Particle Beam Radiation Therapy for Skull Base Sarcomas.

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

doi:10.3389/fonc.2020.01368

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.

Highlights

Bone and soft-tissue sarcomas of the base of the skull (SBS) are rare and account for < 1% of all head and neck malignancies [1,2,3,4,5]
This paper reports the clinical results, in terms of disease control, survival, and treatmentassociated adverse effects, of a relatively large group of SBS patients treated with particle beam radiation therapy (PBRT) at the Shanghai Proton and Heavy Ion Center (SPHIC) over the past 5 years
A total of 62 consecutive and non-selected patients with skull base bone and soft-tissue sarcoma who received PBRT with definitive intention at the SPHIC between July 2014, when the first SBS patient was treated at SPHIC, and May 2019 were included in this retrospective analysis

Summary

Introduction

Bone and soft-tissue sarcomas of the base of the skull (SBS) are rare and account for < 1% of all head and neck malignancies [1,2,3,4,5]. Surgery is the treatment of choice for SBS regardless of the histology subtypes. Adjuvant radiation is commonly recommended, both the anatomical complexity, and radioresistant nature of most histology subtypes of SBS negated the efficacy of photon-based radiation, including the more conformal intensity-modulated radiotherapy (IMRT) technology. Despite aggressive multidisciplinary approaches, the prognosis of patients with SBS is poor as compared with patients. For SBS patients with unresectable or inoperable disease, prognosis is usually dismal after radiotherapy [8,9,10,11,12]. To report the clinical experience of carbon-ion and proton radiation therapy for skull base sarcomas

Methods

Results

Discussion

Conclusion