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Proton therapy for skull-base chondrosarcoma, a single-institution outcomes study

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Abstract

Background

We sought to evaluate the effectiveness of definitive or adjuvant external-beam proton therapy on local control and survival in patients with skull-base chondrosarcoma.

Methods

We reviewed the medical records of 43 patients with a median age of 49 years (range, 23–80 years) treated with double-scattered 3D conformal proton therapy for skull-base chondrosarcomas between January 2007 and February 2016. Proton therapy-related toxicities were scored using CTCAE v4.0.

Results

The median radiotherapy dose was 73.8 Gy(RBE) (range, 64.5–74.4 Gy[RBE]). Thirty-six (84%) and 7 (16%) patients underwent surgical resection or biopsy alone. Tumor grade distribution included: grade 1, 19 (44%) patients; grade 2, 22 (51%); and grade 3, 2 (5%). Forty patients had gross disease at the time of radiotherapy and 7 patients were treated for locally recurrent disease following surgery. The median follow-up was 3.7 years (range, 0.7–10.1 years). There were no acute grade 3 toxicities related to RT. At 4 years following RT, actuarial rates of overall survival, cause-specific survival, local control, and RT-related grade 3 toxicity-free survival were 95%, 100%, 89%, and 95%.

Conclusion

High-dose, double-scattered 3D conformal proton therapy alone or following surgical resection for skull-base chondrosarcoma is an effective treatment with a high rate of local control with no acute grade 3 radiation-related toxicity. Further follow-up of this cohort is necessary to better characterize long-term disease control and late toxicities.

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Acknowledgements

The authors would like to acknowledge Robin Cacchio, and Amanda Prince for research assistance; the CNS cancer nursing team, including Michelle Wear, Lauren Mynatt, and Michelle Myers; and Jessica Kirwan and Christopher Stich for editorial assistance.

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Authors and Affiliations

  1. Department of Radiation Oncology, University of Florida College of Medicine, 2015 N Jefferson St, Jacksonville, FL, 32206, USA

    Adam L. Holtzman, Ronny L. Rotondo, Michael S. Rutenberg, Daniel J. Indelicato, Catherine E. Mercado, Christopher G. Morris, Debbie Louis, Stella Flampouri & William M. Mendenhall

  2. Department of Radiology, University of Florida College of Medicine, Jacksonville, FL, USA

    Dinesh Rao

  3. Department of Neurosurgery, University of Florida College of Medicine, Jacksonville, FL, USA

    Daryoush Tavanaiepour

Authors
  1. Adam L. Holtzman
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  2. Ronny L. Rotondo
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  11. William M. Mendenhall
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Contributions

Substantial contributions to the conception or design of the work (ALH, RR, WMM); acquisition, analysis, or interpretation of data for the work (all authors); drafting the work (ALH); revising it critically for important intellectual content (all authors); final approval of the version to be published (all authors).

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Correspondence to Adam L. Holtzman.

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Educational grant from Ion Beam Applications (DI).

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Holtzman, A.L., Rotondo, R.L., Rutenberg, M.S. et al. Proton therapy for skull-base chondrosarcoma, a single-institution outcomes study. J Neurooncol 142, 557–563 (2019). https://doi.org/10.1007/s11060-019-03129-8

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  • DOI: https://doi.org/10.1007/s11060-019-03129-8

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