J Cancer 2019; 10(15):3315-3322. doi:10.7150/jca.29667

Research Paper

Carbon Ion Radiotherapy for Patients with Extracranial Chordoma or Chondrosarcoma - Initial Experience from Shanghai Proton and Heavy Ion Center

Shuang Wu1,3 *, Ping Li2,3 *, Xin Cai2,3, Zhengshan Hong2,3, Zhan Yu2,3, Qing Zhang2,3, Shen Fu1,3,4,5✉

1. Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201321, China
2. Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai 201321, China
3. Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China
4. Key Laboratory of Nuclear Physics and Ion-Beam Application (MOE), Fudan University, Shanghai 200433, China
5. Department of Radiation Oncology, Shanghai Concord Cancer Hospital, Shanghai 200020, China
*The first 2 authors contributed equally to this article.

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Citation:
Wu S, Li P, Cai X, Hong Z, Yu Z, Zhang Q, Fu S. Carbon Ion Radiotherapy for Patients with Extracranial Chordoma or Chondrosarcoma - Initial Experience from Shanghai Proton and Heavy Ion Center. J Cancer 2019; 10(15):3315-3322. doi:10.7150/jca.29667. Available from http://www.jcancer.org/v10p3315.htm

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Abstract

Purpose: The purpose of this study was to evaluate the outcomes of patients with extracranial chordoma or chondrosarcoma treated by carbon ion radiotherapy (CIRT).

Patients and methods: Between May 2015 and April 2018, 21 consecutive patients with chordoma (n=16) or chondrosarcoma (n=5) treated by CIRT at Shanghai Proton and Heavy Ion Center (SPHIC) were enrolled. The local control (LC), progression free survival (PFS), and overall survival (OS) rates were estimated using the Kaplan-Meier method. Association between each of the candidate prognostic factors and the estimated LC, PFS or OS was tested using the log rank test.

Results: The median gross tumor volume (GTV) was 512.7 ml (range, 142.6-2893.0 ml). The median prescription dose was 69 gray equivalent (GyE) (range, 57-80 GyE). After a median follow-up of 21.8 months (range, 7.2-39.2 months), the 1-year LC, PFS, and OS were 93.8%, 88.4%, and 100%, respectively, whereas the 2-year LC, PFS, and OS were 85.2%, 80.4%, and 100%, respectively. A univariate analysis revealed that age, metal implant status, treatment status, sex, dose, and GTV were not significant prognostic factors for LC, PFS or OS. No grade 2 or higher early and late toxicities were observed within the follow-up.

Conclusion: The results of this retrospective study are encouraging. Patients with extracranial chordoma or chondrosarcoma treated by CIRT in our center achieved a favorable shot-term outcome, without developing severe acute or late adverse events. The long-term results deserve further investigation, even in a prospective randomized trial.

Keywords: carbon ion, chordoma, chondrosarcoma, radiotherapy.