Proton radiation therapy for chordomas and chondrosarcomas of the skull base

Mure than 500 patients with chordomas and low-grade chondrosarcomas of the skull base have undergone fractionated proton radiation therapy since 1475. Maximum surgical resection followed by high-dose irradiation resulted in durable tumor control and superior results in the majority of patients, compared with conventional x-ray treatment. Some complications have been observed, but the rate of serious toxicities appears to be acceptable. Patients with chondrosarcomas fare better than patients with chordomas. Small tumor size and prior surgical decompression of dose limiting structures are also associated with improved tumor control.