Clinical outcomes and toxicities of 100 patients treated with proton therapy for chordoma on the proton collaborative group prospective registry Journal Article
| Authors: | Chhabra, A. M.; Rice, S. R.; Holtzman, A.; Choi, J. I.; Hasan, S.; Press, R. H.; Chang, J.; Halasz, L.; Tsai, H. K.; Wang, C. J.; Kabolizadeh, P.; Gondi, V.; Hartsell, W. F.; Vora, S. A.; Vargas, C. E.; Simone, C. B. 2nd |
| Article Title: | Clinical outcomes and toxicities of 100 patients treated with proton therapy for chordoma on the proton collaborative group prospective registry |
| Abstract: | Background: We present efficacy and toxicity outcomes among patients with chordoma treated on the Proton Collaborative Group prospective registry. Methods: Consecutive chordoma patients treated between 2010–2018 were evaluated. One hundred fifty patients were identified, 100 had adequate follow-up information. Locations included base of skull (61%), spine (23%), and sacrum (16%). Patients had a performance status of ECOG 0–1 (82%) and median age of 58 years. Eighty-five percent of patients underwent surgical resection. The median proton RT dose was 74 Gy (RBE) (range 21–86 Gy (RBE)) using passive scatter proton RT (PS-PBT) (13%), uniform scanning proton RT (US-PBT) (54%) and pencil beam scanning proton RT (PBS-PBT) (33%). Rates of local control (LC), progression-free survival (PFS), overall survival (OS) and acute and late toxicities were assessed. Results: 2/3-year LC, PFS, and OS rates are 97%/94%, 89%/74%, and 89%/83%, respectively. LC did not differ based on surgical resection (p = 0.61), though this is likely limited by most patients having undergone a prior resection. Eight patients experienced acute grade 3 toxicities, most commonly pain (n = 3), radiation dermatitis (n = 2), fatigue (n = 1), insomnia (n = 1) and dizziness (n = 1). No grade ≥ 4 acute toxicities were reported. No grade ≥ 3 late toxicities were reported, and most common grade 2 toxicities were fatigue (n = 5), headache (n = 2), CNS necrosis (n = 1), and pain (n = 1). Conclusions: In our series, PBT achieved excellent safety and efficacy outcomes with very low rates of treatment failure. CNS necrosis is exceedingly low (<1%) despite the high doses of PBT delivered. Further maturation of data and larger patient numbers are necessary to optimize therapy in chordoma. © 2023 Elsevier B.V. |
| Keywords: | adult; controlled study; aged; middle aged; cancer surgery; excision; major clinical study; overall survival; fatigue; cancer patient; cancer radiotherapy; follow up; prospective study; progression free survival; pain; peripheral neuropathy; radiation injury; dizziness; confusion; insomnia; spine; patient safety; clinical effectiveness; headache; dyspepsia; urine retention; chordoma; sacrum; radiation dermatitis; rectum hemorrhage; central nervous system disease; skull; feces incontinence; clinical outcome; proton therapy; human; male; female; article; ecog performance status; body weight gain; patient registry; central nervous system necrosis; pencil-beam |
| Journal Title: | Radiotherapy and Oncology |
| Volume: | 183 |
| ISSN: | 0167-8140 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2023-06-01 |
| Start Page: | 109551 |
| Language: | English |
| DOI: | 10.1016/j.radonc.2023.109551 |
| PUBMED: | 36813169 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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