高剂量碳离子放射治疗不可切除的上颈椎（C1-2）脊索瘤的长期疗效
Long-term outcomes of high dose carbon-ion radiation therapy for unresectable upper cervical (C1-2) chordoma.
作者信息
Aoki Shuri, Koto Masashi, Ikawa Hiroaki, Imai Reiko, Tokuhiko Omatsu, Shinoto Makoto, Takiyama Hirotoshi, Yamada Shigeru, Tsuji Hiroshi
机构信息
QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan.
Department of Radiology, University of Tokyo Hospital, Tokyo, Japan.
出版信息
Head Neck. 2022 Oct;44(10):2162-2170. doi: 10.1002/hed.27127. Epub 2022 Jun 23.
BACKGROUND
Chordoma is a rare, locally invasive neoplasm of the axial skeleton. Complete resection is often difficult, especially for the upper-cervical (C1-2) spine. We evaluated the efficacy and safety of carbon-ion radiotherapy (CIRT) for unresectable C1-2 chordoma.
METHODS
Patients with C1-2 chordoma treated with definitive CIRT (60.8 Gy [RBE] in 16 fractions) were retrospectively analyzed. We evaluated OS, LC, PFS, and toxicity.
RESULTS
Nineteen eligible patients all completed the planned course of CIRT. With the median follow-up 68 months (range: 29-144), median OS was 126 months (range: 36-NA). Five-year OS, LC, and PFS were 68.4% (95% CI, 42.8%-84.4%), 75.2% (46.1%-90.0%), and 64.1% (36.3%-82.3%), respectively. Regarding acute toxicity of grade ≥3, there was only one grade 3 mucositis. Late toxicity included radiation-induced myelitis (grade 3 in 1 patient; 5.3%), and compression fractures (n = 5; 26.3%).
CONCLUSIONS
High-dose CIRT is a promising treatment option for unresectable upper cervical chordoma.
背景
脊索瘤是一种罕见的、局部侵袭性的中轴骨肿瘤。完整切除往往很困难，尤其是对于上颈椎（C1-2）脊柱的脊索瘤。我们评估了碳离子放疗（CIRT）治疗不可切除的C1-2脊索瘤的疗效和安全性。
方法
对接受确定性CIRT（16次分割，总剂量60.8 Gy [RBE]）治疗的C1-2脊索瘤患者进行回顾性分析。我们评估了总生存期（OS）、局部控制率（LC）、无进展生存期（PFS）和毒性反应。
结果
19例符合条件的患者均完成了计划的CIRT疗程。中位随访68个月（范围：29-144个月），中位OS为126个月（范围：36个月至未达到）。5年OS、LC和PFS分别为68.4%（95%CI，42.8%-84.4%）、75.2%（46.1%-90.0%）和64.1%（36.3%-82.3%）。关于≥3级的急性毒性反应，仅出现1例3级黏膜炎。晚期毒性反应包括放射性脊髓炎（1例3级；5.3%）和压缩性骨折（n = 5；26.3%）。
结论
高剂量CIRT是不可切除的上颈椎脊索瘤的一种有前景的治疗选择。
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