• Bulletin du cancer · Jul 2002

    [Radiation therapy for chordomas and chondrosarcomas of the base of the skull and cervical spine].

    • Georges Noël, Eric Jauffret, CrevoisierRenaud DeRD, Jean-Louis Habrand, Hamid Mammar, Christine Haie-Meder, Dominique Hasboun, Régis Ferrand, Gilbert Boisserie, Dominique Pontvert, Anne Beaudré, Geneviève Gaboriaud, Alexandre Mazal, Ferran Guedea, Lourdes Petriz, and Jean-Jacques Mazeron.
    • Centre de protonthérapie, BP 65, 91402 Orsay Cedex, France. noel@ipno.in2p3.fr
    • Bull Cancer. 2002 Jul 1; 89 (7-8): 713-23.

    PurposeProspective analysis of local tumour control, survival and treatment complications in 67 consecutive patients treated with fractionated photon and proton radiation for a chordoma or a chondrosarcoma of the base of the skull and of the cervical spine.Patients And MethodsBetween December 1995 and January 2000, 67 patients with a median age of 52.3 years (14-85), were treated using 201 MeV proton beam of the centre de protonthérapie d'Orsay (CPO), 49 for a chordoma and 18 for a chondrosarcoma. Irradiation combined high-energy photons and protons. Photons represented 2/3 of the total dose and protons 1/3. The median total dose delivered within gross tumour volume was 67 Cobalt Gray Equivalent (CGE) (60-70).ResultsWith a mean follow-up of 32 months (4-71), the 3-year local control rates were for chordomas and chondrosarcomas of 70.8% and 85.2%, respectively and 4-year overall survival rates of 87.7% and 75%, respectively. Fourteen tumours (21.5%) failed locally (eight within the gross tumor volume, four into the CTV and 2 in an unknown site). Seven patients died of tumour and one of intercurrent disease. In univariate analysis, age inférieur ou égal à 52.3 years (p = 0.002), maximum tumoral diameter < 44.7 mm (p = 0.02) and GTV < 28.4 mL (0.02), at time of radiotherapy, influenced positively the local control. According to multivariate analysis, only age was an independent prognostic factor of local control. Only five (7.7%) patients presented grade 3 or 4 complications.ConclusionIn base of skull chordomas and chondrosarcomas, the combined photon and proton therapy offers excellent chances of cure at the price of an acceptable toxicity. These results should be confirmed with a longer follow-up.

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