title: Radiotherapy for chordomas and low-grade chondrosarcomas of the skull base with carbon ions.
abstract: OBJECTIVE
  Compared to photon irradiation, carbon ions provide physical and biologic advantages that may be exploited in chordomas and chondrosarcomas.
  
  
  METHODS
  Between August 1998 and December 2000, 37 patients with chordomas (n = 24) and chondrosarcomas (n = 13) were treated with carbon ion radiotherapy within a Phase I/II trial. Tumor conformal application of carbon ion beams was realized by intensity-controlled raster scanning with pulse-to-pulse energy variation. Three-dimensional treatment planning included biologic plan optimization. The median tumor dose was 60 GyE (GyE = Gy x relative biologic effectiveness).
  
  
  RESULTS
  The mean follow-up was 13 months. The local control rate after 1 and 2 years was 96% and 90%, respectively. We observed 2 recurrences outside the gross tumor volume in patients with chordomas. Progression-free survival was 100% for chondrosarcomas and 83% for chordomas at 2 years. Partial remission after carbon ion radiotherapy was observed in 6 patients. Treatment toxicity was mild.
  
  
  CONCLUSIONS
  These are the first data demonstrating the clinical feasibility, safety, and effectiveness of scanning beam delivery of ion beams in patients with skull base tumors. The preliminary results in patients with skull base chordomas and low-grade chondrosarcomas are encouraging, although the follow-up was too short to draw definite conclusions concerning outcome. In the absence of major toxicity, dose escalation might be considered.
authors: Department of Radiation Oncology, University of Heidelberg, INF 400, Heidelberg 69120, Germany. d.ertner@dkfz-heidelberg.de
authors: Daniela
authors: D
authors: Schulz-Ertner
authors: Thomas
authors: T
authors: Haberer
authors: Oliver
authors: O
authors: Jäkel
authors: Christoph
authors: C
authors: Thilmann
authors: Michael
authors: M
authors: Krämer
authors: Wolfgang
authors: W
authors: Enghardt
authors: Gerhard
authors: G
authors: Kraft
authors: Michael
authors: M
authors: Wannenmacher
authors: Jürgen
authors: J
authors: Debus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002250:Carbon Radioisotopes / Q000627:therapeutic use*; D002813:Chondrosarcoma / Q000532:radiotherapy*; D002817:Chordoma / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019292:Skull Base Neoplasms / Q000532:radiotherapy*; D013238:Stereotaxic Techniques
chemical_list: D002250:Carbon Radioisotopes