Proton beam therapy for chondrosarcoma: A systematic narrative review and meta-analysis

Background This study systematically evaluated the efficacy and safety of proton beam therapy in patients with chondrosarcoma by integrating relevant studies. Methods We searched for the relevant studies on the PubMed, Cochrane Library, and Embase databases on 18 June 2025 using screening criteria established. Statistical analyses were performed using STATA (version 14.0). Results Initially, 1040 articles were obtained through search, of which six studies involving 282 patients with chondrosarcoma who received proton beam therapy were included. In the included studies, the median number of patients was 47 (range 10–107), the mean median age was 38.9 years (10.2–89 years), and the median follow-up duration was ≥12 months (30.7–91 months). The local control (LC) at 1, 2, 3, 4, 5, 10 years was 100% (95% CI: 0.99–1.01, I 2 : 0%), 100% (95% CI: 0.99–1.01, I 2 : 0%), 100% (95% CI: 0.99–1.01, I 2 : 36.4%), 100% (95% CI: 0.98–1.01, I 2 : 64.1%), 95% (95% CI: 0.91–0.99, I 2 : 0%), and 100% (95% CI: 0.98–1.01, I 2 : 0%), respectively. The overall survival (OS) at 1, 2, 3, 4, 5, 10 years was 100% (95% CI: 0.99–1.01, I 2 : 0%), 100% (95% CI: 0.99–1.00, I 2 : 0%), 100% (95% CI: 0.99–1.00, I 2 : 0%), 100% (95% CI: 0.99–1.00, I 2 : 0.0%), 99% (95% CI: 0.98–1.01, I 2 : 61.3%), and 100% (95% CI: 0.99–1.01, I 2 : 0.0%), respectively. All the included studies mostly reported grade ≤2 proton beam therapy-related toxicities. Conclusions Proton beam therapy is an advantageous treatment option for chondrosarcomas, particularly inoperable chondrosarcomas. Our findings revealed good local control and overall survival, with lower toxicity, in patients with chondrosarcoma who received proton beam therapy. Proton beam therapy represents a promising treatment option for chondrosarcomas.