研究梗概 研究目标： 对在保罗谢尔研究所接受分层点扫描质子照射治疗的26位颅底、中轴骨脊索瘤(CH)或软骨肉瘤(CS)儿童患者的临床结果进行评估。 研究方法和数据： 从2000年6月～20...
质子治疗儿童脊索瘤临床试验
研究目标：
对在保罗谢尔研究所接受分层点扫描照射治疗的26位颅底、中轴骨脊索瘤(CH)或软骨肉瘤(CS)儿童患者的临床结果进行评估。
研究方法和数据：
从2000年6月～2010年六月期间，19位脊索瘤和7位软骨肉瘤患者接受了质子治疗，他们的肿瘤原发于颅底(17)和中轴骨(9)。接受质子治疗时的平均年龄为13.2岁。平均照射剂量是：脊索瘤74Gy(相对生物学效应RBE)，软骨肉瘤66Gy(RBE)。单次分割剂量为1.8-2.0Gy(相对生物效应[RBE])。
研究结果：
平均随访时间是46个月。脊索瘤的精确5年局部控制(LC)率是81%，软骨肉瘤是80%。脊索瘤的精确5年整体生存(OS)率是89%，软骨肉瘤是75%。两名脊索瘤患者的局部控制失败：其中一位带瘤生存，另一位在手术路径处局部复发。一位软骨肉瘤患者死于疾病局部进展。未发现高级别的远期毒副作用。
研究结论:
对于儿童脊索瘤和软骨肉瘤患者实施点扫描质子治疗的临床结果是非常好的，远期毒副作用的级别也是可以接受的。今后需要更长的随访时间和更大规模的队列来充分评估肿瘤控制和远期治疗效果。
Research objectives:
The clinical results of 26 children with skull base, axial chordoma (CH) or chondrosarcoma (CS) treated by stratified point scanning irradiation at the Paul Schell Institute were evaluated.
Research methods and data:
From June 2000 to June 2010, 19 patients with chordoma and 7 patients with chondrosarcoma received proton therapy. Their tumors were mainly located in the skull base (17) and medial axis bone (9). The average age of proton therapy was 13.2 years. The average irradiation dose was 74Gy for chordoma (relative biological effect RBE) and 66 Gy for chondrosarcoma (RBE). The single divided dose is 1.8-2.0Gy (relative biological effect [RBE]).
Research results:
The average follow-up time was 46 months. The accurate 5-year local control (LC) rate for chordoma is 81% and chondrosarcoma is 80%. The accurate 5-year overall survival (OS) rate of chordoma is 89%, and chondrosarcoma is 75%. Local control of two chordoma patients failed: one survived with the tumor and the other relapsed locally at the surgical path. A chondrosarcoma patient died of local disease progression. No high-level long-term toxic and side effects were found.
Research conclusion:
The clinical results of point-scan proton therapy for children with chordoma and chondrosarcoma are very good, and the level of long-term toxic and side effects is acceptable. In the future, a longer follow-up time and a larger cohort are needed to fully evaluate the tumor control and long-term therapeutic effects.
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