{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T15:14:46Z","timestamp":1790176486856,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,5,20]],"date-time":"2019-05-20T00:00:00Z","timestamp":1558310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Objectives<\/jats:title><jats:p>Proton therapy (PRT) has emerged as a treatment option for chordomas\/chondrosarcomas to escalate radiation dose more safely. We report results of a phase I\/II trial of PRT in patients with chordoma\/chondrosarcoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty adult patients with pathologically confirmed, nonmetastatic chordoma or chondrosarcoma were enrolled in a single\u2010institution prospective trial of PRT from 2010 to 2014. Seventeen patients received adjuvant PRT and three received definitive PRT. Median dose was 73.8\u2009Gy(RBE; range 68.4\u201079.2\u2009Gy) using PRT\u2010only (<jats:italic>n<\/jats:italic>\u2009=\u20096) or combination PRT\/intensity\u2010modulated radiotherapy (IMRT) (<jats:italic>n<\/jats:italic>\u2009=\u200914). Quality\u2010of\u2010life (QOL) and fatigue were assessed weekly and every 3 months posttreatment with the Functional Assessment of Cancer Therapy \u2010 Brain (FACTBr) and Brief Fatigue Inventory. Primary endpoint was feasibility (90% completing treatment with\u2009&lt;\u200910\u2009day treatment delay and\u2009\u2264\u200920% unexpected acute grade\u2009\u2265\u20093 toxicity).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Tumors included chordomas of the skull base (<jats:italic>n<\/jats:italic>\u2009=\u200910), sacrum (<jats:italic>n<\/jats:italic>\u2009=\u20095), and cervical spine (<jats:italic>n<\/jats:italic>\u2009=\u20093), and skull base chondrosarcomas (<jats:italic>n<\/jats:italic>\u2009=\u20092). Median age was 57. The 80% had positive margins\/gross disease. Median follow\u2010up was 37 months. Feasibility endpoints were met. The 3\u2010year local control and progression\u2010free survival was 86% and 81%. There were no deaths. Two patients had acute grade 3 toxicity (both fatigue). One had late grade 3 toxicity (epistaxis and osteoradionecrosis). There were no significant differences in patient reported fatigue or QOL from baseline to the end\u2010of\u2010treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We report favorable local control, survival, and toxicity following PRT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.25502","type":"journal-article","created":{"date-parts":[[2019,5,21]],"date-time":"2019-05-21T04:44:20Z","timestamp":1558413860000},"page":"200-205","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["A prospective clinical trial of proton therapy for chordoma and chondrosarcoma: Feasibility assessment"],"prefix":"10.1002","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7482-1413","authenticated-orcid":false,"given":"Brian C.","family":"Baumann","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Washington University St. Louis Missouri"},{"name":"Department of Radiation Oncology Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Lustig","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Mazzoni","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean M.","family":"Grady","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bert W.","family":"O\u2019Malley","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Y. 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