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Preliminary experience in treating skull base chordomas with high-dose hyperfractionated stereotactic photon radiation therapy

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objective

Skull base chordomas (SBC) are characterized by persistent progression. Conventional radiation following resection increases 5- and 10-year local control (LC) to 36 and 23 %, respectively. Patients treated with protons result in 10-year LC of 50 %. Brainstem dose constraints have inhibited higher prescription doses with photons. We reviewed our experience using high-dose fractionated stereotactic photon radiation therapy (HD-FSRT) to 81 Gy for SBC.

Methods

We reviewed patients diagnosed with SBC and treated with radiation from 1999 to 2010. We excluded those with metastatic disease and prior radiation. Dose distributions and target volumes were obtained from radiation records.

Results

Twelve patients met the search criteria. Median dose was 81 Gy (76.8–82.5) using a hyperfractionated regimen. Eleven patients with available data had median max and mean doses to the brainstem of 81 Gy (46.7–85.7) and 38 Gy (6.6–58.1). Mean target volume was 22 cm3 (5.3–193. 3). LC at 3 and 5 years was 69 and 46 %. Overall survival was 90 and 68 % with a mean follow-up of 55 months. There was a trend for improved LC in patients treated adjuvantly.

Conclusion

HD-FSRT can achieve comparable doses to proton therapy plans, and preliminary results are an improvement from conventional photon therapy.

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Conflict of interest

Arshin Sheybani, Raheel Ahmed, Mindi J TenNapel, Edward C Pennington, Daniel E Hyer, Kathleen M Anderson, Arnold H Menezes, Patrick Hitchon, and John M Buatti declare that no actual or potential conflict of interest exists in relation to the publication of this manuscript.

Ethical standards statement

Institutional Review Board approval was obtained for this retrospective study. This retrospective series does not contain any studies with human tissues or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Arshin Sheybani, Raheel Ahmed, Mindi TenNapel, Edward C. Pennington, Daniel E. Hyer, Kathleen M. Anderson, Arnold H. Menezes, Patrick Hitchon & John M. Buatti

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  1. Arshin Sheybani
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  2. Raheel Ahmed
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Correspondence to Arshin Sheybani.

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Sheybani, A., Ahmed, R., TenNapel, M. et al. Preliminary experience in treating skull base chordomas with high-dose hyperfractionated stereotactic photon radiation therapy. J Radiat Oncol 3, 57–64 (2014). https://doi.org/10.1007/s13566-013-0122-7

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  • DOI: https://doi.org/10.1007/s13566-013-0122-7

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