi: 10.7150/jca.29667. eCollection 2019.

Abstract

: The purpose of this study was to evaluate the outcomes of patients with extracranial chordoma or chondrosarcoma treated by carbon ion radiotherapy (CIRT). : Between May 2015 and April 2018, 21 consecutive patients with chordoma (n=16) or chondrosarcoma (n=5) treated by CIRT at Shanghai Proton and Heavy Ion Center (SPHIC) were enrolled. The local control (LC), progression free survival (PFS), and overall survival (OS) rates were estimated using the Kaplan-Meier method. Association between each of the candidate prognostic factors and the estimated LC, PFS or OS was tested using the log rank test. : The median gross tumor volume (GTV) was 512.7 ml (range, 142.6-2893.0 ml). The median prescription dose was 69 gray equivalent (GyE) (range, 57-80 GyE). After a median follow-up of 21.8 months (range, 7.2-39.2 months), the 1-year LC, PFS, and OS were 93.8%, 88.4%, and 100%, respectively, whereas the 2-year LC, PFS, and OS were 85.2%, 80.4%, and 100%, respectively. A univariate analysis revealed that age, metal implant status, treatment status, sex, dose, and GTV were not significant prognostic factors for LC, PFS or OS. No grade 2 or higher early and late toxicities were observed within the follow-up. : The results of this retrospective study are encouraging. Patients with extracranial chordoma or chondrosarcoma treated by CIRT in our center achieved a favorable shot-term outcome, without developing severe acute or late adverse events. The long-term results deserve further investigation, even in a prospective randomized trial.

摘要

本研究的目的是评估接受碳离子放疗(CIRT)的颅外脊索瘤或软骨肉瘤患者的治疗结果。2015年5月至2018年4月,上海质子重离子中心(SPHIC)连续收治了21例接受CIRT治疗的脊索瘤患者(n = 16)或软骨肉瘤患者(n = 5)。采用Kaplan-Meier法估计局部控制率(LC)、无进展生存率(PFS)和总生存率(OS)。使用对数秩检验来检验每个候选预后因素与估计的LC、PFS或OS之间的相关性。中位肿瘤总体积(GTV)为512.7 ml(范围为142.6 - 2893.0 ml)。中位处方剂量为69戈瑞当量(GyE)(范围为57 - 80 GyE)。中位随访21.8个月(范围为7.2 - 39.2个月)后,1年的LC、PFS和OS分别为93.8%、88.4%和100%,而2年的LC、PFS和OS分别为85.2%、80.4%和100%。单因素分析显示,年龄、金属植入物状态、治疗状态、性别、剂量和GTV不是LC、PFS或OS的显著预后因素。随访期间未观察到2级或更高等级的早期和晚期毒性反应。这项回顾性研究的结果令人鼓舞。在我们中心接受CIRT治疗的颅外脊索瘤或软骨肉瘤患者取得了良好的短期治疗结果,且未发生严重的急性或晚期不良事件。即使在一项前瞻性随机试验中,长期结果也值得进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e71c/6603407/28557afc7e7d/jcav10p3315g001.jpg

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