Long term outcomes of patients with skull-base low-grade chondrosarcoma and chordoma patients treated with pencil beam scanning proton therapy

Weber, Damien Charles; Malyapa, Robert S.; Albertini, Francesca; Bolsi, Alessandra; Kliebsch, Ulrike; Walser, M.; Pica, Alessia; Combescure, Christophe; Lomax, Anthony; Schneider, R.

doi:10.1016/j.radonc.2016.05.011

Cited by 154 publications

(142 citation statements)

References 36 publications

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“…Notably, a high proportion of recurrences occur late (after 5 and 10 years), requiring long-term follow-up [2, 3]. Limited data are available about long-term recurrence-free survival (RFS), but all available long-term survival projections do not plateau, even after optimal local therapy.…”

Section: Introductionmentioning

confidence: 99%

Best practices for the management of local-regional recurrent chordoma: a position paper by the Chordoma Global Consensus Group

Stacchiotti¹,

et al. 2017

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Chordomas are rare, malignant bone tumors of the skull-base and axial skeleton. Until recently, there was no consensus among experts regarding appropriate clinical management of chordoma, resulting in inconsistent care and suboptimal outcomes for many patients. To address this shortcoming, the European Society of Medical Oncology (ESMO) and the Chordoma Foundation, the global chordoma patient advocacy group, convened a multi-disciplinary group of chordoma specialists to define by consensus evidence-based best practices for the optimal approach to chordoma. In January 2015, the first recommendations of this group were published, covering the management of primary and metastatic chordomas. Additional evidence and further discussion were needed to develop recommendations about the management of local-regional failures. Thus, ESMO and CF convened a second consensus group meeting in November 2015 to address the treatment of locally relapsed chordoma. This meeting involved over 60 specialists from Europe, the United States and Japan with expertise in treatment of patients with chordoma. The consensus achieved during that meeting is the subject of the present publication and complements the recommendations of the first position paper.

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Section: Introductionmentioning

confidence: 99%

Best practices for the management of local-regional recurrent chordoma: a position paper by the Chordoma Global Consensus Group

Stacchiotti¹,

et al. 2017

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“…In contrast, PBT allows irradiation at a high dose of >70 GyE without critical late toxicities [8] [9] and achieves a good 5-year local control rate of 60% -100% for pediatric skull base chordoma at a dose of 65 -74…”

Section: Discussionmentioning

confidence: 99%

“…We have reported early clinical results in 13 cases of clivalchordomas treated by PBT, in which >70 GyE was delivered and the 5-year local control rate exceeded 50% [7]. Other studies have also shown good local control after high dose PBT [8] [9]. We found that hyperfractionated high-dose PBT (78.4 GyE in 56 fractions, 2 fractions per day) for skull base chordoma gave a 5-year local control rate of 70% to 80% in adults [10].…”

Section: Introductionmentioning

confidence: 97%

Preliminary Result of Hyperfractionated High-Dose Proton Beam Radiotherapy for Pediatric Skull Base Chordomas

Mizumoto¹,

Akutsu²,

Yamamoto³

et al. 2017

JCT

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Objective: Proton beam therapy (PBT) may provide good local control for skull base chordoma and reduced toxicities, especially for pediatric patients. Methods: We evaluated the efficacy and safety of hyperfractionated high-dose PBT in6 pediatric patients with newly-diagnosed skull basechordoma who were treated with PBT at our institute from 2011 to 2015. The patients were 5 males and one female, and the median age was 9 years old (range: 5 -13). All patients received surgery before PBT. The median period between surgery and PBT was 57 days (range: 34 -129 days). The treatment dose was 78.4 GyE in 56 fractions (twice per day). Results: All patients received PBT without severe acute toxicity. The median follow-up period was 27 months (range: 21 -71 months). At the last follow-up, all patients were alive and all tumors were well controlled. Acute and late toxicities were generally acceptable, with only grade 1 and 2 events. Late toxicities included growth hormone abnormality and cortical hormone abnormality. One patient needed growth hormone and cortical hormone replacement therapy. Conclusion: Although the number of pediatric patients was small, our overall findings in the 6 cases indicate that hyperfractionated high-dose PBT is safe and effective for pediatric patients with skull base chordoma.

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“…However, recent advances in particle beam therapy, such as proton beam and carbon ion beam, hold some promise. In a very recent study assessing proton therapy in combination with surgical resection for skull base chordomas, the reported 5- and 7-year local control rates were 75.8% and 70.9%, respectively 64 . Another systematic review also concluded that proton therapy improves long-term local control and survival in patients with skull base chordoma 65 .…”

Section: Treatmentmentioning

confidence: 99%

Recent advances in understanding and managing chordomas

et al. 2016

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Chordomas are rare primary bone tumors arising from embryonic remnants of the notochord. They are slow-growing, locally aggressive, and destructive and typically involve the axial skeleton. Genetic studies have identified several mutations implicated in the pathogenesis of these tumors. Treatment poses a challenge given their insidious progression, degree of local invasion at presentation, and high recurrence rate. They tend to respond poorly to conventional chemotherapy and radiation. This makes radical resection the mainstay of their treatment. Recent advances in targeted chemotherapy and focused particle beam radiation, however, have improved the management and prognosis of these tumors.

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Long term outcomes of patients with skull-base low-grade chondrosarcoma and chordoma patients treated with pencil beam scanning proton therapy

Cited by 154 publications

References 36 publications

Best practices for the management of local-regional recurrent chordoma: a position paper by the Chordoma Global Consensus Group

Best practices for the management of local-regional recurrent chordoma: a position paper by the Chordoma Global Consensus Group

Preliminary Result of Hyperfractionated High-Dose Proton Beam Radiotherapy for Pediatric Skull Base Chordomas

Recent advances in understanding and managing chordomas

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