Proton‐based radiotherapy for unresectable or incompletely resected osteosarcoma
Open accessAbstract
BACKGROUND: A study was undertaken to assess clinical outcome and the role of proton therapy for local control of osteosarcoma (OSA). METHODS: All patients who received proton therapy or mixed photon‐proton radiotherapy from 1983 to 2009 at the Massachusetts General Hospital were reviewed. Criteria for proton therapy were the need for high dose in the context of highly conformal radiotherapy of unresected or partially resected OSA, positive postoperative margins, postoperative imaging studies with macroscopic disease, or incomplete resection as defined by the surgeon. The primary endpoint was local control of the site treated; secondary endpoints were disease‐free survival (DFS), overall survival (OS), long‐term toxicity, and prognostic factors associated with clinical outcome. RESULTS: Fifty‐five patients with a median age of 29 years (range, 2‐76 years) were offered proton therapy. The mean dose was 68.4 gray (Gy; standard deviation, 5.4 Gy). Of the total dose, 58.2% (range, 11%‐100%) was delivered with protons. Local control after 3 and 5 years was 82% and 72%, respectively. The distant failure rate was 26% after 3 and 5 years. The 5‐year DFS was 65%, and the 5‐year OS was 67%. The extent of surgical resection did not correlate with outcome. Risk factors for local failure were ≥2 grade disease ( P < .0001) and total treatment length ( P = .008). Grade 3 to 4 late toxicity was seen in 30.1 % of patients. One patient died from treatment‐associated acute lymphocytic leukemia, and 1 from secondary carcinoma of the maxilla. CONCLUSIONS: Proton therapy to deliver high radiotherapy doses allows locally curative treatment for some patients with unresectable or incompletely resected OSA. Cancer 2011;. © 2011 American Cancer Society.
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Five-year local control rates of 62-67% in patients with inoperable pelvic and trunk sarcomas are encouraging.
“Five-year local control rates of 62-67% in patients with inoperable pelvic and trunk sarcomas are encouraging 138,139 .”
From Osteosarcoma (2022) · cites this paper as [138]
Heavy particles offer a technical advantage to deliver the high doses of 60 Gy or ideally 70 Gy deemed necessary for disease control.
“Heavy particles offer a technical advantage to deliver the high doses of 60 Gy or ideally 70 Gy deemed necessary for disease control 138 .”
From Osteosarcoma (2022) · cites this paper as [138]
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Cites
Ritter, J., & Bielack, S. (2010) · Annals of Oncology · doi:10.1093/annonc/mdq276 · Cited by 1,050 · see citing works
Ewing's Sarcoma Family of Tumors: Current Management
Bernstein, M. L., Kovar, H., Paulussen, M., et al. (2006) · The Oncologist · doi:10.1634/theoncologist.11-5-503 · Cited by 524 · see citing works
Osteosarcoma of the Pelvis: Experience of the Cooperative Osteosarcoma Study Group
Ozaki, T., Flege, S., Kevric, M., Lindner, N. J., Maas, R., Delling, G., Schwarz, R., Hochstetter, A. R. V., Salzer-Kuntschik, M., Berdel, W. E., et al. (2003) · Journal of Clinical Oncology · doi:10.1200/jco.2003.01.142 · Cited by 342 · see citing works
Osteosarcoma treatment: state of the art
Ta, H. T., Dass, C. R., Choong, P., & Dunstan, D. E. (2009) · Cancer and Metastasis Reviews · doi:10.1007/s10555-009-9186-7 · Cited by 311 · see citing works
Radiotherapy for local control of osteosarcoma
DeLaney, T. F., Park, L., Goldberg, S. I., Hug, E. B., Liebsch, N. J., Munzenrider, J. E., & Suit, H. D. (2005) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2004.05.051 · Cited by 305 · see citing works
Self-citationEfficacy and Safety of Carbon Ion Radiotherapy in Bone and Soft Tissue Sarcomas
Kamada, T., Tsujii, H., Tsuji, H., et al. (2002) · Journal of Clinical Oncology · doi:10.1200/jco.2002.10.050 · Cited by 290 · see citing works
Ozaki, T., Flege, S., Liljenqvist, U., et al. (2002) · Cancer · doi:10.1002/cncr.10258 · Cited by 284 · see citing works
Phase II Study of High-Dose Photon/Proton Radiotherapy in the Management of Spine Sarcomas
DeLaney, T. F., Liebsch, N. J., Pedlow, F. X., Adams, J., Dean, S., Yeap, B. Y., McManus, P. L., Rosenberg, A. E., Nielsen, G. P., Harmon, D. C., et al. (2008) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2008.08.058 · Cited by 263 · see citing works
Self-citationTrofimov, A. V., Nguyen, P. L., Coen, J. J., et al. (2007) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2007.03.018 · Cited by 224 · see citing works
Osteosarcoma of the Head and Neck: Meta‐analysis of Nonrandomized Studies
Kassir, R. R., Rassekh, C. H., Kinsella, J. B., et al. (1997) · The Laryngoscope · doi:10.1097/00005537-199701000-00013 · Cited by 214 · see citing works
Osteosarcoma of the jaw/craniofacial region
Guadagnolo, B. A., Zagars, G. K., Raymond, A. K., et al. (2009) · Cancer · doi:10.1002/cncr.24297 · Cited by 184 · see citing works
Neoadjuvant Chemotherapy and Local Radiotherapy for High-Grade Osteosarcoma of the Extremities
Machak, G. N., Si, T., Solovyev, Y. N., Sinyukov, P. A., Ivanov, S. M., Кочергина, Н. В., Ryjkov, A. D., Тепляков, В. В., Bokhyan, B. Y., & Glebovskaya, V. V. (2003) · Mayo Clinic Proceedings · doi:10.4065/78.2.147 · Cited by 149 · see citing works
Osteosarcoma: Basic Science and Clinical Implications
Hayden, J. B., & Hoang, B. H. (2006) · Orthopedic Clinics of North America · doi:10.1016/j.ocl.2005.06.004 · Cited by 136 · see citing works
Jasnau, S., Meyer, U., Potratz, J. C., Jundt, G., Kevric, M., Joos, U., Jürgens, H., & Bielack, S. (2007) · Oral Oncology · doi:10.1016/j.oraloncology.2007.03.001 · Cited by 129 · see citing works
Weber, D. C., Trofimov, A. V., DeLaney, T. F., et al. (2004) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2003.11.028 · Cited by 118 · see citing works
Self-citationSystematic Review: Charged-Particle Radiation Therapy for Cancer
Terasawa, T., Dvorak, T., Ip, S., Raman, G., Lau, J., & Trikalinos, T. A. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-8-200910200-00145 · Cited by 104 · see citing works
Wagner, T. D., Kobayashi, W. K., Dean, S., et al. (2008) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2008.03.074 · Cited by 65 · see citing works
Self-citationChung, C. S., Keating, N. L., Yock, T. I., et al. (2008) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2008.06.785 · Cited by 55 · see citing works
Self-citationProton Therapy for Malignant Pleural Mesothelioma After Extrapleural Pleuropneumonectomy
Krayenbuehl, J., Hartmann, M., Lomax, A., et al. (2010) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2009.11.006 · Cited by 37 · see citing works
Cervical spine osteosarcoma treated with carbon-ion radiotherapy
Imai, R., Kamada, T., Tsuji, H., et al. (2006) · The Lancet Oncology · doi:10.1016/s1470-2045(06)70978-0 · Cited by 37 · see citing works
Local control of osteogenic sarcoma by radiation and chemotherapy
Cáceres, E., Zaharia, M., Valdivia, S., et al. (1984) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/0360-3016(84)90409-7 · Cited by 25 · see citing works
Mechanism of apoptotic resistance of human osteosarcoma cell line, HS-Os-1, against irradiation
Ogawa, Y., Takahashi, T., Kobayashi, T., et al. (2003) · International Journal of Molecular Medicine · doi:10.3892/ijmm.12.4.453 · Cited by 23 · see citing works
Wang, V. Y., Potts, M., & Chou, D. (2007) · Neurosurgery Clinics of North America · doi:10.1016/j.nec.2007.10.001 · Cited by 22 · see citing works
New paradigms for therapy for osteosarcoma
Nagarajan, R., Clohisy, D. R., & Weigel, B. J. (2005) · Current Oncology Reports · doi:10.1007/s11912-005-0005-1 · Cited by 19 · see citing works
European boost for particle therapy
Brower, V. (2009) · Nature · doi:10.1038/457139a · Cited by 5 · see citing works
Carbon ion radiotherapy for bone and soft tissue sarcomas
Kamada, T., Imai, R., Tsujii, H., et al. (2008) · Journal of Clinical Oncology · doi:10.1200/jco.2008.26.15_suppl.10538 · Cited by 4 · see citing works
Carbon ion radiotherapy for bone and soft tissue sarcomas
Kamada, T., Sugahara, S., Imai, R., et al. (2009) · German Medical Science (German Research Foundation) · doi:10.3205/09ptcog102 · Cited by 3 · see citing works
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Beird, H. C., Bielack, S. S., Flanagan, A. M., Gill, J., Heymann, D., Janeway, K. A., Livingston, J. A., Roberts, R. D., Strauss, S. J., & Gorlick, R. (2022) · Nature Reviews Disease Primers · doi:10.1038/s41572-022-00409-y · Cited by 660 · see citing works
Strauss, S. J., Frezza, A. M., Abecassis, N., Bajpai, J., Bauer, S., Biagini, R., Bielack, S., Blay, J. Y., Bolle, S., Bonvalot, S., et al. (2021) · Annals of Oncology · doi:10.1016/j.annonc.2021.08.1995 · Cited by 513 · see citing works
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Arndt, C. A. S., Rose, P. S., Folpe, A. L., & Laack, N. N. (2012) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2012.01.015 · Cited by 298 · see citing works
Impact of carbon ion radiotherapy for unresectable osteosarcoma of the trunk
Matsunobu, A., Imai, R., Kamada, T., Imaizumi, T., Tsuji, H., Tsujii, H., Shioyama, Y., Honda, H., Tatezaki, S., & for the Working Group for Bone and Soft Tissue Sarcomas (2012) · Cancer · doi:10.1002/cncr.27451 · Cited by 158 · see citing works
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Jaffe, N., Puri, A., & Gelderblom, H. (2013) · Sarcoma · doi:10.1155/2013/203531 · Cited by 93 · see citing works
Seidensaal, K., Mattke, M., Haufe, S., Rathke, H., Haberkorn, U., Bougatf, N., Kudak, A., Blattmann, C., Oertel, S., Kirchner, M., et al. (2021) · Radiotherapy and Oncology · doi:10.1016/j.radonc.2021.01.029 · Cited by 36 · see citing works
- Authors
- Ciernik, I. F., Niemierko, A., Harmon, D. C., Kobayashi, W., Chen, Y., Yock, T. I., Ebb, D. H., Choy, E., Raskin, K. A., Liebsch, N., Hornicek, F. J., & DeLaney, T. F.
- Affiliations
- Massachusetts General Hospital (US)
- Harvard University (US)
- Corresponding author
- DeLaney, Thomas F.
- ORCID
- Venue
- Cancer
- Publisher
- Wiley
- Published
- 2011-03-29
- Volume
- 117
- Issue
- 19
- Pages
- 4522-4530
- ISSN
- 0008-543X (ISSN-L)
- 1097-0142
- PMC
- PMC3716000
- OpenAlex
- W2080066814
- Cited by
- 191
- References
- 27
- Citations by year
- 2026: 10 · 2025: 17 · 2024: 13 · 2023: 16 · 2022: 23 · 2021: 18 · 2020: 20 · 2019: 6 · 2018: 7 · 2017: 13 · 2016: 10 · 2015: 7 · 2014: 13 · 2013: 8 · 2012: 10
- FWCI
- 8.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cancer (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (P01CA021239)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Sarcoma Diagnosis and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Radiation Therapy and Dosimetry
- Health Sciences › Medicine › Rheumatology › Bone Tumor Diagnosis and Treatments
- Keywords
- osteosarcoma, proton therapy, incomplete resection, local control, disease-free survival, overall survival, late toxicity, prognostic factors, high-dose radiotherapy, acute lymphoblastic leukemia
- MeSH terms
- Adolescent, Adult, Aged, Antineoplastic Agents, Bone Neoplasms, Child, Child, Preschool, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Osteosarcoma, Survival Rate, Radiotherapy, Conformal, Young Adult, Proton Therapy
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