title: Proton radiation therapy for clivus chordoma--case report.
abstract: A 57-year-old male with clival chordoma developed severe hoarseness, dysphagia, and dysphonia 1 month after a second removal of the tumor. Magnetic resonance imaging demonstrated a mass 10 cm in diameter in the region of the middle clivus enhanced inhomogeneously by gadolinium-diethylenetriaminepentaacetic acid, and a defect in the skull base. There was evidence of compression of the anterior surface of the pons. He received proton irradiation employing a pair of parallel opposed lateral proton beams. The dose aimed at the tumor mass was 75.5 Gy, to the pharyngeal wall less than 38 Gy, and to the anterior portion of the pons less than 30 Gy. Time dose and fractionation factor was calculated at 148. Thirty-one months following treatment, he was free of clinical neurological sequelae. Proton therapy should be considered in treatment planning following initial surgical removal or for inoperable clivus chordoma.
authors.affiliation: Department of Neurological Surgery, University of Tsukuba, Ibaraki.
authors.forename: Y
authors.initials: Y
authors.lastname: Yoshii
authors.forename: T
authors.initials: T
authors.lastname: Tsunoda
authors.forename: A
authors.initials: A
authors.lastname: Hyodo
authors.forename: T
authors.initials: T
authors.lastname: Nose
authors.forename: H
authors.initials: H
authors.lastname: Tsujii
authors.forename: H
authors.initials: H
authors.lastname: Tsuji
authors.forename: T
authors.initials: T
authors.lastname: Inada
authors.forename: A
authors.initials: A
authors.lastname: Maruhashi
authors.forename: Y
authors.initials: Y
authors.lastname: Hayakawa
mesh_terms: D002817:Chordoma / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy* / Q000601:surgery; D010255:Paranasal Sinus Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D011522:Protons; D011879:Radiotherapy Dosage; D012888:Skull Neoplasms / Q000532:radiotherapy* / Q000601:surgery
chemical_list: D011522:Protons