1. A Prospective Phase I/II Clinical Trial of High-Dose Proton Therapy for Chordomas and Chondrosarcomas
- Author
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Sana S. Dastgheyb, MD, PhD, Alexandra D. Dreyfuss, MD, Michael J. LaRiviere, MD, Jahan J. Mohiuddin, MD, Brian C. Baumann, MD, Jacob Shabason, MD, Robert A. Lustig, MD, Jay F. Dorsey, MD, PhD, Alexander Lin, MD, Sean M. Grady, MD, Bert W. O'Malley, MD, John Y.K. Lee, MD, Jason G. Newman, MD, James M. Schuster, MD, and Michelle Alonso-Basanta, MD, PhD
- Subjects
Medical physics. Medical radiology. Nuclear medicine ,R895-920 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Purpose: The purpose of this study was to evaluate the feasibility and safety of dose-escalated proton beam therapy for treating chordomas and chondrosarcomas of the skull base and spine. Methods: A prospective cohort of 54 patients (42 with chordomas and 12 with chondrosarcomas) was enrolled between 2010 and 2018. The primary endpoints were feasibility and 5 days, none for toxicities related to treatment. There were no grade 4 acute toxicities and 1 grade 3 acute toxicity (sensory neuropathy). The only 2 grade 3 late toxicities recorded, osteoradionecrosis and intranasal carotid blowout (mild and not emergently treated), occurred in a single patient. We report overall survival as 83% at 5 years, with local failure-free survival and progression-free survival rates of 72% and 68%, respectively. Five patients developed distant disease, and among the 9/54 patients who died, 4 deaths were not attributed to treatment or recurrence. Conclusions: Our findings suggest that high-dose proton therapy alone or in combination with IMRT is a safe and effective treatment option for chordomas and chondrosarcomas of the skull base and spine.
- Published
- 2024
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