Proton and carbon ion radiotherapy for primary brain tumors and tumors of the skull base

被引:21
作者
Combs, Stephanie E. [1 ]
Kessel, Kerstin [1 ]
Habermehl, Daniel [1 ]
Haberer, Thomas [2 ]
Jaekel, Oliver [1 ,2 ]
Debus, Juergen [1 ]
机构
[1] Univ Heidelberg Hosp, Dept Radiat Oncol, D-69120 Heidelberg, Germany
[2] HIT, Heidelberg, Germany
关键词
FRACTIONATED STEREOTACTIC RADIOTHERAPY; LOCAL EFFECT MODEL; POSITRON-EMISSION-TOMOGRAPHY; HIGH-GRADE GLIOMAS; SINGLE INSTITUTION; MALIGNANT MENINGIOMA; RADIATION-THERAPY; RECURRENT GLIOMAS; PHASE-I/II; REIRRADIATION;
D O I
10.3109/0284186X.2013.818255
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
To analyze clinical concepts, toxicity and treatment outcome in patients with brain and skull base tumors treated with photons and particle therapy. Material and methods. In total 260 patients with brain tumors and tumors of the skull base were treated at the Heidelberg Ion Therapy Center (HIT). Patients enrolled in and randomized within prospective clinical trials as well as bony or soft tissue tumors are not included in this analysis. Treatment was delivered as protons, carbon ions, or combinations of photons and a carbon ion boost. All patients are included in a tight follow-up program. The median follow-up time is 12 months (range 2-39 months). Results. Main histologies included meningioma (n = 107) for skull base lesions, pituitary adenomas (n = 14), low-grade gliomas (n = 51) as well as high-grade gliomas (n = 55) for brain tumors. In all patients treatment could be completed without any unexpected severe toxicities. No side effects >CTC Grade III were observed. To date, no severe late toxicities were observed, however, for endpoints such as secondary malignancies or neurocognitive side effects follow-up time still remains too short. Local recurrences were mainly seen in the group of high-grade gliomas or atypical meningiomas; for benign skull base meningiomas, to date, no recurrences were observed during follow-up. Conclusion. The specific benefit of particle therapy will potentially reduce the risk of secondary malignancies as well as improve neurocognitive outcome and quality of life (QOL); thus, longer follow-up will be necessary to confirm these endpoints. Indication-specific trials on meningiomas and gliomas are underway to elucidate the role of protons and carbon ions in these indications.
引用
收藏
页码:1504 / 1509
页数:6
相关论文
共 40 条
[1]   Long-Term Outcome After Radiotherapy in Patients With Atypical and Malignant Meningiomas-Clinical Results in 85 Patients Treated in a Single Institution Leading to Optimized Guidelines for Early Radiation Therapy [J].
Adeberg, Sebastian ;
Hartmann, Christian ;
Welzel, Thomas ;
Rieken, Stefan ;
Habermehl, Daniel ;
von Deimling, Andreas ;
Debus, Juergen ;
Combs, Stephanie E. .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2012, 83 (03) :859-864
[2]   Detection of cranial meningiomas: comparison of 68Ga-DOTATOC PET/CT and contrast-enhanced MRI [J].
Afshar-Oromieh, Ali ;
Giesel, Frederik L. ;
Linhart, Heinz G. ;
Haberkorn, Uwe ;
Haufe, Sabine ;
Combs, Stephanie E. ;
Podlesek, Dino ;
Eisenhut, Michael ;
Kratochwil, Clemens .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2012, 39 (09) :1409-1415
[3]   Comparison of second cancer risk due to out-of-field doses from 6-MV IMRT and proton therapy based on 6 pediatric patient treatment plans [J].
Athar, Basit S. ;
Paganetti, Harald .
RADIOTHERAPY AND ONCOLOGY, 2011, 98 (01) :87-92
[4]   Reirradiation of primary CNS tumors [J].
Bauman, GS ;
Sneed, PK ;
Wara, WM ;
Stalpers, LJA ;
Chang, SM ;
McDermott, MW ;
Gutin, PH ;
Larson, DA .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1996, 36 (02) :433-441
[5]   Reirradiation of recurrent WHO grade III astrocytomas using fractionated stereotactic radiotherapy (FSRT) [J].
Combs, SE ;
Gutwein, S ;
Thilmann, C ;
Debus, J ;
Schulz-Ertner, D .
STRAHLENTHERAPIE UND ONKOLOGIE, 2005, 181 (12) :768-773
[6]   Efficacy of fractionated stereotactic reirradiation in recurrent gliomas: Long-term results in 172 patients treated in a single institution [J].
Combs, SE ;
Thilmann, C ;
Edler, L ;
Debus, J ;
Schulz-Ertner, D .
JOURNAL OF CLINICAL ONCOLOGY, 2005, 23 (34) :8863-8869
[7]   Management of acoustic neuromas with fractionated stereotactic radiotherapy (FSRT): Long-term results in 106 patients treated in a single institution [J].
Combs, SE ;
Volk, S ;
Schulz-Ertner, D ;
Huber, PE ;
Thilmann, C ;
Debus, J .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2005, 63 (01) :75-81
[8]   Radiochemotherapy with temozolomide as re-irradiation using high precision fractionated stereotactic radiotherapy (FSRT) in patients with recurrent gliomas [J].
Combs, Stephanie E. ;
Bischof, Marc ;
Welzel, Thomas ;
Hof, Holger ;
Oertel, Susanne ;
Debus, Juergen ;
Schulz-Ertner, Daniela .
JOURNAL OF NEURO-ONCOLOGY, 2008, 89 (02) :205-210
[9]   Intensity Modulated Radiotherapy (IMRT) and Fractionated Stereotactic Radiotherapy (FSRT) for children with head-and-neck-rhabdomyosarcoma [J].
Combs, Stephanie E. ;
Behnisch, Wolfgang ;
Kulozik, Andreas E. ;
Huber, Peter E. ;
Debus, Juergen ;
Schulz-Ertner, Daniela .
BMC CANCER, 2007, 7 (1)
[10]   Local radiotherapeutic management of ependymomas with fractionated stereotactic radiotherapy (FSRT) [J].
Combs, Stephanie E. ;
Thilmann, Christoph ;
Debus, Juergen ;
Schulz-Ertner, Daniela .
BMC CANCER, 2006, 6 (1)