Hypofractionated proton and carbon ion beam radiotherapy for sacrococcygeal chordoma (ISAC)

• Verfasst von: Seidensaal, Katharina [VerfasserIn]
• Verfasst von: Froehlke, Andreas [VerfasserIn]
• Verfasst von: Hommertgen, Adriane [VerfasserIn]
• Verfasst von: Lehner, Burkhard [VerfasserIn]
• Verfasst von: Geisbüsch, Andreas [VerfasserIn]
• Verfasst von: Meis, Jan [VerfasserIn]
• Verfasst von: Liermann, Jakob [VerfasserIn]
• Verfasst von: Kudak, Andreas [VerfasserIn]
• Verfasst von: Stein, Katharina [VerfasserIn]
• Verfasst von: Uhl, Matthias [VerfasserIn]
• Verfasst von: Tessonnier, Thomas [VerfasserIn]
• Verfasst von: Mairani, Andrea [VerfasserIn]
• Verfasst von: Debus, Jürgen [VerfasserIn]
• Verfasst von: Herfarth, Klaus [VerfasserIn]
• Titel: Hypofractionated proton and carbon ion beam radiotherapy for sacrococcygeal chordoma (ISAC)
• Titelzusatz: an open label, randomized, stratified, phase II trial
• Verf.angabe: Katharina Seidensaal, Andreas Froehlke, Adriane Lentz-Hommertgen, Burkhard Lehner, Andreas Geisbuesch, Jan Meis, Jakob Liermann, Andreas Kudak, Katharina Stein, Matthias Uhl, Thomas Tessonnier, Andrea Mairani, Juergen Debus, Klaus Herfarth
• E-Jahr: 2024
• Jahr: September 2024
• Umfang: 7 S.
• Illustrationen: Illustrationen
• Fussnoten: Online verfügbar: 27. Juni 2024, Artikelversion: 3. Juli 2024 ; Gesehen am 10.01.2025
• Titel Quelle: Enthalten in: Radiotherapy and oncology
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1983
• Jahr Quelle: 2024
• Band/Heft Quelle: 198(2024) vom: Sept., Artikel-ID 110418, Seite 1-7
• ISSN Quelle: 1879-0887
• DOI: doi:10.1016/j.radonc.2024.110418
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Carbon ions
• Sach-SW: Phase II trial
• Sach-SW: Protons
• Sach-SW: Radiotherapy
• Sach-SW: Sacrococcygeal chordoma
• K10plus-PPN: 1914147073

Abstract

Introduction - Sacrococcygeal chordomas have high recurrence rates and are challenging to treat. - Methods - In this phase II prospective, randomized, stratified trial, the safety and feasibility of hypofractionated ion radiation therapy were investigated. The primary focus was monitored through the incidence of Grade 3-5 NCI-CTC-AE toxicity. Secondary endpoints included local progression-free (LPFS) and overall survival (OS). - Results - The study enrolled 82 patients with primary (87 %) and recurrent (13 %) inoperable or incompletely resected sacral chordomas from January 2013 to July 2022, divided equally into proton therapy (Arm A) and carbon ion beam therapy (Arm B) groups, each receiving a total dose of 64 Gy (RBE) in 16 fractions, 5-6 fractions per week. Overall 74 % of patients received no previous surgery and 66 % of tumors were confirmed by a brachyury staining. The mean and median Gross Tumor Volume at the time of treatment (GTV) was 407 ml and 185 ml, respectively. The median follow-up of the surviving patients was 44.7 months, and the 2-year and 4-year OS rates were 96 % and 81 %, respectively. Factors such as smaller GTV and younger age trended towards better OS. The LPFS after 2-year and 4-year was 84 % and 70 %, respectively. Male gender emerged as a significant predictor of LPFS. There was no significant difference between the treatment groups. We observed five grade 4 wound healing disorders (6 %). - Conclusion - The initial response rates were promising; however local control was not sustained. More comparative research on fractionation schemes is essential to refine treatment approaches for inoperable sacral chordoma.