Efficacy and Safety of Adjuvant Proton Therapy Combined With Surgery for Chondrosarcoma of the Skull Base: A Retrospective, Population-Based Study
Purpose Chondrosarcoma is a rare malignant tumor of the cartilage affecting young adults. Surgery, followed by charged-particle irradiation, is considered the reference standard for the treatment of patients with grade I to II skull base chondrosarcoma. The present study was conducted to assess the...
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| creator | Feuvret, Loïc, MD Bracci, Stefano, MD Calugaru, Valentin, MD, PhD Bolle, Stéphanie, MD Mammar, Hamid, MD De Marzi, Ludovic, PhD Bresson, Damien, MD Habrand, Jean-Louis, MD, PhD Mazeron, Jean-Jacques, MD, PhD Dendale, Rémi, MD Noël, Georges, MD, PhD |
| description | Purpose Chondrosarcoma is a rare malignant tumor of the cartilage affecting young adults. Surgery, followed by charged-particle irradiation, is considered the reference standard for the treatment of patients with grade I to II skull base chondrosarcoma. The present study was conducted to assess the effect of the quality of surgery and radiation therapy parameters on local control (LC) and overall survival (OS). Methods and Materials From 1996 to 2013, 159 patients (median age 40 years, range 12-83) were treated with either protons alone or a combination of protons and photons. The median total dose delivered was 70.2 Gy (relative biologic effectiveness [RBE]; range 67-71). Debulking and biopsy were performed in 133 and 13 patients, respectively. Results With a median follow-up of 77 months (range 2-214), 5 tumors relapsed based on the initial gross tumor volume. The 5- and 10-year LC rates were 96.4% and 93.5%, respectively, and the 5- and 10-year OS rates were 94.9% and 87%, respectively. A total of 16 patients died (13 of intercurrent disease, 3 of disease progression). On multivariate analysis, age |
| doi_str_mv | 10.1016/j.ijrobp.2015.12.016 |
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Surgery, followed by charged-particle irradiation, is considered the reference standard for the treatment of patients with grade I to II skull base chondrosarcoma. The present study was conducted to assess the effect of the quality of surgery and radiation therapy parameters on local control (LC) and overall survival (OS). Methods and Materials From 1996 to 2013, 159 patients (median age 40 years, range 12-83) were treated with either protons alone or a combination of protons and photons. The median total dose delivered was 70.2 Gy (relative biologic effectiveness [RBE]; range 67-71). Debulking and biopsy were performed in 133 and 13 patients, respectively. Results With a median follow-up of 77 months (range 2-214), 5 tumors relapsed based on the initial gross tumor volume. The 5- and 10-year LC rates were 96.4% and 93.5%, respectively, and the 5- and 10-year OS rates were 94.9% and 87%, respectively. A total of 16 patients died (13 of intercurrent disease, 3 of disease progression). On multivariate analysis, age <40 years and primary disease status were independent favorable prognostic factors for progression-free survival and OS, and local tumor control was an independent favorable predictor of OS. In contrast, the extent of surgery, dosimetric parameters, and adjacent organs at risk were not prognostic factors for LC or OS. Conclusions Systematic high-dose postoperative proton therapy for skull base chondrosarcoma can achieve a high LC rate with a low toxicity profile. Maximal safe surgery, followed by high-dose conformal proton therapy, is therefore recommended.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2015.12.016</identifier><identifier>PMID: 26883563</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Chondrosarcoma - mortality ; Chondrosarcoma - pathology ; Chondrosarcoma - radiotherapy ; Chondrosarcoma - surgery ; Follow-Up Studies ; GY RANGE 10-100 ; Hematology, Oncology and Palliative Medicine ; Humans ; Middle Aged ; MULTIVARIATE ANALYSIS ; Neoplasm Recurrence, Local ; Organ Sparing Treatments ; Organs at Risk ; PATIENTS ; Photons - therapeutic use ; PROTON BEAMS ; Proton Therapy - adverse effects ; Proton Therapy - methods ; RADIATION HAZARDS ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; Radiotherapy, Adjuvant - adverse effects ; Radiotherapy, Adjuvant - methods ; Relative Biological Effectiveness ; Retrospective Studies ; SARCOMAS ; SKELETAL DISEASES ; SKULL ; Skull Base Neoplasms - mortality ; Skull Base Neoplasms - pathology ; Skull Base Neoplasms - radiotherapy ; Skull Base Neoplasms - surgery ; SURGERY ; Survival Rate ; Time Factors ; Tumor Burden</subject><ispartof>International journal of radiation oncology, biology, physics, 2016-05, Vol.95 (1), p.312-321</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c445t-bc9a330923acd307b7b7bebc79d5e785621f6ec552a0e862b1850ce7aa48407f3</citedby><cites>FETCH-LOGICAL-c445t-bc9a330923acd307b7b7bebc79d5e785621f6ec552a0e862b1850ce7aa48407f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijrobp.2015.12.016$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26883563$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22648643$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Feuvret, Loïc, MD</creatorcontrib><creatorcontrib>Bracci, Stefano, MD</creatorcontrib><creatorcontrib>Calugaru, Valentin, MD, PhD</creatorcontrib><creatorcontrib>Bolle, Stéphanie, MD</creatorcontrib><creatorcontrib>Mammar, Hamid, MD</creatorcontrib><creatorcontrib>De Marzi, Ludovic, PhD</creatorcontrib><creatorcontrib>Bresson, Damien, MD</creatorcontrib><creatorcontrib>Habrand, Jean-Louis, MD, PhD</creatorcontrib><creatorcontrib>Mazeron, Jean-Jacques, MD, PhD</creatorcontrib><creatorcontrib>Dendale, Rémi, MD</creatorcontrib><creatorcontrib>Noël, Georges, MD, PhD</creatorcontrib><title>Efficacy and Safety of Adjuvant Proton Therapy Combined With Surgery for Chondrosarcoma of the Skull Base: A Retrospective, Population-Based Study</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose Chondrosarcoma is a rare malignant tumor of the cartilage affecting young adults. Surgery, followed by charged-particle irradiation, is considered the reference standard for the treatment of patients with grade I to II skull base chondrosarcoma. The present study was conducted to assess the effect of the quality of surgery and radiation therapy parameters on local control (LC) and overall survival (OS). Methods and Materials From 1996 to 2013, 159 patients (median age 40 years, range 12-83) were treated with either protons alone or a combination of protons and photons. The median total dose delivered was 70.2 Gy (relative biologic effectiveness [RBE]; range 67-71). Debulking and biopsy were performed in 133 and 13 patients, respectively. Results With a median follow-up of 77 months (range 2-214), 5 tumors relapsed based on the initial gross tumor volume. The 5- and 10-year LC rates were 96.4% and 93.5%, respectively, and the 5- and 10-year OS rates were 94.9% and 87%, respectively. A total of 16 patients died (13 of intercurrent disease, 3 of disease progression). On multivariate analysis, age <40 years and primary disease status were independent favorable prognostic factors for progression-free survival and OS, and local tumor control was an independent favorable predictor of OS. In contrast, the extent of surgery, dosimetric parameters, and adjacent organs at risk were not prognostic factors for LC or OS. Conclusions Systematic high-dose postoperative proton therapy for skull base chondrosarcoma can achieve a high LC rate with a low toxicity profile. Maximal safe surgery, followed by high-dose conformal proton therapy, is therefore recommended.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Child</subject><subject>Chondrosarcoma - mortality</subject><subject>Chondrosarcoma - pathology</subject><subject>Chondrosarcoma - radiotherapy</subject><subject>Chondrosarcoma - surgery</subject><subject>Follow-Up Studies</subject><subject>GY RANGE 10-100</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>MULTIVARIATE ANALYSIS</subject><subject>Neoplasm Recurrence, Local</subject><subject>Organ Sparing Treatments</subject><subject>Organs at Risk</subject><subject>PATIENTS</subject><subject>Photons - therapeutic use</subject><subject>PROTON BEAMS</subject><subject>Proton Therapy - adverse effects</subject><subject>Proton Therapy - methods</subject><subject>RADIATION HAZARDS</subject><subject>Radiology</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>RADIOTHERAPY</subject><subject>Radiotherapy, Adjuvant - adverse effects</subject><subject>Radiotherapy, Adjuvant - methods</subject><subject>Relative Biological Effectiveness</subject><subject>Retrospective Studies</subject><subject>SARCOMAS</subject><subject>SKELETAL DISEASES</subject><subject>SKULL</subject><subject>Skull Base Neoplasms - mortality</subject><subject>Skull Base Neoplasms - pathology</subject><subject>Skull Base Neoplasms - radiotherapy</subject><subject>Skull Base Neoplasms - surgery</subject><subject>SURGERY</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>Tumor Burden</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUl2L1DAUDaK44-o_EAn4amvSNG3HB2F2WD9gwcVZcd9Cmtw66XaSkqQD_Rv-YlOqPvgieQhczjn33HsuQi8pySmh1ds-N7137ZgXhPKcFnkqPkIb2tTbjHF-_xhtCKtIxlL9Aj0LoSeEUFqXT9FFUTUN4xXboJ_XXWeUVDOWVuOD7CDO2HV4p_vpLG3Et95FZ_HdEbwcZ7x3p9ZY0Pi7iUd8mPwP8DPunMf7o7PauyC9cie5aMQj4MPDNAz4SgZ4h3f4K8SEGEFFc4Y3-NaN0yCjcTZbEKl_nPT8HD3p5BDgxe__En37cH23_5TdfPn4eb-7yVRZ8pi1aisZI9uCSaUZqdvlQavqreZQN7wqaFeB4ryQBJqqaGnDiYJayrIpSd2xS_R61XUhGhGUiaCOylmb7ImiqMqmKllClStKJefBQydGb07Sz4ISsQQherEGIZYgBC1EKibaq5U2Tu0J9F_Sn80nwPsVAGnEswG_OACrQBu_GNDO_K_DvwJqMDZlOTzADKF3k7dpfYKKkAjisBzDcguUJw-8vGe_AGXysg4</recordid><startdate>20160501</startdate><enddate>20160501</enddate><creator>Feuvret, Loïc, MD</creator><creator>Bracci, Stefano, MD</creator><creator>Calugaru, Valentin, MD, PhD</creator><creator>Bolle, Stéphanie, MD</creator><creator>Mammar, Hamid, MD</creator><creator>De Marzi, Ludovic, PhD</creator><creator>Bresson, Damien, MD</creator><creator>Habrand, Jean-Louis, MD, PhD</creator><creator>Mazeron, Jean-Jacques, MD, PhD</creator><creator>Dendale, Rémi, MD</creator><creator>Noël, Georges, MD, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>OTOTI</scope></search><sort><creationdate>20160501</creationdate><title>Efficacy and Safety of Adjuvant Proton Therapy Combined With Surgery for Chondrosarcoma of the Skull Base: A Retrospective, Population-Based Study</title><author>Feuvret, Loïc, MD ; Bracci, Stefano, MD ; Calugaru, Valentin, MD, PhD ; Bolle, Stéphanie, MD ; Mammar, Hamid, MD ; De Marzi, Ludovic, PhD ; Bresson, Damien, MD ; Habrand, Jean-Louis, MD, PhD ; Mazeron, Jean-Jacques, MD, PhD ; Dendale, Rémi, MD ; Noël, Georges, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c445t-bc9a330923acd307b7b7bebc79d5e785621f6ec552a0e862b1850ce7aa48407f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Child</topic><topic>Chondrosarcoma - mortality</topic><topic>Chondrosarcoma - pathology</topic><topic>Chondrosarcoma - radiotherapy</topic><topic>Chondrosarcoma - surgery</topic><topic>Follow-Up Studies</topic><topic>GY RANGE 10-100</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Middle Aged</topic><topic>MULTIVARIATE ANALYSIS</topic><topic>Neoplasm Recurrence, Local</topic><topic>Organ Sparing Treatments</topic><topic>Organs at Risk</topic><topic>PATIENTS</topic><topic>Photons - therapeutic use</topic><topic>PROTON BEAMS</topic><topic>Proton Therapy - adverse effects</topic><topic>Proton Therapy - methods</topic><topic>RADIATION HAZARDS</topic><topic>Radiology</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>RADIOTHERAPY</topic><topic>Radiotherapy, Adjuvant - adverse effects</topic><topic>Radiotherapy, Adjuvant - methods</topic><topic>Relative Biological Effectiveness</topic><topic>Retrospective Studies</topic><topic>SARCOMAS</topic><topic>SKELETAL DISEASES</topic><topic>SKULL</topic><topic>Skull Base Neoplasms - mortality</topic><topic>Skull Base Neoplasms - pathology</topic><topic>Skull Base Neoplasms - radiotherapy</topic><topic>Skull Base Neoplasms - surgery</topic><topic>SURGERY</topic><topic>Survival Rate</topic><topic>Time Factors</topic><topic>Tumor Burden</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Feuvret, Loïc, MD</creatorcontrib><creatorcontrib>Bracci, Stefano, MD</creatorcontrib><creatorcontrib>Calugaru, Valentin, MD, PhD</creatorcontrib><creatorcontrib>Bolle, Stéphanie, MD</creatorcontrib><creatorcontrib>Mammar, Hamid, MD</creatorcontrib><creatorcontrib>De Marzi, Ludovic, PhD</creatorcontrib><creatorcontrib>Bresson, Damien, MD</creatorcontrib><creatorcontrib>Habrand, Jean-Louis, MD, PhD</creatorcontrib><creatorcontrib>Mazeron, Jean-Jacques, MD, PhD</creatorcontrib><creatorcontrib>Dendale, Rémi, MD</creatorcontrib><creatorcontrib>Noël, Georges, MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Feuvret, Loïc, MD</au><au>Bracci, Stefano, MD</au><au>Calugaru, Valentin, MD, PhD</au><au>Bolle, Stéphanie, MD</au><au>Mammar, Hamid, MD</au><au>De Marzi, Ludovic, PhD</au><au>Bresson, Damien, MD</au><au>Habrand, Jean-Louis, MD, PhD</au><au>Mazeron, Jean-Jacques, MD, PhD</au><au>Dendale, Rémi, MD</au><au>Noël, Georges, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy and Safety of Adjuvant Proton Therapy Combined With Surgery for Chondrosarcoma of the Skull Base: A Retrospective, Population-Based Study</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2016-05-01</date><risdate>2016</risdate><volume>95</volume><issue>1</issue><spage>312</spage><epage>321</epage><pages>312-321</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><abstract>Purpose Chondrosarcoma is a rare malignant tumor of the cartilage affecting young adults. Surgery, followed by charged-particle irradiation, is considered the reference standard for the treatment of patients with grade I to II skull base chondrosarcoma. The present study was conducted to assess the effect of the quality of surgery and radiation therapy parameters on local control (LC) and overall survival (OS). Methods and Materials From 1996 to 2013, 159 patients (median age 40 years, range 12-83) were treated with either protons alone or a combination of protons and photons. The median total dose delivered was 70.2 Gy (relative biologic effectiveness [RBE]; range 67-71). Debulking and biopsy were performed in 133 and 13 patients, respectively. Results With a median follow-up of 77 months (range 2-214), 5 tumors relapsed based on the initial gross tumor volume. The 5- and 10-year LC rates were 96.4% and 93.5%, respectively, and the 5- and 10-year OS rates were 94.9% and 87%, respectively. A total of 16 patients died (13 of intercurrent disease, 3 of disease progression). On multivariate analysis, age <40 years and primary disease status were independent favorable prognostic factors for progression-free survival and OS, and local tumor control was an independent favorable predictor of OS. In contrast, the extent of surgery, dosimetric parameters, and adjacent organs at risk were not prognostic factors for LC or OS. Conclusions Systematic high-dose postoperative proton therapy for skull base chondrosarcoma can achieve a high LC rate with a low toxicity profile. Maximal safe surgery, followed by high-dose conformal proton therapy, is therefore recommended.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26883563</pmid><doi>10.1016/j.ijrobp.2015.12.016</doi><tpages>10</tpages></addata></record> |
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| identifier | ISSN: 0360-3016 |
| ispartof | International journal of radiation oncology, biology, physics, 2016-05, Vol.95 (1), p.312-321 |
| issn | 0360-3016 1879-355X |
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| subjects | Adolescent Adult Aged Aged, 80 and over Child Chondrosarcoma - mortality Chondrosarcoma - pathology Chondrosarcoma - radiotherapy Chondrosarcoma - surgery Follow-Up Studies GY RANGE 10-100 Hematology, Oncology and Palliative Medicine Humans Middle Aged MULTIVARIATE ANALYSIS Neoplasm Recurrence, Local Organ Sparing Treatments Organs at Risk PATIENTS Photons - therapeutic use PROTON BEAMS Proton Therapy - adverse effects Proton Therapy - methods RADIATION HAZARDS Radiology RADIOLOGY AND NUCLEAR MEDICINE RADIOTHERAPY Radiotherapy, Adjuvant - adverse effects Radiotherapy, Adjuvant - methods Relative Biological Effectiveness Retrospective Studies SARCOMAS SKELETAL DISEASES SKULL Skull Base Neoplasms - mortality Skull Base Neoplasms - pathology Skull Base Neoplasms - radiotherapy Skull Base Neoplasms - surgery SURGERY Survival Rate Time Factors Tumor Burden |
| title | Efficacy and Safety of Adjuvant Proton Therapy Combined With Surgery for Chondrosarcoma of the Skull Base: A Retrospective, Population-Based Study |
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