Riva Giulia, Cavallo Iacopo, Gandini Sara, Ingargiola Rossana, Pecorilla Mattia, Imparato Sara, Rossi Eleonora, Mirandola Alfredo, Ciocca Mario, Orlandi Ester, Iannalfi Alberto
Clinical Department, National Center for Oncological Hadrontherapy (CNAO), 27100 Pavia, Italy.
Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy.
Cancers (Basel). 2021 Sep 2;13(17):4423. doi: 10.3390/cancers13174423.
The standard treatment for skull base chondrosarcoma (SB-CHS) consists of surgery and high-dose radiation therapy. Our aim was to evaluate outcome in terms of local control (LC) and toxicity of proton therapy (PT) and carbon ion (CIRT) after surgery.
From September 2011 to July 2020, 48 patients underwent particle therapy (67% PT, 33% CIRT) for SB-CHS. PT and CIRT total dose was 70 GyRBE (relative biological effectiveness) in 35 fractions and 70.4 GyRBE in 16 fractions, respectively. Toxicity was assessed using the Common Terminology Criteria for Adverse Events (CTCAE v5).
After a median follow-up time of 38 months, one local failure (2%) was documented and the patient died for progressive disease. Overall, 3-year LC was 98%. One (2%) and 4 (8%) patients experienced G3 acute and late toxicity, respectively. White-matter brain changes were documented in 22 (46%) patients, but only 7 needed steroids (G2). No patients had G3 brain toxicity. No G4-5 complications were reported. We did not find any correlation between high-grade toxicity or white-matter changes and characteristics of patients, disease and surgery.
PT and CIRT appeared to be effective and safe treatments for patients with SB-CHS, resulting in high LC rates and an acceptable toxicity profile.
颅底软骨肉瘤(SB-CHS)的标准治疗包括手术和高剂量放射治疗。我们的目的是评估手术后质子治疗(PT)和碳离子治疗(CIRT)在局部控制(LC)和毒性方面的疗效。
2011年9月至2020年7月,48例患者接受了针对SB-CHS的粒子治疗(67%为PT,33%为CIRT)。PT和CIRT的总剂量分别为35次分割70 Gy相对生物效应(RBE)和16次分割70.4 Gy RBE。使用不良事件通用术语标准(CTCAE v5)评估毒性。
中位随访时间38个月后,记录到1例局部失败(2%),患者因疾病进展死亡。总体而言,3年局部控制率为98%。分别有1例(2%)和4例(8%)患者出现3级急性和晚期毒性。22例(46%)患者记录到脑白质改变,但仅7例需要使用类固醇(2级)。无患者出现3级脑毒性。未报告4-5级并发症。我们未发现高级别毒性或脑白质改变与患者、疾病及手术特征之间存在任何相关性。
PT和CIRT对SB-CHS患者似乎是有效且安全的治疗方法,可实现高局部控制率和可接受的毒性特征。