Carbon ion radiotherapy performed as re-irradiation using active beam delivery in patients with tumors of the brain, skull base and sacral region

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• 作者：Stephanie E. Combs^a ; ^{Stephanie.Combs@med.uni-heidelberg.de} ; Adriana Kalbe^a ; Anna Nikoghosyan^a ; Benjamin Ackermann^c ; Oliver Jä ; kel^b ; ^c ; Thomas Haberer^c ; Jü ; rgen Debus^a
• 关键词：Chordoma ; Chondrosarcoma ; Meningioma ; Adenoid-cystic carcinoma ; Toxicity ; Particle therapy
• 刊名：Radiotherapy and Oncology
• 出版年：2011
• 出版时间：January 2011
• 年：2011
• 卷：98
• 期：1
• 页码：63-67
• 全文大小：192 K

文摘

Introduction

To asses carbon ion radiation therapy (RT) performed as re-irradiation in 28 patients with recurrent tumors.

Materials and methods

Twenty-eight patients were treated with carbon ion RT as re-irradiation for recurrent chordoma and chondrosarcoma of the skull base (n = 16 and n = 2), one chordoma and one chondrosarcoma of the os sacrum, high-risk meningioma (n = 3), adenoid-cystic carcinoma (n = 4) as well as one SCCHN.

All patients were treated using active raster scanning, and treatment planning was performed on CT- and MRI-basis.

All patients were followed prospectively during follow-up.

Results

In all patients re-irradiation could be applied safely without interruptions. For skull base tumors, local tumor control after re-irradiation was 92 % at 24 months and 64 % at 36 months. Survival after re-irradiation was 86 % at 24 months, and 43 % at 60 months. In all three meningiomas treated with C12 for re-irradiation, the tumor recurrence was located within the former RT-field. Two patients developed tumor progression at 6 months, and in one patient the tumor remained stable for 67 months. In patients with head-and-neck tumors, three patients developed local tumor progression at 12, 24 and 29 months after re-irradiation. Median local progression-free survival was 24 months.

For sacral tumors, re-irradiation offered palliation with tumor control for 24 and 36 months.

Conclusion

Due to the physical characteristics particle therapy offers a new treatment modality in cases with tumor recurrences. With carbon ions, the additional biological benefits may be exploited for long-term tumor control. Further evaluation in a larger patients’ cohort will be performed in the future.