Charged particle irradiation of chordoma and chondrosarcoma of the base of skull and cervical spine: The lawrence berkeley laboratory experience

• Published in: International journal of radiation oncology, biology, physics Vol. 15; no. 3; pp. 559 - 565
• Main Authors: Berson, Anthony M., Castro, Joseph R., Petti, Paula, Phillips, Theodore L., Gauger, Grant E., Gutin, Philip, Collier, J.Michael, Henderson, Sheri D., Baken, Kari
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.1988; Elsevier
• Subjects: Actuarial Analysis; Adult; Base of skull; Biological and medical sciences; Cervical spine; Cervical Vertebrae; Charged particle radiotherapy; Chondrosarcoma; Chondrosarcoma - mortality; Chondrosarcoma - radiotherapy; Chordoma; Chordoma - mortality; Chordoma - radiotherapy; Female; Follow-Up Studies; Humans; Male; Medical sciences; Neurology; Radiotherapy Dosage; Radiotherapy, High-Energy; Skull Neoplasms - mortality; Skull Neoplasms - radiotherapy; Spinal Neoplasms - mortality; Spinal Neoplasms - radiotherapy; Tumors of the nervous system. Phacomatoses; Base of skull; Chordoma; Chondrosarcoma; Charged particle radiotherapy; Cervical spine; Therapeutic efficiency; Human; Intracranial; Nervous system diseases; Vertebral canal; Diseases of the osteoarticular system; Radiotherapy; Photon; Follow up study; Complication; Tumor; Base of the skull
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/0360-3016(88)90295-7

Forty-five consecutive patients with chordoma or chondrosarcoma at the base of skull or cervical spine were treated at the University of California Lawrence Berkeley Laboratory (UCLBL) and University of California School of Medicine, San Francisco (UCSF) between November 1977 and October 1986. All patients had undergone a subtotal surgical resection. Twenty-three patients were treated definitively with charged particles, 13 patients were treated with photons and particles, and 9 patients were treated for recurrent disease. Total doses ranged from 36 to 80 Gray equivalent (GyE). Thirty-three patients are alive with a minimum followup of 1 year. The actuarial survival and local control for all patients at 5 years is 62% and 59%, respectively. Patients treated for primary disease had a 78% actuarial local control rate at 2 years, whereas the rate for patients with recurrent disease was 33%. Patients with smaller visible tumor volumes (<20 cc) had a significantly better local control rate than patients with larger tumor volumes (80% vs 33% actuarial rate at 5 years). Patients with chondrosarcoma had the highest local control rate, as did patients treated with particles alone. Complications included 3 patients with unilateral visual loss, two patients who became blind, and 4 patients with radiation injury to the brainstem.