1. Outcomes of osteosarcoma, chondrosarcoma and chordoma treated with image guided-intensity modulated radiation therapy
- Author
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Prathamesh Pai, Nirmala Jambhekar, Ajay Puri, Bharat Rekhi, Mukta Ramadwar, Jifmi Jose Manjali, Girish Chinnaswamy, Nehal Khanna, Deepa Nair, Akshay Mangaj, Jyoti Bajpai, Sashikant Juvekar, Kumar Prabhash, Amit Janu, Siddhartha Laskar, Sangeeta Kakoti, Prakash Nayak, Nilendu Purandare, Ashish Gulia, Venkatesh Rangarajan, and Sajid S. Qureshi
- Subjects
Osteosarcoma ,business.industry ,medicine.medical_treatment ,Significant difference ,Chondrosarcoma ,Bone Neoplasms ,Radiotherapy Dosage ,Hematology ,Intensity-modulated radiation therapy ,medicine.disease ,Radiation therapy ,Oncology ,Toxicity ,Chordoma ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Radiotherapy, Intensity-Modulated ,Sarcoma ,business ,Nuclear medicine - Abstract
To evaluate the efficacy and toxicity of dose-escalated image guided-intensity modulated radiation therapy (IG-IMRT) in osteosarcoma (OGS), chondrosarcoma (CS) and chordoma (CH) of head and neck (HN) and pelvis.In this prospective non-randomized study, 65 patients of HN or pelvic OGS (24), CS (7) and CH (34) mandating definitive or post-operative radiotherapy from May 2013 to December 2018 were included. Radiotherapy doses in definitive setting were 72.0 Gy for CH and 70.2 Gy for OGS and CS; while in post-operative setting it was 66.6 Gy and 64.8 Gy respectively (at 1.8 Gy per fraction).Planned doses of radiotherapy could be completed in 61 (93.8%) patients; with grade III or higher acute and late toxicities of 3% and 0% respectively. With a median follow-up of 52 (range 6-92) months, the five-year actuarial local control (LC) rates were 66% in OGS, 38.1% in CS and 75.9% in CH; while cause-specific survival (CSS) rates were 54.7%, 64.3% and 92.2% respectively. There was no statistically significant difference in outcomes for patients receiving definitive and post-operative radiotherapy. Locally controlled disease at first follow-up after radiotherapy was associated with improved CSS and OS in CS (p = 0.014) and CH (p 0.001). Radiotherapy resulted in significant and sustained improvement in Musculoskeletal tumour society (MSTS) score and reduction in pain score. Salvage re-irradiation was feasible in local progression after radiotherapy, with good outcomes and tolerability.Dose-escalated IG-IMRT results in good LCfunctional improvement with minimal toxicity in OGS, CS and CH.
- Published
- 2021