Abstract

Background

Carbon ion radiotherapy (CIRT) is an emerging radiation therapy to treat skull base chordomas and chondrosarcomas. To date, its use is limited to a few centers around the world, and there has been no attempt to systematically evaluate survival and toxicity outcomes reported in the literature. Correspondingly, the aim of this study was to qualitatively and quantitatively assess these outcomes.

Methods

A systematic search of seven electronic databases from inception to November 2019 was conducted following PRISMA guidelines. Articles were screened against pre-specified criteria. Outcomes were then pooled by random-effects meta-analyses of proportions.

Results

A total of nine studies provided unique metadata for assessment, with six originating from Heidelberg, Germany. The surveyed cohort size was 632 patients, with 389 (62%) chordomas and 243 (38%) chondrosarcomas of the skull base. Across all studies, median cohort age at therapy and female proportion were 46 years and 51% respectively. Estimates of local control incidence at 1-, 5-, and 10-years in chordoma-only studies were 99%, 80%, and 56%, and in chondrosarcoma-only studies were 99%, 89%, and 88%. Estimates of overall survival probability at 1-, 5-, and 10-years in chordoma-only studies were 100%, 94%, and 78%, and in chondrosarcoma-only studies were 99%, 95%, and 79%. The incidence of early and late toxicity (Grade ≥ 3) ranged from 0 to 4% across all study groups.

Conclusions

The emerging use of CIRT to treat skull base chordomas and chondrosarcomas appear promising with regard to tumor control, overall survival, and risk profile of early and late toxicity. The current literature suffers from the fact only a few centers in the world currently employ this technology.

中文翻译：

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颅底脊索瘤和软骨肉瘤的碳离子放射治疗：局部控制，生存和毒性结果的系统评价和荟萃分析。

摘要

背景

碳离子放射疗法（CIRT）是一种新兴的放射疗法，用于治疗颅底脊索瘤和软骨肉瘤。迄今为止，它的使用仅限于世界上的一些中心，并且还没有尝试系统地评估文献中报道的生存和毒性结果。相应地，本研究的目的是定性和定量评估这些结果。

方法

根据PRISMA指南，从成立到2019年11月对七个电子数据库进行了系统搜索。根据预先指定的标准筛选文章。然后通过比例的随机效应荟萃分析汇总结果。

结果

共有9项研究提供了独特的评估元数据，其中6项源自德国海德堡。所调查的队列大小为632例患者，其中颅底脊索肉瘤389例（占62％）和软骨肉瘤243例（占​​38％）。在所有研究中，接受治疗的队列中位年龄和女性比例分别为46岁和51％。仅脊索瘤研究在1年，5年和10年的局部控制发生率估计为99％，80％和56％，仅软骨肉瘤研究为99％，89％和88％。仅脊索瘤的研究在1年，5年和10年的总体生存率估计为100％，94％和78％，仅软骨肉瘤的研究为99％，95％和79％。在所有研究组中，早期和晚期毒性（≥3级）的发生率在0％至4％之间。

结论

在肿瘤控制，总体生存以及早期和晚期毒性的危险性方面，CIRT在颅骨基脊索瘤和软骨肉瘤治疗中的新兴应用前景看好。当前的文献遭受这样的事实的困扰，即世界上只有很少的中心目前采用该技术。