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Abstract
BACKGROUND:
The current study compares the results of irradiation with protons and irradiation with carbon ions via a raster scan technique in patients with G1 and G2 skull base chondrosarcomas.

METHODS:
Between 2009 and 2014, a total of 101 patients (40 men and 61 women) with a median age of 44 years (range, 19-77 years) were irradiated with carbon ions (79 patients) or protons (22 patients) via a raster scan technique at the Heidelberg Ion Beam Therapy Center. The median total dose was 60 Gy (relative biological effectiveness [RBE]) at 3 Gy per fraction for carbon ions and 70 Gy (RBE) at 2 Gy per fraction for protons. The median boost planning target volume was 38 cm3 (range, 8-133 cm3 ). Overall survival (OS) and local control (LC) were evaluated with the Kaplan-Meier method.

RESULTS:
The median follow-up period was 40 months (range, 0.8-78.1 months). At the start of the irradiation, all patients had residual macroscopic tumors. Five patients (5%) developed a local recurrence during the follow-up. The 1-, 2-, and 4-year LC rates were 100%, 100%, and 100%, respectively, for protons and 98.6%, 97.2%, and 90.5%, respectively, for carbon ions. The OS rates during the same periods of time were 100%, 100%, and 100%, respectively, for protons and 100%, 98.5%, and 92.9%, respectively, for carbon ions. An age ≤ 44 years was associated with a trend for a better outcome. No toxicity worse than Common Toxicity Criteria grade 3 was observed after treatment.

CONCLUSIONS:
No significant difference between carbon ions and protons in the therapy of skull base chondrosarcoma could be detected in these initial retrospective results. 

Author information

Mattke M1,2, Vogt K1,2, Bougatf N1,2,3,4, Welzel T1,2, Oelmann-Avendano J1,2, Hauswald H1,2,3,4, Jensen A5, Ellerbrock M2,3, Jäkel O1,2,3,4, Haberer T2,3, Herfarth K1,2,3, Debus J1,2,3,4, Uhl M1,2,3.
1
Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany.
2
Heidelberg Institute for Radiation Oncology, National Center for Radiation Research in Oncology, Heidelberg, Germany.
3
Heidelberg Ion Beam Therapy Center, Heidelberg, Germany.
4
German Cancer Research Center, Heidelberg, Germany.
5
Department of Radiation Oncology, Ludwig Maximilian University of Munich, Munich, Germany.