P05.39  Skull-base chordoma treated with proton and carbon ion radiotherapy: C.N.A.O. clinical experience

Skull-base chordoma (SBC) can be treated with carbon ion radiotherapy (CIRT) to improve local control (LC). The study aimed to explore the role of multi-parametric radiomic, dosiomic and clinical features as prognostic factors for LC in SBC patients undergoing CIRT. Before CIRT, 57 patients underwent MR and CT imaging, from which tumour contours and dose maps were obtained. MRI and CT-based radiomic, and dosiomic features were selected and fed to two survival models, singularly or by combining them with clinical factors. Adverse LC was given by in-field recurrence or tumour progression. The dataset was split in development and test sets and the models’ performance evaluated using the concordance index (C-index). Patients were then assigned a low- or high-risk score. Survival curves were estimated, and risk groups compared through log-rank tests (after Bonferroni correction α = 0.0083). The best performing models were built on features describing tumour shape and dosiomic heterogeneity (median/interquartile range validation C-index: 0.80/024 and 0.79/0.26), followed by combined (0.73/0.30 and 0.75/0.27) and CT-based models (0.77/0.24 and 0.64/0.28). Dosiomic and combined models could consistently stratify patients in two significantly different groups. Dosiomic and multi-parametric radiomic features showed to be promising prognostic factors for LC in SBC treated with CIRT.

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Long‐term outcomes of skull base chordoma treated with high‐dose carbon‐ion radiotherapy

Head & Neck ◽

10.1002/hed.26307 ◽

2020 ◽

Vol 42 (9) ◽

pp. 2607-2613 ◽

Cited By ~ 1

Author(s):

Masashi Koto ◽

Hiroaki Ikawa ◽

Takashi Kaneko ◽

Yasuhito Hagiwara ◽

Kazuhiko Hayashi ◽

...

Keyword(s):

Skull Base ◽

Carbon Ion Radiotherapy ◽

High Dose ◽

Long Term Outcomes ◽

Carbon Ion ◽

Skull Base Chordoma

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A step towards international prospective trials in carbon ion radiotherapy: investigation of factors influencing dose distribution in the facilities in operation based on a case of skull base chordoma

Radiation Oncology ◽

10.1186/s13014-019-1224-1 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 2

Author(s):

G. Vogin ◽

◽

A. Wambersie ◽

M. Koto ◽

T. Ohno ◽

...

Keyword(s):

Skull Base ◽

Dose Distribution ◽

Carbon Ion Radiotherapy ◽

Carbon Ion ◽

Factors Influencing ◽

Prospective Trials ◽

Skull Base Chordoma

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Carbon Ion Radiotherapy for Skull Base Chordoma

Skull Base ◽

10.1055/s-0028-1114295 ◽

2009 ◽

Vol 19 (03) ◽

pp. 219-224 ◽

Cited By ~ 51

Author(s):

Jun–etsu Mizoe ◽

Azusa Hasegawa ◽

Ryo Takagi ◽

Hiroki Bessho ◽

Takeshi Onda ◽

...

Keyword(s):

Skull Base ◽

Carbon Ion Radiotherapy ◽

Carbon Ion ◽

Skull Base Chordoma

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Proton and carbon ion radiotherapy in skull base chordomas: a prospective study based on a dual particle and a patient-customized treatment strategy

Neuro-Oncology ◽

10.1093/neuonc/noaa067 ◽

2020 ◽

Vol 22 (9) ◽

pp. 1348-1358 ◽

Cited By ~ 1

Author(s):

Alberto Iannalfi ◽

Emma D’Ippolito ◽

Giulia Riva ◽

Silvia Molinelli ◽

Sara Gandini ◽

...

Keyword(s):

Prognostic Factors ◽

Skull Base ◽

Organs At Risk ◽

High Rate ◽

Carbon Ion Radiotherapy ◽

Particle Therapy ◽

Carbon Ion ◽

Brainstem Compression ◽

Optic Pathways ◽

Skull Base Chordoma

Abstract Background The aim of this study is to evaluate results in terms of local control (LC), overall survival (OS), and toxicity profile and to better identify factors influencing clinical outcome of skull base chordoma treated with proton therapy (PT) and carbon ion radiotherapy (CIRT). Methods We prospectively collected and analyzed data of 135 patients treated between November 2011 and December 2018. Total prescription dose in the PT group (70 patients) and CIRT group (65 patients) was 74 Gy relative biological effectiveness (RBE) delivered in 37 fractions and 70.4 Gy(RBE) delivered in 16 fractions, respectively (CIRT in unfavorable patients). LC and OS were evaluated using the Kaplan–Meier method. Univariate and multivariate analyses were performed, to identify prognostic factors on clinical outcomes. Results After a median follow-up of 44 (range, 6–87) months, 14 (21%) and 8 (11%) local failures were observed in CIRT and PT group, respectively. Five-year LC rate was 71% in CIRT cohort and 84% in PT cohort. The estimated 5-year OS rate in the CIRT and PT group was 82% and 83%, respectively. On multivariate analysis, gross tumor volume (GTV), optic pathways, and/or brainstem compression and dose coverage are independent prognostic factors of local failure risk. High rate toxicity grade ≥3 was reported in 11% of patients. Conclusions Particle radiotherapy is an effective treatment for skull base chordoma with acceptable late toxicity. GTV, optic pathways, and/or brainstem compression and target coverage were independent prognostic factors for LC. Key Points • Proton and carbon ion therapy are effective and safe in skull base chordoma. • Prognostic factors are GTV, organs at risk compression, and dose coverage. • Dual particle therapy and customized strategy was adopted.

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