Skip to main content
SpringerLink
Log in

Chordomas and Chondrosarcomas: Treatment with Particle Radiotherapy

  • Chapter
  • First Online:
Tumors of the Central Nervous System, Volume 8

Part of the book series: Tumors of the Central Nervous System ((TCNS,volume 8))

  • 1427 Accesses

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Ares C, Hug EB, Lomax AJ, Bolsi A, Timmermann B, Rutz HP, Schuller JC, Pedroni E, Goitein G (2009) Effectiveness and safety of spot scanning proton radiation therapy for chordomas and chondrosarcomas of the skull base: first long-term report. Int J Radiat Oncol Biol Phys 75(4):1111–11118

    Article  PubMed  Google Scholar 

  • Bergh P, Gunterberg B, Meis-Kindblom JM, Kindblom LG (2001) Prognostic factors and outcome of pelvic, sacral, and spinal chondrosarcomas. Cancer 91(7):1201–1212

    Article  PubMed  CAS  Google Scholar 

  • Castro JR, Linstadt DE, Bahary JP, Petti PL, Daftari I, Collier JM, Gutin PH, Gauger G, Phillips TL (1994) Experience in charged particle irradiation of tumors of the skull base: 1977–1992. Int J Radiat Oncol Biol Phys 29(4):647–655

    Article  PubMed  CAS  Google Scholar 

  • Debus J, Hug EB, Liebsch NJ, O’Farrel D, Finkelstein D, Efird J, Munzenrider JE (1997) Brainstem tolerance to conformal radiotherapy of skull base tumors. Int J Radiat Oncol Biol Phys 39(5):967–975

    Article  PubMed  CAS  Google Scholar 

  • Debus J, Schulz-Ertner D, Schad L, Essig M, Rhein B, Thilmann C, Wannenmacher M (2000) Stereotactic fractionated radiotherapy for chordomas and chondrosarcomas of the skull base. Int J Radiat Oncol Biol Phys 47(3):591–596

    Article  PubMed  CAS  Google Scholar 

  • Demizu Y, Murakami M, Miyawaki D, Niwa Y, Akagi T, Sasaki R, Terashima K, Suga D, Kamae I, Hishikawa Y (2009) Analysis of vision loss caused by radiation-induced optic neuropathy after particle therapy for head-and-neck and skull-base tumors adjacent to optic nerves. Int J Radiat Oncol Biol Phys 75(5):1487–1492

    Article  PubMed  Google Scholar 

  • Dickey ID, Rose PS, Fuchs B, Wold LE, Okuno SH, Sim FH, Scully SP (2004) Dedifferentiated chondrosarcoma: the role of chemotherapy with updated outcomes. J Bone Joint Surg Am 86:2412–2418

    PubMed  Google Scholar 

  • Evans HL, Ayala AG, Romsdahl MM (1977) Prognostic factors in chondrosarcoma of bone. Cancer 40:818–831

    Article  PubMed  CAS  Google Scholar 

  • Fuller DB, Bloom JG (1988) Radiotherapy for chordoma. Int J Radiat Oncol Biol Phys 15:331–339

    Article  PubMed  CAS  Google Scholar 

  • Habrand JL, Austin-Seymour M, Birnbaum S, Wray S, Carroll R, Munzenrider J, Verhey L, Urie M, Goitein M (1989) Neurovisual outcome following proton radiation therapy. Int J Radiat Oncol Biol Phys 16(6):1601–1606

    Article  PubMed  CAS  Google Scholar 

  • Hisaoka M, Hashimoto H (2005) Extraskeletal myxoid chondrosarcoma: updated clinicopathological and molecular genetic characteristics. Pathol Int 55:453–463

    Article  PubMed  Google Scholar 

  • Hug EB, Loredo LN, Slater JD, DeVries A, Grove RI, Schaefer RA, Rosenberg AE, Slater JM (1999) Proton radiation therapy for chordomas and chondrosarcomas of the skull base. J Neurosurg 91(3):432–439

    Article  PubMed  CAS  Google Scholar 

  • Igaki H, Tokuuye K, Okumura T, Sugahara S, Hata M, Ohara K, Hashimoto T, Tsuboi K, Takano S, Matsumura A, Akine Y (2004) Clinical results of proton beam therapy for skull base chordomal. Int J Radiat Oncol Biol Phys 60(4):1120–1126

    Article  PubMed  Google Scholar 

  • Jäkel O, Krämer M, Karger CP, Debus J (2001) Treatment planning for heavy ion radiotherapy: clinical implementation and application. Phys Med Biol 46:1101–1116

    Article  PubMed  Google Scholar 

  • Krämer M and Scholz M (2000) Treatment planning for heavy-ion radiotherapy. Calculation and antimization of biologically effective dose. Phys Med Biol 45:3319–3330

    Article  PubMed  Google Scholar 

  • Kraft G (1999) RBE and its interpretation. Strahlenther Onkol 175(Suppl II):44–47

    Article  PubMed  Google Scholar 

  • Lee SY, Lim YC, Song MH, Seok JY, Lee WS, Choi EC (2005) Chondrosarcoma of the head and neck. Yonsei Med J 46(2):228–232

    Article  PubMed  Google Scholar 

  • McGrory JE, Rock MG, Nascimento AG, Oliveira AM (2001) Extraskeletal myxoid chondrosarcoma. Clin Orthop Relat Res 382:185–190

    Article  PubMed  Google Scholar 

  • Mizoe JE, Hasegawa A, Takagi R, Bessho H, Onda T, Tsujii H (2009) Carbon ion radiotherapy for skull base chordoma. Skull Base 19(3):219–224

    Article  PubMed  Google Scholar 

  • Munzenrider JE, Liebsch NJ (1999) Proton therapy for tumors of the skull base. Strahlenther Onkol 175(Suppl 2):57–63

    Article  PubMed  Google Scholar 

  • Noel G, Habrand JL, Jauffret E, de Crevoisier R, Dederke S, Mammar H, Haie-Méder C, Pontvert D, Hasboun D, Ferrand R, Boisserie D, Beaudré A, Gaboriaud G, Guedea F, Petriz L, Mazeron JJ (2003) Radiation therapy for chordoma and chondrosarcoma of the skull base and the cervical spine. Strahlenther Onkol 179:241–248

    Article  PubMed  Google Scholar 

  • Noel G, Habrand JL, Jauffret E, Calugaru V, Dhermain F, Mammar H, Haie-Méder C, Ponvert D, Hasboun D, Ferrand R, Nauraye C, Boisserie G, Beaudre A, Gaboriaud G, Mazal A, Habrand JL, Mazeron JJ (2005) Chordomas of the base of the skull and upper cervical spine. One hundred patients irradiated by a 3D conformal technique combining photon and protons beams. Acta Oncol 44:700–708

    Article  PubMed  Google Scholar 

  • O’Connell JX, Renard LG, Liebsch NJ, Efird JT, Munzenrider JE, Rosenberg AE (1994) Base of skull chordoma. Cancer 74(8):2261–2267

    Article  PubMed  Google Scholar 

  • Pritchard DJ, Lunke RJ, Taylor WF, Dahlin DC, Medley BE (1980) Chondrosarcoma: a clinicopathologic and statistical analysis. Cancer 45:149–157

    Article  PubMed  CAS  Google Scholar 

  • Romero J, Cardenes A, la Torre A, Valcarcel F, Magallon R, Regueiro C, Aragon G (1993) Chordoma: results of radiation therapy in eighteen patients. Radiother Oncol 29:27–32

    Article  PubMed  CAS  Google Scholar 

  • Rosenberg AE, Nielsen GP, Keel SB, Renard LG, Fitzek MM, Munzenrider JE, Liebsch NJ (1999) Chondrosarcoma of the base of the skull: a clinicopathologic study of 200 cases with emphasis on its distinction from chordoma. Am J Surg Pathol 23(11):1370–1378

    Article  PubMed  CAS  Google Scholar 

  • Ruark DS, Schlehaider UK, Shah JP (1992) Chondrosarcomas of the head and neck. World J Surg 16(5):1010–1015

    Article  PubMed  CAS  Google Scholar 

  • Rutz HP, Weber DC, Sugahara S, Timmermann B, Lomax AJ, Bolsi A, Pedroni E, Coray A, Jermann M, Goitein G (2007) Extracranial chordoma: outcome in patients treated with function-preserving surgery followed by spot-scanning proton beam irradiation. Int J Radiat Oncol Biol Phys 67(2):512–520

    Article  PubMed  Google Scholar 

  • Saito N, Bert C, Chaudhri N, Gemmel A, Schardt D, Durante M, Rietzel E (2009) Speed and accuracy of a beam tracking system for treatment of moving targets with scanned ion beams. Phys Med Biol 54(16):4849–4862

    Article  PubMed  CAS  Google Scholar 

  • Salisbury JR (1993) The pathology of the human notochord. J Pathol 171:253–255

    Article  PubMed  CAS  Google Scholar 

  • Santoni R, Liebsch N, Finkelstein DM, Hug EB, Hanssens P, Goitein M (1998) Temporal lobe (TL) damage following surgery and high-dose photon and proton irradiation in 96 patients affected by chordomas and chondrosarcomas of the base of the skull. Int J Radiat Oncol Biol Phys 41(1):59–68

    Article  PubMed  CAS  Google Scholar 

  • Schardt D, Elsässer T, Schulz-Ertner D (2010) Heavy-ion tumor therapy: physical and radiobiological benefits. Rev Mod Phys 82:383–425

    Article  Google Scholar 

  • Schlampp I, Karger CP, Jäkel O, Scholz M, Didinger B, Nikoghosyan A, Hoess A, Krämer M, Debus J, Schulz-Ertner D (2008) Clinical validation of the Local Effect Model (LEM) in the treatment planning of carbon Ion RT in patients with skull base tumors. Int J Radiat Oncol Biol Phys 72(Suppl 1):S229

    Article  Google Scholar 

  • Schulz-Ertner D, Nikoghosyan A, Thilmann C, Haberer T, Jäkel O, Karger C, Scholz M, Kraft G, Wannenmacher M, Debus J (2003) Carbon ion radiotherapy for chordomas and low-grade chondrosarcomas of the skull base. Strahlenther Onkol 179:598–605

    Article  PubMed  Google Scholar 

  • Schulz-Ertner D, Nikoghosyan A, Hof H, Didinger B, Combs SE, Jäkel O, Karger CP, Edler L, Debus J (2007a) Carbon ion radiotherapy in chondrosarcomas. Int J Radiat Oncol Biol Phys 67(1):171–177

    Article  PubMed  Google Scholar 

  • Schulz-Ertner D, Karger CP, Feuerhake A, Nikoghosyan A, Combs SE, Jäkel O, Edler L, Scholz M, Debus J (2007b) Effectiveness of carbon ion radiotherapy in the treatment of skull-base chordomas. Int J Radiat Oncol Biol Phys 68(2):449–457

    Article  PubMed  Google Scholar 

  • Tai PTH, Craighead P, Bagdon F (1995) Optimization of radiotherapy for patients with cranial chordoma. Cancer 75(3):749–756

    Article  PubMed  CAS  Google Scholar 

  • Takahashi S, Kawase T, Yoshida K, Hasegawa A, Mizoe JE (2009) Skull base chordomas: efficacy of surgery followed by carbon ion radiotherapy. Acta Neurochir (Wien) 151(7):759–769

    Article  Google Scholar 

  • Terahara A, Niemierko A, Goitein M, Finkelstein D, Hug E, Liebsch N, O’Farrell D, Lyons S, Munzenrider J (1999) Analysis of the relationship between tumor dose inhomogeneity and local control in patients with skull base chordoma. Int J Radiat Oncol Biol Phys 45(2):351–358

    Article  PubMed  CAS  Google Scholar 

  • Thieblemont C, Biron P, Rocher F, Bouhour D, Bobin JY, Gerard JP, Blay JY (1995) Prognostic factors in chordoma: role of postoperative radiotherapy. Eur J Cancer 31A(13–14):2255–2259

    Article  PubMed  CAS  Google Scholar 

  • Urie MM, Fullerton B, Tatsuzaki H, Birnbaum BS, Suit HD, Convery K, Skates S, Goitein M (1992) A dose response analysis of injury to cranial nerves and/or nuclei following proton beam radiation therapy. Int J Radiat Oncol Biol Phys 23:27–39

    Article  PubMed  CAS  Google Scholar 

  • Weber DC, Rutz HP, Pedroni ES, Bolsi A, Timmermann B, Verwey J, Lomax AJ, Goitein G (2005) Results of spot-scanning proton radiation therapy for chordoma and chondrosarcoma of the skull base: the Paul Scherrer Institut experience. Int J Radiat Oncol Biol Phys 63(2):401–409

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Radiological Institute, Markus Hospital, Wilhelm-Epstein-Str. 4, 60431, Frankfurt, Germany

    Daniela Schulz-Ertner

Authors
  1. Daniela Schulz-Ertner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniela Schulz-Ertner .

Editor information

Editors and Affiliations

  1. , Kean University, Room 213, Library building, Morris Avenue 1000, Union, 07083, New Jersey, USA

    M.A. Hayat

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Schulz-Ertner, D. (2012). Chordomas and Chondrosarcomas: Treatment with Particle Radiotherapy. In: Hayat, M. (eds) Tumors of the Central Nervous System, Volume 8. Tumors of the Central Nervous System, vol 8. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-4213-0_18

Download citation

  • DOI: https://doi.org/10.1007/978-94-007-4213-0_18

  • Published:

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-007-4212-3

  • Online ISBN: 978-94-007-4213-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation