• G Noël, J L Habrand, H Mammar, D Pontvert, C Haie-Méder, D Hasboun, P Moisson, R Ferrand, A Beaudré, G Boisserie, G Gaboriaud, A Mazal, K Kérody, M Schlienger, and J J Mazeron.
• Centre de Protonthérapie d'Orsay, Orsay, France. noel@ipno.in2p3.fr
• Int. J. Radiat. Oncol. Biol. Phys. 2001 Oct 1; 51 (2): 392-8.

PurposeProspective analysis of local tumor control, survival, and treatment complications in 44 consecutive patients treated with fractionated photon and proton radiation for a chordoma or chondrosarcoma of the skull base.Methods And MaterialsBetween December 1995 and December 1998, 45 patients with a median age of 55 years (14-85) were treated using a 201-MeV proton beam at the Centre de Protonthérapie d'Orsay, 34 for a chordoma and 11 for a chondrosarcoma. Irradiation combined high-energy photons and protons. Photons represented two-thirds of the total dose and protons one-third. The median total dose delivered within the gross tumor volume was 67 cobalt Gray equivalent (CGE) (range: 60-70).ResultsWith a mean follow-up of 30.5 months (range: 2-56), the 3-year local control rates for chordomas and chondrosarcomas were 83.1% and 90%, respectively, and 3-year overall survival rates were 91% and 90%, respectively. Eight patients (18%) failed locally (7 within the clinical tumor volume and 1 unknown). Four patients died of tumor and 2 others of intercurrent disease. In univariate analysis, young age at time of radiotherapy influenced local control positively (p < 0.03), but not in multivariate analysis. Only 2 patients presented Grade 3 or 4 complications.ConclusionIn skull-base chordomas and chondrosarcomas, the combination of photons with a proton boost of one-third the total dose offers an excellent chance of cure at the price of an acceptable toxicity. These results should be confirmed with a longer follow-up.

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