vmireavizВестник медицинского института «РЕАВИЗ». Реабилитация, Врач и ЗдоровьеBulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)2226-762X2782-1579РЕАВИЗ10.20340/vmi-rvz.2026.2.CLIN.3vmireaviz-1546Research ArticleКлиническая медицинаClinical medicineРезультаты лечения хордом ската черепа: опыт ФГБУ ФНКЦРИО ФМБА РоссииResults of Treatment of Skull Ray Chordoma: Experience of FSCCRO of FMBA of Russiahttps://orcid.org/0009-0009-6744-7441СаакянА. Б.SaakyanA. B.

Саакян Арсэн Баградович -Врач-радиотерапевт отделения  радиотерапии №1 стационара

пр. Ленина, д. 30Б, г. Димитровград, 433512, Россия

Arsen B. Saakyan - Radiotherapist at the Radiotherapy Department No. 1

 Lenin ave., 30B, Dimitrovgrad, 433512, Russia 

saakjanab@fnkcrio.ruhttps://orcid.org/0009-0003-3711-7229БукареваО. П.BukarevaO. P.

Букарева Ольга Петровна - Врач-радиотерапевт отделения радиотерапии №1 стационара

пр. Ленина, д. 30Б, г. Димитровград, 433512, Россия

Olga P. Bukareva - Radiotherapist at the Radiotherapy Department No. 1

Lenin ave., 30B, Dimitrovgrad, 433512, Russia

o-bukareva@mail.ruhttps://orcid.org/0000-0003-1711-6950НезвецкийА. В.NezvetskiyA. V.

Незвецкий Алексей Владимирович - Заведующий отделением радиотерапии №1, врач-радиотерапевт

 пр. Ленина, д. 30Б, г. Димитровград, 433512, Россия 

Aleksey V. Nezvetskiy - Head of the Radiotherapy Department No. 1, Radiotherapist

Lenin ave., 30B, Dimitrovgrad, 433512, Russia

nezvetskijav@fnkcrio.ruhttps://orcid.org/0000-0003-0988-0182АндреевВ. А.AndreevV. A.

Андреев Василий Алексеевич - Врач-радиотерапевт отделения радиотерапии №1 стационара

пр. Ленина, д. 30Б, г. Димитровград, 433512, Россия

Vasiliy A. Andreev - Radiotherapist at the Radiotherapy Department No. 1

Lenin ave., 30B, Dimitrovgrad, 433512, Russia

andreevva@fnkcrio.ruhttps://orcid.org/0009-0002-5392-711XДобролюбоваИ. Э.DobrolyubovaI. E.

Добролюбова Ирина Эдуардовна - Врач-стажер отделения радиотерапии №1 стационара

пр. Ленина, д. 30Б, г. Димитровград, 433512, Россия

Irina E. Dobrolyubova - Trainee doctor at the Radiotherapy Department No. 1

Lenin ave., 30B, Dimitrovgrad, 433512, Russia

dobroljubovaie@fnkcrio.ruhttps://orcid.org/0000-0002-3896-3182БелостоцкийА. В.BelostotskiyA. V.

Белостоцкий Андрей Викторович - Доктор мед. наук, профессор, исполняющий обязанности генерального директора 

 пр. Ленина, д. 30Б, г. Димитровград, 433512, Россия 

Andrey V. Belostotskiy - Dr. Sci. (Med.), Professor, Acting Director General

Lenin ave., 30B, Dimitrovgrad, 433512, Russia

kadyrovaam@fnkcrio.ruhttps://orcid.org/0000-0001-5551-818XМаяковаЕ. В.MayakovaE. V.

Маякова Елена Викторовна - Главный врач

пр. Ленина, д. 30Б, г. Димитровград, 433512, Россия

Elena V. Mayakova - Chief Physician 

Lenin ave., 30B, Dimitrovgrad, 433512, Russia

mayakova@fnkcrio.ruФедеральный научно-клинический центр медицинской радиологии и онкологии Федерального медико-биологического агентстваРоссияFederal Scientific and Clinical Center of Medical Radiology and Oncology of the Federal Medical and Biological AgencyRussian Federation2026150720261626267Copyright © Саакян А.Б., Букарева О.П., Незвецкий А.В., Андреев В.А., Добролюбова И.Э., Белостоцкий А.В., Маякова Е.В., 20262026Саакян А.Б., Букарева О.П., Незвецкий А.В., Андреев В.А., Добролюбова И.Э., Белостоцкий А.В., Маякова Е.В.Saakyan A.B., Bukareva O.P., Nezvetskiy A.V., Andreev V.A., Dobrolyubova I.E., Belostotskiy A.V., Mayakova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestnik.reaviz.ru/jour/article/view/1546

Цель: оценить эффективность и безопасность протонной лучевой терапии с технологией карандашного сканирования (PBS) в лечении хордом ската черепа на клинической базе ФГБУ ФНКЦРИО ФМБА России.Материалы и методы. В исследование включены 11 пациентов с хордомами ската черепа, получивших курс протонной терапии в период 2021–2022 гг. Всем пациентам ранее выполнено хирургическое вмешательство (R0 – 9,09%, R1 – 18,18%, R2 – 72,72%). Лучевая терапия проводилась по методике PBS в средней дозе 70,0±4 Гр (RBE). Медиана наблюдения составила 21 месяц. Оценены локальный контроль, общая выживаемость и токсичность (CTCAE v.5.0).Результаты. Показатели 1- и 2-летней выживаемости составили 100%, 3-летней – 89,9% (одна смерть от инфаркта миокарда). Локальные рецидивы зарегистрированы у 2 (18,1%) пациентов через 32 и 36 месяцев, оба с исходно большим объёмом опухоли (GTV>62 см3). Острая токсичность представлена кератитом 1–2 степени (45,5%). Поздняя токсичность 3 степени (оптическая нейропатия) отмечена у 1 (9%) пациента. Токсичности 4–5 степени не наблюдалось.Заключение. Протонная лучевая терапия с использованием технологии PBS является безопасным и эффективным методом лечения хордом ската черепа и может быть рекомендована к рутинному клиническому применению.

Objective. To evaluate the efficacy and safety of pencil beam scanning (PBS) proton therapy in the treatment of skull base chordomas at the clinical facility of the Federal Scientific and Clinical Center of Medical Radiology and Oncology of FMBA of Russia.Materials and Methods. The study included 11 patients with skull base chordomas who underwent proton therapy between 2021 and 2022. All patients had prior surgical resection (R0 – 9.09%, R1 – 18.18%, R2 – 72.72%). Radiotherapy was delivered using PBS technique at a mean dose of 70.0±4 Gy (RBE). Median follow-up was 21 months. Local control, overall survival, and toxicity (CTCAE v.5.0) were assessed.Results. The 1- and 2-year survival rates were 100%, and the 3-year survival rate was 89.9% (one death from myocardial infarction). Local recurrences occurred in 2 patients (18.1%) at 32 and 36 months, both with initially large tumor volumes (GTV > 62 cm³). Acute toxicity included grade 1–2 keratitis (45.5%). Late grade 3 toxicity (optic neuropathy) was observed in 1 patient (9%). No grade 4–5 toxicity was reported.Conclusion. Proton therapy with PBS technique is a safe and effective treatment modality for skull base chordomas and should be recommended for routine clinical practice.

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Свидетельство о государственной регистрации программы для ЭВМ № 2022660422 Российская Федерация. Проторегистр-21: № 2022619817: заявл. 27.05.2022: опубл. 03.06.2022; заявитель ФГБУ ФНКЦРиО ФМБА России.Tikhomirov N.E., Udalov Yu.D. Certificate of State Registration of a Computer Program No. 2022660422, Russian Federation. Protoregistr-21: No. 2022619817: applied for on May 27, 2022: published on June 3, 2022; applicant: FSCCRO of FMBA of Russia. (In Russ.)

The authors declare that there are no conflicts of interest present.