Clinical outcomes and quality of life after proton therapy for cranial and extracranial solitary fibrous tumors
Abstract
Objectives: Solitary fibrous tumors (SFTs) are rare malignancies. Surgical resection, particularly gross total resection, is the mainstay of therapy. The benefit of postoperative radiotherapy (RT) remains uncertain, with inconsistent findings across studies. Existing literature predominantly reported photon-based RT. This study evaluates clinical outcomes, late toxicities, and quality of life (QoL) in patients with SFTs treated with postoperative pencil beam scanning proton therapy (PT).
Methods: We performed a retrospective single-center analysis of patients with histologically confirmed cranial or extracranial SFTs treated with PT. Local control (LC) was assessed using Brain Tumor Reporting and Data System (BT-RADS) or Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Toxicities were recorded using Common Terminology Criteria for Adverse Events (CTCAE) v5.0, and QoL was assessed prospectively in patients with cranial SFTs. Kaplan-Meier analysis was used to estimate overall survival (OS) and LC, with subgroup comparisons made using the log-rank test.
Results: Seventeen patients were included, with a majority presenting with cranial SFTs (64.7%). After a median follow-up of 47 months (range 7-208 months), OS was 100%. The 5-year LC rate was 81.8% (95% CI, 61.9%-100%) for the entire cohort. Acute toxicities were limited to grade 1-2. Two patients (11.8%) experienced severe late toxicity. Overall QoL appeared broadly stable over time and was comparable to reference population values.
Conclusion: PT provided encouraging preliminary OS and LC rates in patients with cranial and extracranial SFTs. Despite a low rate, the severity of these late toxicities highlights substantial risks near the central nervous system axis.
Advances in knowledge: This retrospective single-center study provides the largest analyzed cohort of patients with cranial and extracranial SFTs treated with PT to our knowledge.
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BibTeX
@article{reinhardt2026clinical,
title = {{Clinical outcomes and quality of life after proton therapy for cranial and extracranial solitary fibrous tumors}},
author = {Philipp Reinhardt and Alessandra Bolsi and Damien Charles Weber},
journal = {BJR Open},
year = {2026},
month = oct,
doi = {10.1093/bjro/tzag023},
url = {https://doi.org/10.1093/bjro/tzag023},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Clinical outcomes and quality of life after proton therapy for cranial and extracranial solitary fibrous tumors
AU - Philipp Reinhardt
AU - Alessandra Bolsi
AU - Damien Charles Weber
PY - 2026
DA - 2026/10/26
JO - BJR Open
DO - 10.1093/bjro/tzag023
UR - https://doi.org/10.1093/bjro/tzag023
AB - Objectives: Solitary fibrous tumors (SFTs) are rare malignancies. Surgical resection, particularly gross total resection, is the mainstay of therapy. The benefit of postoperative radiotherapy (RT) remains uncertain, with inconsistent findings across studies. Existing literature predominantly reported photon-based RT. This study evaluates clinical outcomes, late toxicities, and quality of life (QoL) in patients with SFTs treated with postoperative pencil beam scanning proton therapy (PT). Methods: We performed a retrospective single-center analysis of patients with histologically confirmed cranial or extracranial SFTs treated with PT. Local control (LC) was assessed using Brain Tumor Reporting and Data System (BT-RADS) or Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Toxicities were recorded using Common Terminology Criteria for Adverse Events (CTCAE) v5.0, and QoL was assessed prospectively in patients with cranial SFTs. Kaplan-Meier analysis was used to estimate overall survival (OS) and LC, with subgroup comparisons made using the log-rank test. Results: Seventeen patients were included, with a majority presenting with cranial SFTs (64.7%). After a median follow-up of 47 months (range 7-208 months), OS was 100%. The 5-year LC rate was 81.8% (95% CI, 61.9%-100%) for the entire cohort. Acute toxicities were limited to grade 1-2. Two patients (11.8%) experienced severe late toxicity. Overall QoL appeared broadly stable over time and was comparable to reference population values. Conclusion: PT provided encouraging preliminary OS and LC rates in patients with cranial and extracranial SFTs. Despite a low rate, the severity of these late toxicities highlights substantial risks near the central nervous system axis. Advances in knowledge: This retrospective single-center study provides the largest analyzed cohort of patients with cranial and extracranial SFTs treated with PT to our knowledge.
SN - 2513-9878
ER -