Proton Therapy Centre Czech, Prague, Czech Republic.
Department of Oncology, 2nd Faculty of Medicine, Charles University Prague and Motol University Hospital, Prague, Czech Republic.
J Med Radiat Sci. 2022 Dec;69(4):456-462. doi: 10.1002/jmrs.612. Epub 2022 Aug 16.
Glomus jugulare tumours (GJT) are benign tumours that arise locally and destructively in the base of the skull and can be successfully treated with radiotherapy. Patients have a long-life expectancy and the late effects of radiotherapy can be serious. Proton radiotherapy reduces doses to critical organs and can reduce late side effects of radiotherapy. The aim of this study was to report feasibility and early clinical results of 12 patients treated using proton therapy.
Between December 2013 and June 2019, 12 patients (pts) with GJT (median volume 20.4 cm ; range 8.5-41 cm ) were treated with intensity modulated proton therapy (IMPT). Median dose was 54 GyE (Gray Equivalents) (50-60 GyE) with daily fractions of 2 GyE. Twelve patients were analysed with a median follow-up time of 42.2 months (11.3-86.7). Feasibility, dosimetric parameters, acute and late toxicity and local effect on tumour were evaluated in this retrospective study.
All patients finished treatment without interruption, with excellent dosimetric parameters and mild acute toxicity. Stabilisation of tumour size was detected on MRI in all patients. No changes in symptoms were observed in comparison with pre-treatment conditions. No late effects of radiotherapy were observed.
Pencil-beam scanning proton radiotherapy is highly feasible in the treatment of large GJT with mild acute toxicity and promising short-term results. Longer follow-up and larger patient cohorts are required to further identify the role of pencil-beam scanning (PBS) for this indication.
颈静脉球体瘤(GJT)是一种良性肿瘤,起源于颅底并具有局部侵袭性,可通过放射治疗成功治疗。患者预期寿命较长,放射治疗的晚期副作用可能很严重。质子放射治疗可降低关键器官的剂量,并可减少放射治疗的晚期副作用。本研究旨在报告 12 例采用质子治疗的患者的可行性和早期临床结果。
在 2013 年 12 月至 2019 年 6 月期间,12 例 GJT 患者(中位数体积 20.4cm3;范围 8.5-41cm3)接受了强度调制质子治疗(IMPT)。中位数剂量为 54 GyE(格雷当量)(50-60 GyE),每日剂量为 2 GyE。12 例患者接受了中位数为 42.2 个月(11.3-86.7)的随访。本回顾性研究评估了可行性、剂量学参数、急性和晚期毒性以及肿瘤局部效应。
所有患者均顺利完成治疗,无中断,剂量学参数良好,急性毒性轻微。所有患者的 MRI 均显示肿瘤大小稳定。与治疗前相比,症状无变化。未观察到放射治疗的晚期效应。
在治疗大型 GJT 时,铅笔束扫描质子放射治疗具有高度可行性,急性毒性轻微,短期效果良好。需要更长的随访时间和更大的患者队列来进一步确定铅笔束扫描(PBS)在该适应证中的作用。