Fractionated proton radiation therapy of chordoma and low-grade chondrosarcoma of the base of the skull

Mary Austin-Seymour Departments of Radiation Medicine, Neurosurgery, and Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, and Harvard Cyclotron Laboratory, Cambridge, Massachusetts

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John Munzenrider Departments of Radiation Medicine, Neurosurgery, and Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, and Harvard Cyclotron Laboratory, Cambridge, Massachusetts

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Michael Goitein Departments of Radiation Medicine, Neurosurgery, and Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, and Harvard Cyclotron Laboratory, Cambridge, Massachusetts

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Lynn Verhey Departments of Radiation Medicine, Neurosurgery, and Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, and Harvard Cyclotron Laboratory, Cambridge, Massachusetts

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Marcia Urie Departments of Radiation Medicine, Neurosurgery, and Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, and Harvard Cyclotron Laboratory, Cambridge, Massachusetts

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Richard Gentry Departments of Radiation Medicine, Neurosurgery, and Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, and Harvard Cyclotron Laboratory, Cambridge, Massachusetts

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Steven Birnbaum Departments of Radiation Medicine, Neurosurgery, and Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, and Harvard Cyclotron Laboratory, Cambridge, Massachusetts

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Donna Ruotolo Departments of Radiation Medicine, Neurosurgery, and Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, and Harvard Cyclotron Laboratory, Cambridge, Massachusetts

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Patricia McManus Departments of Radiation Medicine, Neurosurgery, and Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, and Harvard Cyclotron Laboratory, Cambridge, Massachusetts

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Steven Skates Departments of Radiation Medicine, Neurosurgery, and Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, and Harvard Cyclotron Laboratory, Cambridge, Massachusetts

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Robert G. Ojemann Departments of Radiation Medicine, Neurosurgery, and Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, and Harvard Cyclotron Laboratory, Cambridge, Massachusetts

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Andrew Rosenberg Departments of Radiation Medicine, Neurosurgery, and Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, and Harvard Cyclotron Laboratory, Cambridge, Massachusetts

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Alan Schiller Departments of Radiation Medicine, Neurosurgery, and Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, and Harvard Cyclotron Laboratory, Cambridge, Massachusetts

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Andreas Koehler Departments of Radiation Medicine, Neurosurgery, and Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, and Harvard Cyclotron Laboratory, Cambridge, Massachusetts

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Herman D. Suit Departments of Radiation Medicine, Neurosurgery, and Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, and Harvard Cyclotron Laboratory, Cambridge, Massachusetts

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✓ Sixty-eight patients with chordoma or low-grade chondrosarcoma at the base of the skull received fractionated high-dose postoperative radiation delivered with a 160-MeV proton beam. Protons have favorable physical characteristics which allow the delivery of high doses of radiation to these critically located tumors. The methods employed for these treatments are described. These patients have been followed for at least 17 months and for a median of 34 months. The median tumor dose was 69 CGE (cobalt Gy equivalent): CGE is the dose in proton Gy multiplied by 1.1, which is the relative biological effectiveness for protons compared to cobalt-60. The daily dose was 1.8 to 2.1 CGE. For this group the 5-year actuarial local control rate is 82% and disease-free survival rate is 76%. The incidence of treatment-related morbidity has been acceptable.

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