Background: To report survival of craniofacial osteosarcoma patients treated by particle radiotherapy.
Methods: Between January 2010 and December 2021, 51 patients with primary ( = 35) or recurrent ( = 16) inoperable or incompletely resected craniofacial osteosarcoma were treated. In most cases, intracranial infiltration (59%) and macroscopic tumor on MRI/CT (75%) were present. Thirteen had a secondary osteosarcoma (25%). Treatment concepts included combined ion beam radiotherapy (CIBRT, = 18), protons only ( = 3), carbon ions only ( = 12), IMRT with a carbon ion boost ( = 5), and carbon ion re-irradiation ( = 13). Eighty percent (N = 41) received additionally chemotherapy, most frequently EURAMOS-1 (47%) or EURO-B.O.S.S. (18%).
Results: The median age was 38, and all patients finished treatment predominantly as outpatients ( = 44). Information on overall survival was available for N = 49 patients. The median follow-up of the survivors was 55 months. For the whole cohort 1-, 2-, 3-, and 5-year overall survival (OS) was 82.8%, 60.4%, 55.2%, and 51.7%, respectively. Those treated by CIBRT (N = 17) demonstrated a superior OS with 92.9% after 1 and 2 years and 83.6% after 3 and 5 years. The median clinical target volume (CTV) was 192.7 and 95.2 cc for the primary and boost plan, respectively. CIBRT, primary diagnosis, age ≤40a, and no macroscopic residual tumor were associated with improved survival in univariate analysis ( = 0.006, = 0.004, = 0.002, = 0.026, respectively), while any foregoing resection compared to biopsy was not identified as a prognostic factor. CIBRT and no macroscopic residual tumor were confirmed as independent predictors of OS on multivariate analysis (HR = 0.107, 95% CI = [0.014, 0.797], = 0.029 and HR = 0.130, 95% CI = [0.023, 0.724], = 0.020, respectively). No acute toxicity > grade III was observed.
Conclusion: CIBRT shows promising results for patients with inoperable or incompletely resected craniofacial osteosarcoma.
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| http://dx.doi.org/10.3389/fonc.2022.927399 | DOI Listing |
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