Carbon ion radiotherapy for pediatric patients and young adults treated for tumors of the skull base

Abstract

Background: The current study was conducted to evaluate the outcome of carbon ion radiotherapy (RT) in children and young adults with skull base chordomas and chondrosarcomas.

Methods: Between 1997 and 2007, 394 patients were treated with carbon ion RT at Gesellschaft für Schwerionenforschung in Darmstadt, Germany. Of these patients, 17 patients were aged<or=21 years. Seventeen of these young patients were treated for chordoma or low-grade chondrosarcoma of the skull base and were analyzed in this study. Irradiation was performed after primary diagnosis in 14 patients (82%) and for recurrent tumors in 3 patients (18%). The authors applied a median total dose of 60 gray equivalents (Gy E) (range, 60-66.6 Gy E) in a fractionation of 7x3 Gy E per week of carbon ion RT using the raster scan technique. All patients were observed prospectively on a regular basis after carbon ion RT.

Results: The median follow-up time was 49 months. Treatment was well tolerated without severe side effects and could be completed on an outpatient basis in all patients without interruptions. One patient with chordoma developed tumor progression at 60 months after carbon ion RT. All other patients demonstrated no signs of tumor progression during follow-up.

Conclusions: Despite its promising outcome in children and young adults with chordomas and chondrosarcomas, further evaluation in a larger patient collective is required. Randomized studies comparing the outcome after carbon ion RT with proton RT are especially needed to evaluate the role of particle beams in the treatment of skull base tumors in children and young adults.