• Reiko Imai, Tadashi Kamada, Nobuhito Araki, and Working Group for Bone and Soft Tissue Sarcomas.
• Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan. Electronic address: r_imai@nirs.go.jp.
• Int. J. Radiat. Oncol. Biol. Phys. 2016 May 1; 95 (1): 322-327.

PurposeTo evaluate the results of carbon ion radiation therapy administered to 188 patients with unresectable primary sacral chordomas.Patients And MethodsOne hundred eighty-eight patients were treated with carbon ion radiation therapy at a single institute between 1996 and 2013 and retrospectively analyzed. The median age was 66 years. The highest proximal invasion reached past S2 level in 137 patients. The median clinical target volume was 345 cm(3). One hundred six patients received 67.2 gray equivalents (GyE)/16 fractions (fr), 74 patients received 70.4 GyE/16 fr, 7 patients received 73.6 GyE/16 fr, and 1 patient received 64.0 GyE/16 fr.ResultsThe median follow-up period was 62 months (range, 6.8-147.5 months). Seventy percent of patients were followed for 5 years or until death. The 5-year local control, overall survival, and disease-free survival rates were 77.2%, 81.1%, and 50.3%, respectively. Forty-one patients had a local recurrence. Sex, tumor volume, level of proximal invasion, and irradiated dose were unrelated to local control. There was grade 3 toxicity of the peripheral nerves in 6 patients and grade 4 toxicity of the skin in 2 patients. Ambulation remained in 97% of patients.ConclusionsCarbon ion radiation therapy was safe and effective for unresectable chordoma and provided good local control and survival while preserving ambulation.Copyright © 2016 Elsevier Inc. All rights reserved.

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