Long‐term results of Phase II study of high dose photon/proton radiotherapy in the management of spine chordomas, chondrosarcomas, and other sarcomas

摘要: Background Negative surgical margins are uncommon for spine sarcomas; hence, adjuvant radiotherapy (RT) may be recommended but tumor dose constrained by spinal cord, nerve, and viscera tolerance. Methods Prospective Phase II clinical trial incorporating high RT. Eligible patients had primary or locally recurrent thoracic, lumbar, and/or sacral spine/paraspinal chordomas sarcomas. Treatment included pre- post-operative photon/proton RT ± radical resection. Results Fifty (29 chordoma, 14 chondrosarcoma, 7 other) underwent gross total (n = 25) subtotal (n = 12) resection biopsy (n = 13). RT was ≤72.0 GyRBE in 25 76.6–77.4 GyRBE patients. With 7.3-year median follow-up, the 5 8-year actuarial local control (LC) rates were 94% 85% tumors 81% 74% entire group. Local recurrence less common tumors, 4/36 (11%) versus 7/14 (50%) P = 0.002. The risk of grade 3–4 late morbidity 13%. No myelopathies seen. neurologic toxicities noted with radiation doses while three neuropathies appeared after 76.6–77.4 GyRBE. Conclusions LC this treatment is tumors. Late appears to acceptable. J. Surg. Oncol. 2014; 110:115–122. © 2014 Wiley Periodicals, Inc.