Proton beam radiotherapy: report of the first ten patients treated at the “Centro Nazionale di Adroterapia Oncologica (CNAO)” for skull base and spine tumours
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The Italian National Centre for Oncological Hadrontherapy (Centro Nazionale di Adroterapia Oncologica, CNAO), equipped with a proton and ion synchrotron, started clinical activity in September 2011. The clinical and technical characteristics of the first ten proton beam radiotherapy treatments are reported.
Materials and methods
Ten patients, six males and four females (age range 27–73 years, median 55.5), were treated with proton beam radiotherapy. After one to two surgical procedures, seven patients received a histological diagnosis of chordoma (of the skull base in three cases, the cervical spine in one case and the sacrum in three cases) and three of low-grade chondrosarcoma (skull base). Prescribed doses were 74 GyE for chordoma and 70 GyE for chondrosarcoma at 2 GyE/fraction delivered 5 days per week.
Treatment was well tolerated without toxicity-related interruptions. The maximal acute toxicity was grade 2, with oropharyngeal mucositis, nausea and vomiting for the skull base tumours, and grade 2 dermatitis for the sacral tumours. After 6–12 months of follow-up, no patient developed tumour progression.
The analysis of the first ten patients treated with proton therapy at CNAO showed that this treatment was feasible and safe. Currently, patient accrual into these as well as other approved protocols is continuing, and a longer follow-up period is needed to assess tumour control and late toxicity.
KeywordsProton therapy Skull base Spine Chordoma Chondrosarcoma Hadrontherapy
The authors would like to acknowledge the President, the Technical and Scientific Committee, the Advisory Board, the General Secretary, the Office of Communications, the Department of Safety Prevention and Environment Service, the Department of Legal Affairs and Human Resources, the Department of Radioprotection, the Office of Quality, the Accelerator Department, the Department of Infrastructure, the Department of Administration and Finance, the Radiation Technologist Unit and the nursing staff for their contribution towards making it possible to initiate clinical activity at CNAO.
Conflict of interest
Roberto Orecchia, V. Vitolo, M.R. Fiore, P. Fossati, A. Iannalfi, B. Vischioni, A. Srivastava, J. Tuan, M. Ciocca, S. Molinelli, A. Mirandola, G. Vilches, A. Mairani, B. Tagaste, M. Riboldi, G. Fontana, G. Baroni, S. Rossi and M. Krengli declare no conflict of interest.