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Despite their radioresistant properties, proton therapy has been successfully used as an adjunct to resection or as a\u00a0definitive treatment. Herewith, we present our experience with robustly optimized intensity-modulated proton therapy (IMPT) and related toxicities in skull base chordoma and chondrosarcoma patients treated at HollandPTC, Delft, the Netherlands.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Clinical data, treatment plans, and acute toxicities of patients treated between July 2019 and August 2021 were reviewed. CT and 3.0T MRI scans for treatment planning were performed in supine position in a\u00a0thermoplastic mold. In total, 21\u00a0dose optimization and 28\u00a0dose evaluation scenarios were simulated. Acute toxicity was scored weekly before and during the treatment according to the CTCAE v4.0. Median follow-up was 35\u00a0months (range 12\u201336\u00a0months).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Overall, 9\u00a0chordoma and 3\u00a0chondrosarcoma patients with 1\u20133 resections prior to IMPT were included; 4\u00a0patients had titanium implants. Brainstem core and surface and spinal cord core and surface were used for nominal plan robust optimization in 11, 10, 8, and 7\u00a0patients, respectively. Middle ear inflammation, dry mouth, radiation dermatitis, taste disorder, and\/or alopecia of grades 1\u20133 were noted at the end of treatment among 6\u00a0patients without similar complaints at inclusion; symptoms disappeared 3\u00a0months following the treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Robustly optimized IMPT is clinically feasible as a\u00a0postoperative treatment for skull base chordoma and chondrosarcoma patients. We observed acceptable early toxicities (grade\u00a01\u20133) that disappeared within the first 3\u00a0months after irradiation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00066-024-02280-0","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T15:12:14Z","timestamp":1724944334000},"page":"1066-1073","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Robust IMPT and follow-up toxicity in skull base chordoma and chondrosarcoma\u2014a\u00a0single-institution clinical experience"],"prefix":"10.1007","volume":"200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1849-1624","authenticated-orcid":false,"given":"Vesna","family":"Miladinovic","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvonne L. 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