Work

Impact of proton vs. photon radiotherapy on overall survival in the management of spinal chondrosarcoma and mortality risk prediction: A nationwide analysis

Year: 2025

Type: article

Abstract: Background: Spinal chondrosarcomas are rare, aggressive bone tumors with limited data on optimal radiotherapy strategies, particularly regarding the comparison between proton and photon therapies. This study aims to evaluate long-term survival outcomes and identify effective treatments and risk factors using the National Cancer Database. Methods: Patients diagnosed with spinal chondrosarcomas were categorized into radiation and no-radiation groups. The radiation group was subdivided into proton and photon therapy cohorts. Univariate and Kaplan-Meier analyses assessed demographic, clinical, and survival outcomes. Multivariate Cox proportional hazards models identified prognostic factors, and survival predictive models were evaluated using Area Under the Curve (AUC) metrics. Results: = .003). Machine learning identified tumor size thresholds of 75 mm for photon and 70 mm for proton therapy as predictive of mortality. DeepSurv (AUC = 0.708) identified distant metastasis, tumor size, and age as important prognostic factors for 10-year survival. Conclusion: Gross total resection (GTR) is the most effective treatment for spinal chondrosarcoma. High-dose radiation therapy (BED > 70 Gy) can be combined with surgery to improve survival in advanced cases. Proton therapy offers superior long-term survival compared to photons, and dose-escalated techniques (Stereotactic Radiosurgery [SRS] and Intensity-modulated radiation therapy [IMRT]) show potential in enhancing outcomes.

Source: Neuro-Oncology Advances

DOI: 10.1093/noajnl/vdaf240