Clinical outcome of proton therapy for patients with chordomas

Youn, Sang Hee; Cho, Kwan Ho; Kim, Joo-Young; Ha, Boram; Lim, Young Kyung; Jeong, Jee–Heon; Lee, Sang Hyun; Yoo, Heon; Gwak, Ho-Shin; Shin, Sang Hoon; Hong, Eun Kyung; Kim, Han Kyu; Hong, Jong Chul

doi:10.3857/roj.2018.00164

Cited by 13 publications

(11 citation statements)

References 19 publications

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“…Therefore, particle therapy is preferred over conventional radiotherapy therapy to deliver a sufficient dose to the designated site. The LC rate has been reported to be 69.7%–87.9% [ 31 – 34 ] with an OS rate range of 80%–88.3% at 5 years [ 31 – 33 ]. For sacral chordoma, a similar outcome has been reported for PBT [ 34 – 36 ].…”

Section: Clinical Applications Of Cptmentioning

confidence: 99%

“…The LC rate has been reported to be 69.7%–87.9% [ 31 – 34 ] with an OS rate range of 80%–88.3% at 5 years [ 31 – 33 ]. For sacral chordoma, a similar outcome has been reported for PBT [ 34 – 36 ]. Although direct comparison of photon and particle therapy has not been reported, a recent analysis of 863 patients with chordoma and chondrosarcoma from the National Cancer Center Database showed that PBT was associated with an improved OS compared to photon radiotherapy [ 37 ].…”

Section: Clinical Applications Of Cptmentioning

confidence: 99%

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Who Will Benefit from Charged-Particle Therapy?

Kim

2021

Cancer Res Treat

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Charged-particle therapy (CPT) such as proton beam therapy (PBT) and carbon-ion radiotherapy (CIRT) exhibit substantial physical and biological advantages compared to conventional photon radiotherapy. As it can reduce the amount of radiation irradiated in the normal organ, CPT has been mainly applied to pediatric cancer and radioresistent tumors in the eloquent area. Although there is a possibility that more patients can benefit from it, high set-up cost and dearth of high level of clinical evidence hinders wide spread of CPT. This review aims to present recent clinical results of PBT and CIRT in selected diseases focusing on possible indications of CPT. We also discussed how clinical studies are conducted to increase the number of patients who can benefit from CPT considering the high cost of it.

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Section: Clinical Applications Of Cptmentioning

confidence: 99%

Section: Clinical Applications Of Cptmentioning

confidence: 99%

Who Will Benefit from Charged-Particle Therapy?

Kim

2021

Cancer Res Treat

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“…The observed 5 year local tumour control was 92.8 and 63.0% for patients treated with ≥69.6 and<69.6 Gy, respectively. 61 Likewise, an analysis of 863 chordoma patients captured in the National Cancer Data base has shown undisputedly that dose for chordoma was associated with a significant increase in OS on univariate analysis. 1 Other proton series have shown such a dose-response with sbC.…”

Section: Skull-base Tumoursmentioning

confidence: 99%

Proton therapy for brain tumours in the area of evidence-based medicine

Weber

Lim

Tran

et al. 2019

The British Journal of Radiology

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Proton therapy (PT) has been administered for many years to a number of cancers, including brain tumours. Due to their remarkable physical properties, delivering their radiation to a very precise brain volume with no exit dose, protons are particularly appropriate for these tumours. The decrease of the brain integral dose may translate with a diminution of neuro-cognitive toxicity and increase of quality of life, particularly so in children. The brain tumour patient’s access to PT will be substantially increased in the future, with many new facilities being planned or currently constructed in Europe, Asia and the United States. Although approximately 150’000 patients have been treated with PT, no level I evidence has been demonstrated for this treatment. As such, it is this necessary to generate high-quality data and some new prospective trials will include protons or will be activated to compare photons to protons in a randomized design. PT comes however with an additional cost factor that may contribute to the ever-growing health’s expenditure allocated to cancer management. These additional costs and financial toxicity will have to be analysed in the light of a more conformal radiation delivery, non-target brain irradiation and lack of potential for dose escalation when compared to photons. The latter is due to the radiosensitivity of organs at risk in vicinity of the brain tumour, that photons cannot spare optimally. Consequentially, radiation-induced toxicities and tumour recurrences, which are cost-intensive, may decrease with PT resulting in an optimized photon/proton financial ratio in the end. Advances in knowledge: This review details the indication of brain tumors for proton therapy and give a list of the open prospective trials for these challenging tumors.

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“…Chordoma is a rare primary bone tumor, which develops from intraosseous notochordal remnants along the neuroaxis [ 1 ]. Therefore, it commonly occurs at the sacrococcygeal region (50%) or base of the skull (35%) and rarely occurs at the mobile spine (15%) or the lumbar spine (6%) [ 2 3 ].…”

Section: Introductionmentioning

confidence: 99%

Recurrent L3 Chordoma Presented as Intradural Extramedullary Mass With Distant Metastasis: A Case Report

Jang

Han

Hong

et al. 2022

Brain Tumor Res Treat

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Here, we report a rare case of L3 chordoma progressed to an intradural extramedullary (IDEM) mass and distant metastasis to the fascia lata. A 64-year old female patient presented to a local university hospital due to back pain and received excisional biopsy for a L3 destructive bony lesion. Local radiation therapy was initially administered, assuming a malignancy of unknown origin, but she developed cerebrospinal fluid leakage during adjuvant radiation therapy, which was managed by wound revision and lumbar drainage. As the destructive lesion progressed, she visited our hospital for a second opinion 3 months after the biopsy. After review of outside pathology, we diagnosed the lesion to be a chordoma, and performed a L3 corpectomy with cage and plate fixation. One and a half years later, positron emission tomography and computed tomography (PET-CT) revealed a right tensor fascia lata hypermetabolic lesion. Excisional biopsy confirmed a distant metastasis of the chordoma. One year later, she complained of L2 radiating pain. PET-CT and CT myelogram revealed an IDEM lesion. Surgical excision confirmed the transdural invasion of the chordoma. To our knowledge, this is the first report of an iatrogenic IDEM invasion and distant metastasis to the tensor of the fascia lata by a L3 chordoma.

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Clinical outcome of proton therapy for patients with chordomas

Cited by 13 publications

References 19 publications

Who Will Benefit from Charged-Particle Therapy?

Who Will Benefit from Charged-Particle Therapy?

Proton therapy for brain tumours in the area of evidence-based medicine

Recurrent L3 Chordoma Presented as Intradural Extramedullary Mass With Distant Metastasis: A Case Report

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