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Table 4 Survival outcomes, toxicity incidence and prognostic factors on patients of all included studies

From: Efficacy and safety of carbon ion radiotherapy for chordomas: a systematic review and meta-analysis

Study

Local recurrence

Metastasis

Local control

Overall survival

Toxicity

Prognostic factors been evaluated

Mizoe 2009 [15]

Unclear

NR

5-y (85.1%)

10-y (63.8%)

5-y (87.7%)

10-y (67.0%)

Acute: ≤ G2

Late: ≤ G2 (G2 = 3%)

Age, Sex, KPS, Dose, GTV volume

Imai 2011 [16]

6 (6.3%)

NR

5-y (88.0%)

5-y (86.0%)

Acute: ≤ G3 (G3 = 3.2%)

Late: ≤ G4 (G3 = 2.1%, G4 = 2.1%)

NR

Imai 2016 [17]

41 (21.8%)

54 (28.7%)

5-y (77.2%)

10-y (52.0%)

5-y (81.1%)

10-y (66.8%)

Acute: NR

Late: ≤ G4 (G4 = 1.1%)

Sex, Tumor volume (≤ 500 cc or > 500 cc), Level of proximal invasion (≥ S2 or < S2), Total irradiated dose (≤ 67.2GyE or > 67.2GyE)

Koto 2020 [18]

11 (32.4%)

3 (8.8%)

5-y (76.9%)

9-y (69.2%)

5-y (93.5%)

9-y (77.4%)

Acute: ≤ G3 (G2 = 20.6%, G3 = 2.9%)

Late: ≤ G5 (G3 = 2.9%, G4 = 5.9%, G5 = 2.9%)

Sex, Age(> 52 or ≤ 52), Performance status(0/1/2), Tumor status (Naïve/Recurrence/Residua tumor)b, Eye symptom(yes or no), GTV volume (> 34.7 cc or ≤ 34.7 cc)a,b, D1cc (> 58.9GyE or ≤ 58.9GyE)b

Demizu 2021 [19]

61 (27.9%)

39 (17.8%)

5-y (72.0%)

5-y (84.0%)

Acute: ≤ G4 (G3 = 3.2%, G4 = 0.5%)

Late: ≤ G4 (G3 = 3.7%, G4 = 2.3%)

Age (≥ 67 or < 67)b, c, Sex, Performance status, PTV volume (≥ 500 cc or < 500 cc)b

§Shiba 2021 [20]

8 (15.1%)

11 (20.8%)

3-y (92.5%)

5-y (84.8%)

3-y (91.3%)

5-y (91.3%)

Acute: ≤ G2

Late: ≤ G3

Age, Sex, Chemotherapy, Performance status (0–1 or 2–3)c, Prior treatment, Distance of tumor-GI (≤ 3 mm or > 3 mm), Distance of tumor-GI (≤ 5 mm or > 5 mm), GTV volume (≤ 300 cc or > 300 cc)a, GTV D98 (≤ 64GyE or > 64GyE), GTV D95 (≤ 66GyE or > 66GyE), GTV V64 (≤ 98 or > 98), GTV V60 (≤ 98 or > 98), GTV V<64 (≤ 1cm3 or > 1cm3), GTV V<60 (≤ 1cm3 or > 1cm3)a

Aoki 2022 [21]

7 (36.8%)

5 (26.3%)

2-y (94.7%)

5-y (75.2%)

10-y (46.4%)

2-y (100%)

5-y (68.4%)

10-y (52.1%)

Acute: ≤ G3 (G3 = 5.3%)

Late: ≤ G3 (G3 = 10.5%)

Age, Sex, KPS, Tumor status (initial or recurrent), GTV volume (> 40 cc or ≤ 40 cc)b, Spinal cord infiltration, Minimum dose of GTV

Evangelisti 2019 [22]

2 (11.%)

0

2-y (89.0%)

2-y (100%)

Acute: ≤ G1 (G1 = 27.8%)

Late: ≤ G3 (G2 or G3 = 16.7%)

NR

†Iannalfi 2020 [23]

14 (21.5%)

9 (13.8%)

3-y (77.0%)

5-y (71.0%)

3-y (90.0%)

5-y (82.0%)

Acute: ≤ G2

Late: Unclear

Sex, Age, Histology, Anatomic extension of the disease (upper/middle/lower clivus), GTV volume (≤ 23.1 cc or > 23.1 cc)a,b, Optic pathways and brainstem compressiona, Target coverage (D95% of CTV-HR and GTV)

Uhl 2014 [24]

55 (35.5%)

4 (2.6%)

3-y (82.0%)

5-y (72.0%)

10-y (54.0%)

3-y (95.0%)

5-y (85.0%)

10-y (75.0%)

Acute: NR

Late: Quantitative toxicity results

PTV volume (< 100 ml or ≥ 100 ml)a, Total dose (≤ 51 GyE or > 51 GyE)a

†Mattke 2023 [25]

NR

NR

1-y (96.1%)

3-y (80.4%)

5-y (64.5%)

1-y (99.0%)

3-y (91.2%)

5-y (83.3%)

Acute: ≤ G1

Late: ≤ G3

Age, Sex, Tumor status (primary or recurrent)

  1. Bold indicates statistically significant difference
  2. NR no reported, KPS Karnofsky performance status, GTV gross target volume, PTV plan target volume, GI: gastrointestinal
  3. †Only carbon ion data is included
  4. §Only chordoma data is included
  5. aFactor significantly correlated with local control (LC) (p ≤ 0.05)
  6. bFactor significantly correlated with overall survival (OS) (p ≤ 0.05)
  7. cFactor significantly correlated with progress-free survival (PFS) (p ≤ 0.05)