Department of Radiation Oncology, Hyogo Ion Beam Medical Center Kobe Proton Center, Kobe, Japan; Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan.
QST Hospital, Quantum Medical Science Directorate, National Institute for Quantum and Radiological Sciences and Technology, Chiba, Japan.
Radiother Oncol. 2021 Jan;154:1-5. doi: 10.1016/j.radonc.2020.09.018. Epub 2020 Sep 14.
Usefulness of carbon ion radiotherapy (CIRT) for sacral chordoma has been reported from single institutions. We conducted a retrospective nationwide multicentre study to evaluate the clinical outcomes of CIRT for sacral chordoma in Japan.
A total of 219 patients who underwent CIRT for sacral chordoma at institutions across Japan between December 2003 and July 2014 were included in this study.
Median patient age was 67 years (range, 26-87 years). Most patients had no history of surgical resection (96%). The most frequent planning target volume (PTV) range was 100-500 mL (65%). The most frequently used dose-fractionation was 67.2 Gy (relative biological effectiveness) in 16 fractions (65%). The median follow-up was 56 months (range, 7-132 months). The 5-year overall survival (OS), progression-free survival, and local control rates were 84%, 48%, and 72%, respectively. Frequent sites of out-of-field recurrence included bone (9%) and lung (9%) metastases. The Cox proportional hazards model revealed that both younger age (P = 0.004) and smaller PTV (P = 0.001) were associated with significantly better OS. Acute toxicities of ≥Grade 3 occurred in eight patients (4%). Late toxicities of ≥Grade 3 occurred in 13 patients (6%): skin disorders in six patients (3%), pain in three (1%), myositis in three (1%), etc. CONCLUSION: Our retrospective nationwide multicentre study showed that CIRT for sacral chordoma was effective and safe, and replicated the previously reported data from a representative CIRT institution in Japan demonstrating high local control and low toxicity rates.
已有单机构报道碳离子放疗（CIRT）治疗骶骨脊索瘤的有效性。我们开展了一项回顾性全国多中心研究，以评估日本 CIRT 治疗骶骨脊索瘤的临床结果。
本研究纳入了 2003 年 12 月至 2014 年 7 月期间在日本各地机构接受 CIRT 治疗的 219 例骶骨脊索瘤患者。
中位患者年龄为 67 岁（范围，26-87 岁）。大多数患者无手术切除史（96%）。最常见的计划靶区（PTV）范围为 100-500mL（65%）。最常采用的剂量分割为 16 次 67.2Gy（相对生物效应）（65%）。中位随访时间为 56 个月（范围，7-132 个月）。5 年总生存率（OS）、无进展生存率和局部控制率分别为 84%、48%和 72%。场外出现复发的常见部位包括骨（9%）和肺（9%）转移。Cox 比例风险模型显示，年龄较小（P=0.004）和 PTV 较小（P=0.001）与 OS 显著改善相关。8 例患者发生≥3 级急性毒性（4%）。13 例患者发生≥3 级迟发性毒性（6%）：6 例皮肤疾病（3%）、3 例疼痛（1%）、3 例肌炎（1%）等。
本回顾性全国多中心研究表明，CIRT 治疗骶骨脊索瘤有效且安全，复制了日本一家代表性 CIRT 机构的既往报道数据，表明其局部控制率高、毒性低。
