Chordomas and Chondrosarcomas: Treatment with Particle Radiotherapy
Particle beams like protons and heavier ions offer improved dose distributions in comparison with photon beams and thus enable dose escalation in skull base tumors while sparing normal tissue. Recent technological developments in the fields of accelerator engineering, beam delivery and treatment planning have contributed to the safety and precision of particle beam delivery. Patients with chordomas and chondrosarcomas of the skull base have been found to benefit most from treatment with particle beams since these tumors are relatively unresponsive against conventional radiation therapy. The radiation therapy doses needed for tumor control are much higher than the tolerance doses of critical structures surrounding these tumors in the skull base region.
During the last two decades it has been shown that particle therapy with protons and carbon ions improves local control rates in patients with skull base chordomas and chondrosarcomas by dose escalation. Particle beam irradiation is therefore considered the standard treatment for these tumors after incomplete tumor resection.
This manuscript summarizes the technological and radiobiological basic principles of particle beam irradiation, describes the routine management of chordomas and chondrosarcomas of the skull base and summarizes the treatment results and toxicity profile after particle radiation therapy.
KeywordsSkull Base Planning Target Volume Local Control Rate Relative Biological Effectiveness Extraskeletal Myxoid Chondrosarcoma
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