Background: skull base chordoma (Ch) and chondrosarcoma (ChSa) are rare neoplasms prone to local relapse. Alongside surgery, proton therapy (PT) is a well-established treatment for them. Given the relatively long patient survival expectancy, post-treatment quality of life (QoL) is crucial. This study prospectively assessed long-term QoL in this collective.Methods: seventy-seven adult patients (median age, 50 years; malen= 31; 40.3%) with skull base Ch/ChSa completed at least two EORTC-QLQ-C30 and BN20 questionnaires during and after PT. Oncological outcomes and therapy-related toxicities were recorded during follow-up. QoL was analyzed, with post-treatment scores compared to each patient’s baseline and correlated to oncological outcomes.Results: median follow-up was 51 months (range, 1–94), with 5-year overall survival (5yOS) and local control (5yLC) rates of 88.8% and 82.8%, respectively. The time to local or distant failure ranged from 8 to 58 (median, 22) months. QoL deteriorated directly at completion of PT and two to three years thereafter, especially in patients with local or distant failure. From the fifth year onward, QoL improved again. Complete resection before PT correlated to better QoL at all time points. Disease progression was associated with overall worse QoL, higher neurological symptoms already before PT, and higher symptom burden one year thereafter. Males reported better QoL before and one year after PT than females.Conclusions: PT achieves excellent OS and LC in patients with skull base Ch/ChSa. QoL declines directly after PT but remains close to reference population values. From the fifth year onward, QoL improves again. Gender, resection status, and disease progression significantly affect QoL in these patients.
背景：颅底脊索瘤（Ch）与软骨肉瘤（ChSa）是易局部复发的罕见肿瘤。除手术外，质子治疗（PT）是其公认的治疗手段。鉴于患者生存期相对较长，治疗后生活质量（QoL）至关重要。本研究前瞻性评估了该群体的长期生活质量。 方法：77例颅底Ch/ChSa成年患者（中位年龄50岁；男性31例，占40.3%）在质子治疗期间及治疗后至少完成两次EORTC-QLQ-C30与BN20量表评估。随访期间记录肿瘤学结局及治疗相关毒性反应。通过对比治疗后评分与患者基线水平，并将生活质量与肿瘤学结局进行关联分析。 结果：中位随访时间51个月（范围1-94个月），5年总生存率（5yOS）与局部控制率（5yLC）分别为88.8%与82.8%。局部或远处复发时间为8-58个月（中位22个月）。生活质量在质子治疗结束时及治疗后2-3年内显著下降，尤其在出现局部或远处复发的患者中更为明显。从第五年开始，生活质量再次改善。质子治疗前完全切除与各时间点更好的生活质量相关。疾病进展与整体生活质量下降、质子治疗前已存在较高神经症状负担及治疗后一年症状加重显著相关。男性在质子治疗前及治疗后一年的生活质量报告均优于女性。 结论：质子治疗对颅底Ch/ChSa患者可获得优异的总体生存率与局部控制率。生活质量在治疗后短期内下降，但仍接近参考人群水平。从第五年开始生活质量逐步回升。性别、切除状态及疾病进展是影响此类患者生活质量的重要因素。
肿瘤(癌症)患者之家