Highly effective treatment of skull base chordoma with carbon ion irradiation using a raster scan technique in 155 patients: first long-term results.

Abstract

BACKGROUND:

The current study was conducted to evaluate the long-term results of irradiation with carbon ions in a raster scanning technique in patients with skull base chordomas.

METHODS:

Between 1998 and 2008, a total of 155 patients (76 men and 79 women) with a median age of 48 years (range, 15 years-85 years) were irradiated with carbon ions using a raster scan technique. The irradiation was performed at the Society for Heavy Ion Research in Darmstadt, Germany. The median total dose was 60 gray (relative biological effectiveness) at 3 gray (relative biological effectiveness) per fraction. The median boost planning target volume was 70 mL (range, 2 mL-294 mL). Local control (LC) and overall survival (OS) were evaluated using the Kaplan-Meier method, whereas long-term toxicity was evaluated via questionnaires.

RESULTS:

The median follow-up was 72 months (range, 12 months-165 months). All patients had residual macroscopic tumors at the initiation of radiotherapy. The authors observed 55 local recurrences during follow-up, as well as systemic disease progression in 4 patients. The resulting 3-year, 5-year, and 10-year LC rates were 82%, 72%, and 54%, respectively, whereas the 3-year, 5-year, and 10-year OS rates were 95%, 85%, and 75%, respectively. Age <48 years and a boost volume >75 mL were associated with a significantly improved LC and OS. Primary treatment resulted in a significantly better OS probability. No higher late toxicity could be detected after carbon ion treatment.

CONCLUSIONS:

Carbon ion therapy appears to be a safe and effective treatment for patients with skull base chordoma, resulting in high LC and OS rates.

• Authors: Matthias Uhl, Matthias Mattke, Thomas Welzel, Falk Roeder, Jan Oelmann, Gregor Habl, Alexandra Jensen, Malte Ellerbrock, Oliver Jäkel, Thomas Haberer, Klaus Herfarth, Jürgen Debus
• Journal: Cancer (Cancer) Vol. 120 Issue 21 Pg. 3410-7 (Nov 01 2014) ISSN: 1097-0142 [Electronic] United States
• PMID: 24948519 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2014 American Cancer Society.

Chemical References

• Carbon Radioisotopes

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Carbon Radioisotopes (adverse effects, therapeutic use)
• Chordoma (pathology, radiotherapy)
• Female
• Follow-Up Studies
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Skull Base Neoplasms (pathology, radiotherapy)