+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Spot scanning proton therapy for malignancies of the base of skull: treatment planning, acute toxicities, and preliminary clinical outcomes



Spot scanning proton therapy for malignancies of the base of skull: treatment planning, acute toxicities, and preliminary clinical outcomes



International Journal of Radiation Oncology, Biology, Physics 90(3): 540-546



To describe treatment planning techniques and early clinical outcomes in patients treated with spot scanning proton therapy for chordoma or chondrosarcoma of the skull base. From June 2010 through August 2011, 15 patients were treated with spot scanning proton therapy for chordoma (n=10) or chondrosarcoma (n=5) at a single institution. Toxicity was prospectively evaluated and scored weekly and at all follow-up visits according to Common Terminology Criteria for Adverse Events, version 3.0. Treatment planning techniques and dosimetric data were recorded and compared with those of passive scattering plans created with clinically applicable dose constraints. Ten patients were treated with single-field-optimized scanning beam plans and 5 with multifield-optimized intensity modulated proton therapy. All but 2 patients received a simultaneous integrated boost as well. The mean prescribed radiation doses were 69.8 Gy (relative biological effectiveness [RBE]; range, 68-70 Gy [RBE]) for chordoma and 68.4 Gy (RBE) (range, 66-70) for chondrosarcoma. In comparison with passive scattering plans, spot scanning plans demonstrated improved high-dose conformality and sparing of temporal lobes and brainstem. Clinically, the most common acute toxicities included fatigue (grade 2 for 2 patients, grade 1 for 8 patients) and nausea (grade 2 for 2 patients, grade 1 for 6 patients). No toxicities of grades 3 to 5 were recorded. At a median follow-up time of 27 months (range, 13-42 months), 1 patient had experienced local recurrence and a second developed distant metastatic disease. Two patients had magnetic resonance imaging-documented temporal lobe changes, and a third patient developed facial numbness. No other subacute or late effects were recorded. In comparison to passive scattering, treatment plans for spot scanning proton therapy displayed improved high-dose conformality. Clinically, the treatment was well tolerated, and with short-term follow-up, disease control rates and toxicity profiles were favorable.

(PDF emailed within 0-6 h: $19.90)

Accession: 055893726

Download citation: RISBibTeXText

PMID: 25304948

DOI: 10.1016/j.ijrobp.2014.07.005


Related references

Benchmarking of a treatment planning system for spot scanning proton therapy: comparison and analysis of robustness to setup errors of photon IMRT and proton SFUD treatment plans of base of skull meningioma. Medical Physics 41(11): 111710-111710, 2015

Proton therapy for spinal ependymomas: planning, acute toxicities, and preliminary outcomes. International Journal of Radiation Oncology, Biology, Physics 83(5): 1419-1424, 2012

Spot-scanning beam proton therapy vs intensity-modulated radiation therapy for ipsilateral head and neck malignancies: a treatment planning comparison. Medical Dosimetry 38(4): 390-394, 2014

Development and clinical implementation of a universal bolus to maintain spot size during delivery of base of skull pencil beam scanning proton therapy. International Journal of Radiation Oncology, Biology, Physics 90(1): 79-84, 2014

Preliminary evaluation of multifield and single-field optimization for the treatment planning of spot-scanning proton therapy of head and neck cancer. Medical Physics 40(8): 081709-081709, 2014

Results of Spot-Scanning Proton Radiation Therapy for Chordoma and Chondrosarcoma of the Skull Base: The Paul Scherrer Institut Experience. Yearbook of Oncology 2007: 333-334, 2007

Results of spot-scanning proton radiation therapy for chordoma and chondrosarcoma of the skull base: the Paul Scherrer Institut experience. International Journal of Radiation Oncology, Biology, Physics 63(2): 401-409, 2005

Effectiveness and safety of spot scanning proton radiation therapy for chordomas and chondrosarcomas of the skull base: first long-term report. International Journal of Radiation Oncology, Biology, Physics 75(4): 1111-1118, 2009

NTCP modeling analysis of acute hematologic toxicity in whole pelvic radiation therapy for gynecologic malignancies - A dosimetric comparison of IMRT and spot-scanning proton therapy (SSPT). Physica Medica 32(9): 1095-1102, 2016

Treatment planning and verification of proton therapy using spot scanning: initial experiences. Medical Physics 31(11): 3150-3157, 2004

Treatment Outcomes of Proton or Carbon Ion Radiation Therapy for Chordoma of the Skull Base. International Journal of Radiation Oncology*biology*physics 90(1): S551-S552, 2014

Long-term outcomes and prognostic factors of skull-base chondrosarcoma patients treated with pencil-beam scanning proton therapy at the Paul Scherrer Institute. Neuro-Oncology 18(2): 236-243, 2016

PV-0049: Recurrent skull base and extra-cranial chordoma following proton therapy: clinical outcomes. RadioTherapy and Oncology 123: S21-S22, 2017

A single-field integrated boost treatment planning technique for spot scanning proton therapy. Radiation Oncology 9(): 202-202, 2015

Dosimetric benefits of robust treatment planning for intensity modulated proton therapy for base-of-skull cancers. Practical Radiation Oncology 4(6): 384-391, 2015