Robust IMPT and follow-up toxicity in skull base chordoma and chondrosarcoma—a single-institution clinical experience

Strahlentherapie und Onkologie, 2024 · DOI: https://doi.org/10.1007/s00066-024-02280-0 · Published: August 29, 2024

Simple Explanation

This study investigates the use of intensity-modulated proton therapy (IMPT) for treating rare skull base tumors called chordomas and chondrosarcomas. These tumors are difficult to treat due to their location near critical brain structures. The researchers analyzed data from 12 patients who received IMPT at a single institution, focusing on the effectiveness of the treatment and any associated toxicities (side effects). The study found that IMPT is a feasible treatment option for these tumors, with acceptable early toxicities that generally resolved within a few months after treatment.

Study Duration

Between July 2019 and August 2021

Participants

12 patients (9 chordoma and 3 chondrosarcoma)

Evidence Level

Not specified

Key Findings

1
Robustly optimized IMPT is clinically feasible as a postoperative treatment for skull base chordoma and chondrosarcoma patients.
2
Acceptable early toxicities (grade 1–3) were observed that disappeared within the ﬁrst 3 months after irradiation.
3
Good CTV coverage (97.66–98.00%), even in the presence of implants, while sparing the adjacent dose-sensitive structures

Research Summary

The study evaluates the feasibility and toxicity of robustly optimized intensity-modulated proton therapy (IMPT) in treating skull base chordoma and chondrosarcoma. The results indicate that IMPT is a clinically feasible postoperative treatment with acceptable early toxicities that resolve within three months post-irradiation. The study highlights the importance of collaboration between neurosurgeons and radiation oncologists for adequate treatment planning, especially in the presence of surgical implants.

Practical Implications

Clinical Practice

IMPT can be considered a viable treatment option for skull base chordomas and chondrosarcomas, particularly post-resection.

Treatment Planning

Robust optimization techniques are essential in IMPT to account for uncertainties and ensure adequate target coverage while sparing critical structures.

Collaboration

Close collaboration between neurosurgeons and radiation oncologists is crucial for optimal treatment planning, especially when surgical implants are present.

Study Limitations

1
Small group of patients analyzed
2
Relatively short follow-up period
3
Unavailability of results on patients treated with conventional photon therapy as a control group

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