International Journal of Radiation Oncology * Biology * Physics
Volume 74, Issue 3 , Pages 732-739 , 1 July 2009

Phase II Study of High-Dose Photon/Proton Radiotherapy in the Management of Spine Sarcomas

  • Thomas F. DeLaney, M.D.

      Affiliations

    • Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
    • Corresponding Author InformationReprint requests to: Thomas F. DeLaney, M.D., Department of Radiation Oncology, Francis H. Burr Proton Therapy Center, Massachusetts General Hospital, 30 Fruit Street, Boston MA 02114. Tel: (617) 726-7869; Fax: (617) 724-9532
  • ,
  • Norbert J. Liebsch, M.D., Ph.D.

      Affiliations

    • Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • ,
  • Francis X. Pedlow, M.D.

      Affiliations

    • Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • ,
  • Judith Adams, C.M.D.

      Affiliations

    • Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • ,
  • Susan Dean, B.A.

      Affiliations

    • Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • ,
  • Beow Y. Yeap, Sc.D.

      Affiliations

    • Department of Biostatistics, Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • ,
  • Patricia McManus, R.N.

      Affiliations

    • Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • ,
  • Andrew E. Rosenberg, M.D.

      Affiliations

    • Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • ,
  • G. Petur Nielsen, M.D.

      Affiliations

    • Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • ,
  • David C. Harmon, M.D.

      Affiliations

    • Department of Medicine, Division of Hematology Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • ,
  • Ira J. Spiro, M.D., Ph.D.

      Affiliations

    • Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • ,
  • Kevin A. Raskin, M.D.

      Affiliations

    • Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • ,
  • Herman D. Suit, M.D., D.Phil.

      Affiliations

    • Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • ,
  • Sam S. Yoon, M.D.

      Affiliations

    • Department of Surgery (Section of Surgical Oncology), Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • ,
  • Francis J. Hornicek, M.D., Ph.D.

      Affiliations

    • Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA

Received 23 May 2008 ,Revised 25 August 2008 ,Accepted 26 August 2008.

References 

  1. Schultheiss TE, Kun LE, Ang KK, et al. Radiation response of the central nervous system. Int J Radiat Oncol Biol Phys. 1995;31:1093–1112
  2. Zagars GK, Ballo MT. Significance of dose in postoperative radiotherapy for soft tissue sarcoma. Int J Radiat Oncol Biol Phys. 2003;56:473–481
  3. Yang JC, Chang AE, Baker AR, et al. Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol. 1998;16:197–203
  4. Delaney TF, Kepka L, Goldberg SI, et al. Radiation therapy for control of soft-tissue sarcomas resected with positive margins. Int J Radiat Oncol Biol Phys. 2007;67:1460–1469
  5. Kepka L, DeLaney TF, Goldberg SI, et al. Results of radiation therapy for unresected soft tissue sarcomas. Int J Radiat Oncol Biol Phys. 2005;63:852–859
  6. Cummings BJ, Hodson DI, Bush RS. Chordoma: The results of megavoltage radiation therapy. Int J Radiat Oncol Biol Phys. 1983;9:633–642
  7. Rich TA, Schiller A, Suit HD, et al. Clinical and pathologic review of 48 cases of chordoma. Cancer. 1985;56:182–187
  8. Bjornsson J, Wold LE, Ebersold MJ, et al. Chordoma of the mobile spine. A clinicopathologic analysis of 40 patients. Cancer. 1993;71:735–740
  9. Keisch ME, Garcia DM, Shibuya RB. Retrospective long-term follow-up analysis in 21 patients with chordomas of various sites treated at a single institution. J Neurosurg. 1991;75:374–377
  10. Sundaresan N, Rosenthal DI, Schiller AL, et al. Chordomas. In:  Sundaresan N,  Schmidek HH,  Schiller AL, et al. editor. Tumors of the spine. Diagnosis and clinical management. Philadelphia, PA: W.B. Saunders; 1990;p. 192–213
  11. Evans HL, Ayala AG, Romsdahl MM. Prognostic factors in chondrosarcoma of bone: A clinicopathologic analysis with emphasis on histologic grading. Cancer. 1977;40:818–831
  12. Henderson ED, Dahlin DC. Chondrosarcoma of bon–a study of two hundred and eighty-eight cases. J Bone Joint Surg Am. 1963;45:1450–1458
  13. Bergh P, Gunterberg B, Meis-Kindblom JM, et al. Prognostic factors and outcome of pelvic, sacral, and spinal chondrosarcomas: A center-based study of 69 cases. Cancer. 2001;91:1201–1212
  14. Talac R, Yaszemski MJ, Currier BL, et al. Relationship between surgical margins and local recurrence in sarcomas of the spine. Clin Orthop Relat Res. 2002;127–132
  15. Munzenrider JE, Austin-Seymour M, Blitzer PJ, et al. Proton therapy at Harvard. Strahlentherapie. 1985;161:756–763
  16. Austin-Seymour M, Munzenrider J, Goitein M, et al. Fractionated proton radiation therapy of chordoma and low grade chondrosarcoma of the base of skull. J Neurosurg. 1989;70:13–17
  17. Goitein M, Abrams M. Multidimensional treatment planning: Beam's eye view, back projection, and projection through CT sections. Int J Radiat Oncol Biol Phys. 1983;9:789–797
  18. Hug EB, Fitzek MM, Liebsch NJ, et al. Locally challenging osteo- and chondrogenic tumors of the axial skeleton: Results of combined proton and photon radiation therapy using three-dimensional treatment planning. Int J Radiat Oncol Biol Phys. 1995;31:467–476
  19. Lewandrowski KU, Hecht AC, DeLaney TF, et al. Anterior spinal arthrodesis with structural cortical allografts and instrumentation for spine tumor surgery. Spine. 2004;29:1150–1158discussion 1159
  20. Engelsman M, Rosenthal SJ, Michaud SL, et al. Intra- and interfractional patient motion for a variety of immobilization devices. Med Phys. 2005;32:3468–3474
  21. Urie M, Goitein M, Wagner M. Compensating for heterogeneities in proton radiation therapy. Phys Med Biol. 1984;29:553–566
  22. DeLaney TF, Chen GT, Mauceri TC, et al. Intraoperative dural irradiation by customized (192)Iridium AND (90)Yttrium brachytherapy plaques. Int J Radiat Oncol Biol Phys. 2003;57:239–245
  23. Rutz HP, Weber DC, Sugahara S, et al. Extracranial chordoma: Outcome in patients treated with function-preserving surgery followed by spot-scanning proton beam irradiation. Int J Radiat Oncol Biol Phys. 2007;67:512–520
  24. Pieters RS, Niemierko A, Fullerton BC, et al. Cauda equina tolerance to high-dose fractionated irradiation. Int J Radiat Oncol Biol Phys. 2006;64:251–257[Epub 2005 Jul 2001]
  25. Yamada Y, Lovelock DM, Yenice KM, et al. Multifractionated image-guided and stereotactic intensity-modulated radiotherapy of paraspinal tumors: A preliminary report. Int J Radiat Oncol Biol Phys. 2005;62:53–61
  26. Weber DC, Trofimov AV, Delaney TF, et al. A treatment planning comparison of intensity modulated photon and proton therapy for paraspinal sarcomas. Int J Radiat Oncol Biol Phys. 2004;58:1596–1606
  27. Kamada T, Tsujii H, Tsuji H, et al. Efficacy and safety of carbon ion radiotherapy in bone and soft tissue sarcomas. J Clin Oncol. 2002;20:4466–4471
  28. Imai R, Kamada T, Tsuji H, et al. Cervical spine osteosarcoma treated with carbon-ion radiotherapy. Lancet Oncol. 2006;7:1034–1035
  29. Imai R, Kamada T, Tsuji H, et al. Carbon ion radiotherapy for unresectable sacral chordomas. Clin Cancer Res. 2004;10:5741–5746

 Presented at the 48th Annual Meeting of the American Society of Therapeutic Radiology and Oncology, November 5-9, 2006, Philadelphia, PA.

 Conflict of interest: Dr. DeLaney has received honoraria from IBA Proton Therapy for speaking at Industry Sponsored Symposia on Proton Beam Radiotherapy.

PII: S0360-3016(08)03504-9

doi: 10.1016/j.ijrobp.2008.08.058

International Journal of Radiation Oncology * Biology * Physics
Volume 74, Issue 3 , Pages 732-739 , 1 July 2009