International Journal of
Radiation Oncology biology
physics
www.redjournal.org
CNS, Skull Base, and Spine
Efficacy and Safety of Adjuvant Proton Therapy Combined With Surgery for Chondrosarcoma of the Skull Base: A Retrospective, Population-Based Study Loı¨c Feuvret, MD,*,y Stefano Bracci, MD,z Valentin Calugaru, MD, PhD,y Ste´phanie Bolle, MD,x Hamid Mammar, MD,y Ludovic De Marzi, PhD,y Damien Bresson, MD,k Jean-Louis Habrand, MD, PhD,{ Jean-Jacques Mazeron, MD, PhD,* Re´mi Dendale, MD,y and Georges Noe¨l, MD, PhD# *Department of Radiation Oncology, Groupe Hospitalier La Pitie´-Salpeˆtrie`reeCharles Foix (Assistance PubliqueeHoˆpitaux de Paris), Paris, France; yDepartment of Radiation Oncology, Institut CurieeCentre de protonthe´rapie d’Orsay (CPO), Orsay, France; zInstitute of Radiation Oncology, Sapienza University, Sant’Andrea Hospital, Rome, Italy; xDepartment of Radiation Oncology, Gustave Roussy, Villejuif, France; kDepartment of Neurosurgery, Hoˆpital Lariboisie`re (Assistance PubliqueeHoˆpitaux de Paris), Paris, France; {Department of Radiation Oncology, Centre Franc¸ois Baclesse, Caen, France; and #Department of Radiation Oncology, Centre Paul Strauss, Strasbourg, France Received May 11, 2015, and in revised form Nov 17, 2015. Accepted for publication Dec 2, 2015.
Summary Surgery, followed by charged-particle irradiation, is considered to be the reference standard for the treatment of patients with grade I to II skull base chondrosarcoma. Owing to the rarity of this disease, the data are scarce, heterogeneous, and discordant. In the present study, we report that
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%,
Reprint requests to: Loı¨c Feuvret, MD, Department of Radiation Oncology, Groupe Hospitalier La Pitie´-Salpeˆtrie`reeCharles Foix (Assistance PubliqueeHoˆpitaux de Paris), 47-83, boulevard de l’hoˆpital, 75651 Paris cedex 13, France. Tel: (42) 17-81-71; E-mail: [email protected] Int J Radiation Oncol Biol Phys, Vol. 95, No. 1, pp. 312e321, 2016 0360-3016/$ - see front matter Ó 2016 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.ijrobp.2015.12.016
Conflict of interest: none. AcknowledgmentsdThe authors thank F. Lacroix for providing proton beam data and dosimetric calculations.
Volume 95 Number 1 2016
the extent of surgery, dosimetric parameters, and adjacent organs at risk are not prognostic factors for local control or overall survival. Maximal safe resection, followed by high-dose conformal proton therapy, is therefore recommended.
Proton beam therapy for skull chondrosarcoma
313
respectively. A total of 16 patients died (13 of intercurrent disease, 3 of disease progression). On multivariate analysis, age
Radiation Oncology biology
physics
www.redjournal.org
CNS, Skull Base, and Spine
Efficacy and Safety of Adjuvant Proton Therapy Combined With Surgery for Chondrosarcoma of the Skull Base: A Retrospective, Population-Based Study Loı¨c Feuvret, MD,*,y Stefano Bracci, MD,z Valentin Calugaru, MD, PhD,y Ste´phanie Bolle, MD,x Hamid Mammar, MD,y Ludovic De Marzi, PhD,y Damien Bresson, MD,k Jean-Louis Habrand, MD, PhD,{ Jean-Jacques Mazeron, MD, PhD,* Re´mi Dendale, MD,y and Georges Noe¨l, MD, PhD# *Department of Radiation Oncology, Groupe Hospitalier La Pitie´-Salpeˆtrie`reeCharles Foix (Assistance PubliqueeHoˆpitaux de Paris), Paris, France; yDepartment of Radiation Oncology, Institut CurieeCentre de protonthe´rapie d’Orsay (CPO), Orsay, France; zInstitute of Radiation Oncology, Sapienza University, Sant’Andrea Hospital, Rome, Italy; xDepartment of Radiation Oncology, Gustave Roussy, Villejuif, France; kDepartment of Neurosurgery, Hoˆpital Lariboisie`re (Assistance PubliqueeHoˆpitaux de Paris), Paris, France; {Department of Radiation Oncology, Centre Franc¸ois Baclesse, Caen, France; and #Department of Radiation Oncology, Centre Paul Strauss, Strasbourg, France Received May 11, 2015, and in revised form Nov 17, 2015. Accepted for publication Dec 2, 2015.
Summary Surgery, followed by charged-particle irradiation, is considered to be the reference standard for the treatment of patients with grade I to II skull base chondrosarcoma. Owing to the rarity of this disease, the data are scarce, heterogeneous, and discordant. In the present study, we report that
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%,
Reprint requests to: Loı¨c Feuvret, MD, Department of Radiation Oncology, Groupe Hospitalier La Pitie´-Salpeˆtrie`reeCharles Foix (Assistance PubliqueeHoˆpitaux de Paris), 47-83, boulevard de l’hoˆpital, 75651 Paris cedex 13, France. Tel: (42) 17-81-71; E-mail: [email protected] Int J Radiation Oncol Biol Phys, Vol. 95, No. 1, pp. 312e321, 2016 0360-3016/$ - see front matter Ó 2016 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.ijrobp.2015.12.016
Conflict of interest: none. AcknowledgmentsdThe authors thank F. Lacroix for providing proton beam data and dosimetric calculations.
Volume 95 Number 1 2016
the extent of surgery, dosimetric parameters, and adjacent organs at risk are not prognostic factors for local control or overall survival. Maximal safe resection, followed by high-dose conformal proton therapy, is therefore recommended.
Proton beam therapy for skull chondrosarcoma
313
respectively. A total of 16 patients died (13 of intercurrent disease, 3 of disease progression). On multivariate analysis, age
