PURPOSE: To evaluate effectiveness and safety of spot-scanning-based proton-radiotherapy (PT) for extracranial @entity3580 (ECC). METHODS AND MATERIAL: Between 1999-2006, 40 @entity1 with @entity3580 of C-, T-, and L-spine and sacrum were treated at Paul Scherrer Institute (PSI) with PT using spot-scanning. Median @entity1 age was 58 years (range, 10-81 years); 63% were male, and 36% were female. Nineteen @entity1 (47%) had gross @entity66 (mean 69 cc; range, 13-495 cc) before PT, and 21 @entity1 (53%) had undergone prior @entity702 -based @entity1344 ( @entity1344 ) and reconstruction of the axial skeleton. Proton doses were expressed as Gy(RBE). A conversion factor of 1.1 was used to account for higher relative biological effectiveness (RBE) of protons compared with photons. Mean total dose was 72.5 Gy(RBE) [range, 59.4-75.2 Gy(RBE)] delivered at 1.8-2.0 Gy(RBE) dose per fraction. Median follow-up time was 43 months. RESULTS: In 19 @entity1 without @entity1344 , actuarial local control (LC) rate at 5 years was 100%. LC for @entity1 with gross @entity66 but without @entity1344 was also 100% at 5 years. In contrast, 12 failures occurred in 21 @entity1 with @entity1344 , yielding a significantly decreased 5-year LC rate of 30% (p = 0.0003). For the entire cohort, 5-year LC rates were 62%, disease-free survival rates were 57%, and overall survival rates were 80%. Rates were 100% for @entity1 without @entity1344 . No other factor, including dosimetric parameters (V95, V80) were predictive for @entity5 control on univariate analysis. CONCLUSION: Spot-scanning-based PT at PSI delivered subsequently to function-preserving surgery for @entity5 debulking, decompression of spinal cord, or biopsy only is safe and highly effective in @entity1 with ECC without major surgical instrumentation even in view of large, unresectable disease.

Spot-scanning-based proton therapy for extracranial XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity66 :: ('MESH:D004194', 'Disease') :: ['residual disease'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity3580 :: ('MESH:D002817', 'Disease') :: ['chordomas', 'chordoma'] @entity1344 :: ('MESH:D043171', 'Disease') :: ['SS', 'surgical stabilization'] @entity702 :: ('MESH:D014025', 'Chemical') :: ['titanium']
@entity3580 :: (MESH:D002817,Disease) :: ['chordoma']
