Carbon ion radiotherapy of skull base chondrosarcomas

Schulz-Ertner, Daniela; Nikoghosyan, Anna; Hof, Holger; Didinger, Bernd; Combs, Stephanie E.; Jäkel, Oliver; Karger, Christian P.; Edler, Lutz; Debus, Jürgen

doi:10.1016/j.ijrobp.2006.08.027

Cited by 169 publications

(80 citation statements)

References 32 publications

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“…13 Our results of 54 patients after carbon ion therapy were first published by Schulz-Ertner in 2007, with a reported 3-year LC rate of 96.2%. 10 However, in the aforementioned studies, either the collectives were very small and/or the follow-up period was shorter than in the current study. Nevertheless, the current updated results of 79 patients delivered comparable findings, with 3-year, 5-year, and 10-year LC rates of 95.9%, 88%, and 88%, respectively.…”

Section: Discussionmentioning

confidence: 55%

High control rate in patients with chondrosarcoma of the skull base after carbon ion therapy: First report of long‐term results

Uhl

Mattke

Welzel

et al. 2014

Cancer

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BACKGROUND:The current study was performed to evaluate the safety and effectiveness of irradiation with carbon ions using raster scanning as well as prognostic factors in patients with skull base chondrosarcomas. METHODS: Between 1998 and 2008, 79 patients with chondrosarcoma of the skull base were treated using carbon ions in raster scanning. The applied median total dose was 60 gray equivalent (GyE) at 3 GyE per fraction. Local control and overall survival (OS) were evaluated using the Kaplan-Meier method. Longterm toxicity was quantitatively assessed using questionnaires. RESULTS: The median follow-up after irradiation was 91 months (range, 3 months-175 months). Within the follow-up, 10 patients developed local disease recurrence. The 3-year, 5-year, and 10-year local control rates were 95.9%, 88%, and 88%, respectively; the corresponding OS rates were 96.1%, 96.1%, and 78.9%, respectively. With a median follow-up of 110 months after first diagnosis, the corresponding 3-year, 5-year, and 10-year OS rates were 97.5%, 97.5%, and 91.5%, respectively. Age 45 years and boost volume 55 mL were associated with significantly better local control rates. We observed a clinically relevant improvement in cranial nerve deficits 7 to 10 years after treatment (range, 45.5%-53.3%) compared with the baseline (73.4%). During follow-up, none of the patients in the current study developed a secondary malignancy. CONCLUSIONS: Carbon ion therapy is a safe and effective treatment in patients with chondrosarcoma of the skull base. For further evaluation, a prospective randomized phase 3 trial comparing protons versus carbon ions has been recruiting patients with low-grade and intermediate-grade chondrosarcoma of the skull base since 2009. Cancer 2014;120:1579-85.

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Section: Discussionmentioning

confidence: 55%

High control rate in patients with chondrosarcoma of the skull base after carbon ion therapy: First report of long‐term results

Uhl

Mattke

Welzel

et al. 2014

Cancer

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“…Another analysis by colleagues from the Paul Scherrer Institute (Villigen, Switzerland) of 18 patients with chordoma and 11 patients with chondrosarcoma (total doses applied: 74 or 68 GyE protons) reported 3-year LCs of 87.5% and 100%, respectively [25]. Similar results were achieved by the application of 12 C heavy ions: 54 patients with chondrosarcoma (median dose 60 GyE) achieved LCs of 96.2% and 89.8% at 3 and 4 years, respectively [5]. This treatment was accompanied by very mild toxicity (> ‡3: 1.9%).…”

Section: Base Of Skull Tumours: Chordoma and Chondrosarcomamentioning

confidence: 61%

“…The results of the Heidelberg-GSI co-operation show that carbon-ion treatment yielded excellent local control (LC) and overall survival (OS) rates for patients with chondrosarcoma (LC 89.8% at 4 years, OS 98.2% at 5 years) [5] or chordoma (LC 70% at 5 years, OS 88.5% at 5 years) [6]. Furthermore, the treatment was associated with only very mild side effects [no late toxicity: National Cancer Institute Common Toxicity Criteria (CTC) score .…”

Section: Introductionmentioning

confidence: 99%

Review of clinical experience with ion beam radiotherapy

Jensen

Münter²,

Debus³

2011

BJR

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ABSTRACT. The article describes both the early development of oncology as a core discipline at the University of Heidelberg Hospital and the first steps towards ion beam treatment, from the pilot project carried out in co-operation with the Gesellschaft fü r Schwerionenforschung Darmstadt to the initial start-up of clinical service at the Heidelberg Heavy Ion Centre (HIT). We present an overview, based on data published in the literature, of the available clinical evidence relating the use of ion beam therapy to treat major indications in active particle centres. A rationale for the use of particle therapy in each of these indications is given. In view of the limited availability of data, we discuss the necessity to conduct clinical trials. We also look forward towards the next activities to be undertaken at the HIT.

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“…However, even though carbon ions are known to produce favorable clinical outcomes in selected cases, such as head and neck radioresistant tumors, no clinical evidence to support the advantages of carbon ions over protons and photons is available yet, and randomized clinical trials are needed. [12][13][14] Until then, carbon ion radiotherapy should be, therefore, considered as an experimental treatment modality.…”

Section: Introductionmentioning

confidence: 99%

Dosimetric characterization of a microDiamond detector in clinical scanned carbon ion beams

et al. 2015

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Purpose: To investigate for the first time the dosimetric properties of a new commercial synthetic diamond detector (PTW microDiamond) in high-energy scanned clinical carbon ion beams generated by a synchrotron at the CNAO facility. Methods: The detector response was evaluated in a water phantom with actively scanned carbon ion beams ranging from 115 to 380 MeV/u (30-250 mm Bragg peak depth in water). Homogeneous square fields of 3 × 3 and 6 × 6 cm 2 were used. Short-and medium-term (2 months) detector response stability, dependence on beam energy as well as ion type (carbon ions and protons), linearity with dose, and directional and dose-rate dependence were investigated. The depth dose curve of a 280 MeV/u carbon ion beam, scanned over a 3 × 3 cm 2 area, was measured with the microDiamond detector and compared to that measured using a PTW Advanced Markus ionization chamber, and also simulated using  Monte Carlo code. The detector response in two spread-out-Bragg-peaks (SOBPs), respectively, centered at 9 and 21 cm depths in water and calculated using the treatment planning system (TPS) used at CNAO, was measured. Results: A negligible drift of detector sensitivity within the experimental session was seen, indicating that no detector preirradiation was needed. Short-term response reproducibility around 1% (1 standard deviation) was found. Only 2% maximum variation of microDiamond sensitivity was observed among all the evaluated proton and carbon ion beam energies. The detector response showed a good linear behavior. Detector sensitivity was found to be dose-rate independent, with a variation below 1.3% in the evaluated dose-rate range. A very good agreement between measured and simulated Bragg curves with both microDiamond and Advanced Markus chamber was found, showing a negligible LET dependence of the tested detector. A depth dose curve was also measured by positioning the microDiamond with its main axis oriented orthogonally to the beam direction. A strong distortion in Bragg peak measurement was observed, confirming manufacturer recommendation on avoiding such configuration. Very good results were obtained for SOBP measurements, with a difference below 1% between measured and TPS-calculated doses. The stability of detector sensitivity in the observation period was within the experimental uncertainty. Conclusions: Dosimetric characterization of a PTW microDiamond detector in high-energy scanned carbon ion beams was performed. The results of the present study showed that this detector is suitable for dosimetry of clinical carbon ion beams, with a negligible LET and dose-rate dependence. C 2015 American Association of Physicists in Medicine. [http://dx

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Carbon ion radiotherapy of skull base chondrosarcomas

Cited by 169 publications

References 32 publications

High control rate in patients with chondrosarcoma of the skull base after carbon ion therapy: First report of long‐term results

High control rate in patients with chondrosarcoma of the skull base after carbon ion therapy: First report of long‐term results

Review of clinical experience with ion beam radiotherapy

Dosimetric characterization of a microDiamond detector in clinical scanned carbon ion beams

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