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@ARTICLE{Mattke:181822,
      author       = {M. Mattke and M. Ohlinger and N. Bougatf$^*$ and S. Harrabi
                      and R. Wolf and K. Seidensaal and T. Welzel and F. Röder
                      and S. Gerum and M. Ellerbrock and O. Jäkel$^*$ and T.
                      Haberer and K. Herfarth and M. Uhl and J. Debus$^*$},
      title        = {{P}roton and carbon ion beam treatment with active raster
                      scanning method in 147 patients with skull base chordoma at
                      the {H}eidelberg {I}on {B}eam {T}herapy {C}enter-a
                      single-center experience.},
      journal      = {Strahlentherapie und Onkologie},
      volume       = {199},
      number       = {2},
      issn         = {0179-7158},
      address      = {Heidelberg},
      publisher    = {Springer Medizin},
      reportid     = {DKFZ-2022-02237},
      pages        = {160-168},
      year         = {2023},
      note         = {#LA:E050# /2023 Feb;199(2):160-168},
      abstract     = {This study aimed to compare the results of irradiation with
                      protons versus irradiation with carbon ions in a raster scan
                      technique in patients with skull base chordomas and to
                      identify risk factors that may compromise treatment
                      results.A total of 147 patients (85 men, 62 women) were
                      irradiated with carbon ions (111 patients) or protons (36
                      patients) with a median dose of 66 Gy (RBE (Relative
                      biological effectiveness); carbon ions) in 4 weeks or 74 Gy
                      (RBE; protons) in 7 weeks at the Heidelberg Ion Beam Therapy
                      Center (HIT) in Heidelberg, Germany. The median follow-up
                      time was 49.3 months. All patients had gross residual
                      disease at the beginning of RT. Compression of the brainstem
                      was present in $38\%,$ contact without compression in
                      $18\%,$ and no contact but less than 3 mm distance in
                      $16\%.$ Local control and overall survival were evaluated
                      using the Kaplan-Meier Method based on scheduled treatment
                      (protons vs. carbon ions) and compared via the log rank
                      test. Subgroup analyses were performed to identify possible
                      prognostic factors.During the follow-up, 41 patients
                      $(27.9\%)$ developed a local recurrence. The median
                      follow-up time was 49.3 months $(95\%$ CI: 40.8-53.8;
                      reverse Kaplan-Meier median follow-up time 56.3 months,
                      $95\%$ CI: 51.9-60.7). No significant differences between
                      protons and carbon ions were observed regarding LC, OS, or
                      overall toxicity. The 1‑year, 3‑year, and 5‑year LC
                      rates were $97\%,$ $80\%,$ and $61\%$ (protons) and $96\%,$
                      $80\%,$ and $65\%$ (carbon ions), respectively. The
                      corresponding OS rates were $100\%,$ $92\%,$ and $92\%$
                      (protons) and $99\%,$ $91\%,$ and $83\%$ (carbon ions). No
                      significant prognostic factors for LC or OS could be
                      determined regarding the whole cohort; however, a
                      significantly improved LC could be observed if the tumor was
                      > 3 mm distant from the brainstem in patients presenting in
                      a primary situation.Outcomes of proton and carbon ion
                      treatment of skull base chordomas seem similar regarding
                      tumor control, survival, and toxicity. Close proximity to
                      the brainstem might be a negative prognostic factor, at
                      least in patients presenting in a primary situation.},
      keywords     = {Bragg peak (Other) / C12 (Other) / Heavy ion (Other) / High
                      LET (Other) / Notochordal sarcoma (Other) / Particle therapy
                      (Other)},
      cin          = {E050 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)E050-20160331 / I:(DE-He78)HD01-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:36149438},
      doi          = {10.1007/s00066-022-02002-4},
      url          = {https://inrepo02.dkfz.de/record/181822},
}