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. 2020 Sep 16:10:1368.
doi: 10.3389/fonc.2020.01368. eCollection 2020.

Particle Beam Radiation Therapy for Skull Base Sarcomas

Jing Yang  1   2 , Weixu Hu  1   2 , Xiyin Guan  1   2 , Jiyi Hu  1   2 , Jing Gao  1   2 , Xianxin Qiu  1   2 , Qingting Huang  1   2 , Wenna Zhang  1   2 , Lin Kong  1   2   3 , Jiade J Lu  1   2
Affiliations

Particle Beam Radiation Therapy for Skull Base Sarcomas

Jing Yang et al. Front Oncol. .

Abstract

Background: To report the clinical experience of carbon-ion and proton radiation therapy for skull base sarcomas. Methods: An analysis of the retrospective data registry from the Shanghai Proton and Heavy Ion Center for patients with skull base sarcomas was conducted. The 1-/2-year local relapse-free, distant metastasis-free, progression-free, and overall survival (LRFS, DMFS, PFS, OS) rates as well as associated prognostic indicators were analyzed. Radiotherapy-induced acute and late toxicities were summarized. Results: Between 7/2014 and 5/2019, 62 patients with skull base sarcomas of various subtypes received carbon-ion radiation therapy (53), proton radiation therapy (5), or proton radiation therapy + carbon-ion boost (4). With a median follow-up of 20.4 (range 2.73-91.67) months, the 1-/2-year OS, LRFS, DMFS, and PFS rates were 91.2%/80.2%, 89.2%/80.2%, 86.0%/81.1%, and 75.8%/62.9%, respectively. Grade 3 mucositis and grade 4 hemorrhage were observed in 1 patient for each. Only grade 1 and grade 2 toxicities were observed except for the same patient with grade 4 acute toxicity died of severe hemorrhage (grade 5). Multivariate analyses revealed the lack of prior RT was an independent favorable prognostic factor for OS, PFS, and LRFS, age under 40 was associated with improved OS, early T-disease (T1/2) showed a significant association with better PFS. Conclusion: With few observed acute and late toxicities, particle beam radiation therapy provided effective tumor control and overall survival for patients with skull base sarcomas.

Keywords: carbon-ion beam radiation therapy; charged particle radiation therapy; proton beam radiation therapy; sarcoma; skull base.

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Figures

Figure 1
Figure 1
A typical treatment plan of a patient with soft-tissue sarcoma of the skull base.
Figure 2
Figure 2
OS, LRFS, DMFS, and PFS of the entire cohort of 62 SBS patients treated with PBRT.
Figure 3
Figure 3
OS, LRFS, DMFS, and PFS according to the status of prior RT (i.e., first-time RT vs. re-irradiation).
See this image and copyright information in PMC

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