Carbon ion beam treatment in patients with primary and recurrent sacrococcygeal chordoma
Carbon ion beam treatment in patients with primary and recurrent sacrococcygeal chordoma
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DOI：
10.1007/s00066-015-0825-3
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发表时间：
2015-07-01
影响因子：
3.1
通讯作者：
Debus, Juergen
中科院分区：
文献类型：
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作者：
Uhl, Matthias;Welzel, Thomas;Debus, Juergen
目的-这项工作的目的是评估高剂量放射治疗的结果，使用碳离子治疗，单独或结合调强放射治疗（IMRT），在患者骶choroid.Materials和方法之间2009年和2012年，56例骶choroid. In我中心治疗。肿瘤位于S3以上33例，S3以下23例。总共有41名患者接受了原发性肿瘤的放射治疗，而15名患者接受了复发性肿瘤的治疗。使用NCI CTCAE v.4.03测量毒性。结果23例患者接受碳离子联合光子调强放疗，33例仅接受碳离子治疗。43例患者在治疗开始时有肉眼可见的肿瘤，中位肿瘤大小（GTV）为244 ml（范围5-1188 ml）。中位总剂量为66戈伊（范围60-74戈伊; RBE）。中位随访时间为25个月后，2年和3年局部控制概率分别为76%和53%。总生存率为100%。原发性肿瘤和男性患者的治疗导致显著更好的局部控制。结论大剂量光子/碳离子束放射治疗骶骨脊索瘤安全、有效，尤其对原发性骶骨脊索瘤疗效显著。需要进行一项随机试验来评估原发性确定性大分割粒子治疗与手术联合或不联合辅助放疗的作用。
Purpose The purpose of this work was to evaluate the results of high-dose radiation treatment using carbon ion therapy, alone or combined with intensity-modulated radiation treatment (IMRT), in patients with sacral chordoma.Materials and methods Between 2009 and 2012, 56 patients with sacral chordoma were treated in our center. The tumor was located above S3 in 33 patients and in S3 or below in 23 patients. In all, 41 patients received radiation therapy for the primary tumor, while 15 patients were treated for the recurrent tumor. Toxicity was measured using NCI CTCAE v.4.03. Local control (LC) and overall survival (OS) were evaluated with the Kaplan-Meier method.Results A total of 23 patients were irradiated with carbon ions in combination with photon IMRT, while 33 received carbon ion therapy only. Forty-three patients had a macroscopic tumor at treatment start with a median tumor size (GTV) of 244 ml (range 5-1188 ml). The median total dose was 66 Gy (range 60-74 Gy; RBE). After a median follow-up time of 25 months, the 2- and 3-year local control probability was 76 % and 53 %, respectively. The overall survival rate was 100 %. Treatment for primary tumor and male patients resulted in significant better local control. No higher toxicity occurred within the follow-up time.Conclusion High-dose photon/carbon ion beam radiation therapy is safe and, especially for primary sacral chordomas, highly effective. A randomized trial is required to evaluate the role of primary definitive hypofractionated particle therapy compared with surgery with or without adjuvant radiotherapy.