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Copenhagen, Denmark
Onsite/Online

ESTRO 2022

Session Item

CNS
Poster (digital)
Clinical
Post-operative Proton Beam Therapy in cervical chordoma
Katarzyna Holub, Spain
PO-1129

Abstract

Post-operative Proton Beam Therapy in cervical chordoma
Authors:

Katarzyna Holub1, Sebastien Froelich2, Jean Pierre Guichard3, Thibault Passeri2, Marc Polivka4, Alexandre Carpentier5, Homa Adle-Biassette4, Loic Feuvret6, Guillaume Lot7, Stéphanie Bolle8, Arnaud Beddok9, Radouane El Ayachy9, Farid Goudji9, Isabelle Pasquie9, Valentin Calugaru9, Remi Dendale9, Hamid Mammar9

1Institut Curie, Department of Radiation Oncology, SEOR-CRIS Foundation, Paris, France; 2Hôpital Lariboisière , Department of Neurosurgery, Paris, France; 3Hôpital Lariboisière , Department of Radiology, Paris, France; 4Hôpital Lariboisière , Department of Pathology, Paris, France; 5Hôpital La Pitié Salpêtrière , Department of Neurosurgery, Paris, France; 6Hôpital La Pitié Salpêtrière , Department of Radiation Oncology, Paris, France; 7Fondation Rothschild, Department of Neurosurgery, Paris, France; 8Gustave Roussy, Department of Radiation Oncology, Villejuif, France; 9Institut Curie, Department of Radiation Oncology, University Paris-Saclay, Paris, France

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Purpose or Objective

To present outcomes of postsurgical proton-based RT in patients with cervical chordomas treated between 2014-2018 in the Centre of Protontherapy in Orsay, France. 

Material and Methods

A total of 9 consecutive patients with cervical chordoma with median age was 55.7 years old (range 38.8-72.3) at the time of RT were treated with postsurgical adjutant proton-based RT, at a median dose 73.8GyE (70.2-73.8). Only PT was administered to 5 patients (55.6%) and 4 (44.4%) were treated with a combination of photons (median dose 44.1 Gy, range 23.4-52.2) and PT GyE (median dose 29.7 Gy, range 18.0-50.4).  Female/male ratio was 4/5. Histological subtypes were classic in 7 cases, chordoid in 1 patient and mixt classic-chordoid in 1 patient. Complete resection was achieved in 2 patients. The median time from surgery to PT: 7.6 months (4.6-38.0).  Three patients were treated with 2nd surgery and four patients presented post-surgical squeals: 3 sensorial (hypoesthesia of left cervico-occipital territory, sensory deficit in three left fingers due to median nerve alteration, right latero-cervical hypoesthesia) and 1 motor (left arm motor deficit + XII pc). 

Results

After a median follow up of 44.2 months (range 11.0-70.8, mean 41.6 months), 3 patients presented local and 1 distant progression. As 2 patients died (one due to chordoma progression), the overall survival rate was 73.8% and overall chordoma-related survival rate: 85.7%. Post-PT toxicity was described in 5 patients, all CTCAE grade 1-2 (hear loss unilateral, mild facial hypoesthesia, mild dysphagia, insomnia, mild cervical pain, asthenia, paraesthesia right arm). One patient presented asymptomatic radionecrosis resolved with corticoids. 


Table 1. Characteristics of patients with cervical chordoma treated with PT 


Conclusion

High-dose conformal PT is safe and effective postoperative treatment in spinal chordoma in close proximity to the spinal cord with minimal neurotoxicity.