High control rates of proton- and carbon-ion-beam treatment with intensity-modulated active raster scanning in 101 patients with skull base chondrosarcoma at the Heidelberg Ion Beam Therapy Center

Cancer. 2018 May 1;124(9):2036-2044. doi: 10.1002/cncr.31298. Epub 2018 Feb 22.

Abstract

Background: The current study compares the results of irradiation with protons and irradiation with carbon ions via a raster scan technique in patients with G1 and G2 skull base chondrosarcomas.

Methods: Between 2009 and 2014, a total of 101 patients (40 men and 61 women) with a median age of 44 years (range, 19-77 years) were irradiated with carbon ions (79 patients) or protons (22 patients) via a raster scan technique at the Heidelberg Ion Beam Therapy Center. The median total dose was 60 Gy (relative biological effectiveness [RBE]) at 3 Gy per fraction for carbon ions and 70 Gy (RBE) at 2 Gy per fraction for protons. The median boost planning target volume was 38 cm3 (range, 8-133 cm3 ). Overall survival (OS) and local control (LC) were evaluated with the Kaplan-Meier method.

Results: The median follow-up period was 40 months (range, 0.8-78.1 months). At the start of the irradiation, all patients had residual macroscopic tumors. Five patients (5%) developed a local recurrence during the follow-up. The 1-, 2-, and 4-year LC rates were 100%, 100%, and 100%, respectively, for protons and 98.6%, 97.2%, and 90.5%, respectively, for carbon ions. The OS rates during the same periods of time were 100%, 100%, and 100%, respectively, for protons and 100%, 98.5%, and 92.9%, respectively, for carbon ions. An age ≤ 44 years was associated with a trend for a better outcome. No toxicity worse than Common Toxicity Criteria grade 3 was observed after treatment.

Conclusions: No significant difference between carbon ions and protons in the therapy of skull base chondrosarcoma could be detected in these initial retrospective results. Cancer 2018;124:2036-44. © 2018 American Cancer Society.

Keywords: carbon ion; chondrosarcoma; heavy ion; proton; radiotherapy; skull base.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Carbon Radioisotopes*
  • Chondrosarcoma / mortality
  • Chondrosarcoma / radiotherapy*
  • Dose Fractionation, Radiation
  • Female
  • Follow-Up Studies
  • Germany / epidemiology
  • Heavy Ion Radiotherapy / adverse effects
  • Heavy Ion Radiotherapy / instrumentation
  • Heavy Ion Radiotherapy / methods*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / prevention & control
  • Protons*
  • Radiation Injuries / epidemiology
  • Radiation Injuries / etiology
  • Radiotherapy, Intensity-Modulated / adverse effects
  • Radiotherapy, Intensity-Modulated / instrumentation
  • Radiotherapy, Intensity-Modulated / methods*
  • Retrospective Studies
  • Skull Base Neoplasms / mortality
  • Skull Base Neoplasms / radiotherapy*
  • Survival Rate
  • Treatment Outcome
  • Young Adult

Substances

  • Carbon Radioisotopes
  • Protons