Clinical outcome of proton therapy for patients with chordomas
- Author:
Sang Hee YOUN
1
;
Kwan Ho CHO
;
Joo Young KIM
;
Boram HA
;
Young Kyung LIM
;
Jong Hwi JEONG
;
Sang Hyun LEE
;
Heon YOO
;
Ho Shin GWAK
;
Sang Hoon SHIN
;
Eun Kyung HONG
;
Han Kyu KIM
;
Je Beom HONG
Author Information
- Publication Type:Original Article
- Keywords: Chordoma; Proton therapy; Treatment outcome; Complications
- MeSH: Chordoma; Cobalt; Disease-Free Survival; Follow-Up Studies; Humans; Korea; Methods; Proton Therapy; Protons; Retrospective Studies; Treatment Outcome
- From:Radiation Oncology Journal 2018;36(3):182-191
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: To investigate the clinical outcome of proton therapy (PT) in patients with chordoma. MATERIALS AND METHODS: Fifty-eight patients with chordoma treated with PT between June 2007 and December 2015 at the National Cancer Center, Korea, were retrospectively analyzed. The median total dose was 69.6 cobalt gray equivalent (CGE; range, 64.8 to 79.2 CGE). Local progression-free survival (LPFS), distant metastasis-free survival (DMFS), overall survival (OS), and diseasespecific survival (DSS) rates were calculated by the Kaplan–Meier method. RESULTS: With the median follow-up of 42.8 months (range, 4 to 174 months), the 5-year LPFS, DMFS, OS, and DSS rates were 87.9%, 86.7%, 88.3%, and 92.9%, respectively. The tumor location was associated with the patterns of failure: the LPFS rates were lower for cervical tumors (57.1%) than for non-cervical tumors (93.1%) (p = 0.02), and the DMFS rates were lower for sacral tumors (53.5%) than for non-sacral tumors (100%) (p = 0.001). The total dose was associated with both the LPFS rate and DMFS rate. The initial tumor size was associated with the DMFS rate, but was not associated with the LPFS rate. Three patients had grade 3 late toxicity with none ≥grade 4. CONCLUSION: PT is an effective and safe treatment in patients with chordomas. The tumor location was associated with the patterns of failure: local failure was common in cervical tumors, and distant failure was common in sacral tumors. Further refinement of PT, such as the utilization of intensity modulated PT for cervical tumors, is warranted to improve the outcome.
