{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:56:18Z","timestamp":1791230178586,"version":"4.1.0"},"reference-count":35,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","thegreenjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Radiotherapy and Oncology"],"published-print":{"date-parts":[[2022,6]]},"DOI":"10.1016\/j.radonc.2022.04.007","type":"journal-article","created":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T01:49:39Z","timestamp":1649814579000},"page":"139-145","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":33,"special_numbering":"C","title":["Definitive high-dose, proton-based radiation for unresected mobile spine and sacral chordomas"],"prefix":"10.1016","volume":"171","author":[{"given":"Walter","family":"Banfield","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myrsini","family":"Ioakeim-Ioannidou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saveli","family":"Goldberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soha","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph H.","family":"Schwab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory M.","family":"Cote","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin","family":"Choy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H.","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis J.","family":"Hornicek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert J.","family":"Liebsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Lin E.","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon M.","family":"MacDonald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas F.","family":"DeLaney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.radonc.2022.04.007_b0005","doi-asserted-by":"crossref","first-page":"e71","DOI":"10.1016\/S1470-2045(14)71190-8","article-title":"Building a global consensus approach to chordoma: a position paper from the medical and patient community","volume":"16","author":"Stacchiotti","year":"2015","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.radonc.2022.04.007_b0010","doi-asserted-by":"crossref","DOI":"10.1186\/s13256-018-1784-y","article-title":"Chordoma: a case series and review of the literature","volume":"12","author":"Alan","year":"2018","journal-title":"J Med Case Rep"},{"key":"10.1016\/j.radonc.2022.04.007_b0015","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1111\/j.1757-7861.2009.00027.x","article-title":"Review of current treatment of sacral chordoma","volume":"1","author":"Chen","year":"2009","journal-title":"Orthop Surg"},{"key":"10.1016\/j.radonc.2022.04.007_b0020","series-title":"StatPearls. Treasure Island (FL): StatPearls Publishing Copyright \u00a9 2021","author":"Tenny","year":"2021"},{"key":"10.1016\/j.radonc.2022.04.007_b0025","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.nec.2007.09.006","article-title":"Chordoma of the spinal column","volume":"19","author":"Sciubba","year":"2008","journal-title":"Neurosurg Clin N Am"},{"key":"10.1016\/j.radonc.2022.04.007_b0030","doi-asserted-by":"crossref","DOI":"10.12688\/f1000research.9499.1","article-title":"Recent advances in understanding and managing chordomas","volume":"5","author":"Youssef","year":"2016","journal-title":"F1000Res"},{"key":"10.1016\/j.radonc.2022.04.007_b0035","doi-asserted-by":"crossref","first-page":"e69","DOI":"10.1016\/S1470-2045(11)70337-0","article-title":"Chordoma: current concepts, management, and future directions","volume":"13","author":"Walcott","year":"2012","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.radonc.2022.04.007_b0040","doi-asserted-by":"crossref","first-page":"151","DOI":"10.5152\/eurasianjmed.2015.52","article-title":"Metastatic chordoma: report of the two cases and review of the literature","volume":"47","author":"Rohatgi","year":"2015","journal-title":"Eurasian J Med"},{"key":"10.1016\/j.radonc.2022.04.007_b0045","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1634\/theoncologist.12-11-1344","article-title":"Chordoma: the nonsarcoma primary bone tumor","volume":"12","author":"Chugh","year":"2007","journal-title":"Oncologist"},{"key":"10.1016\/j.radonc.2022.04.007_b0050","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1186\/s13018-019-1225-7","article-title":"Conditional survival and changing risk profile in patients with chordoma: a population-based longitudinal cohort study","volume":"14","author":"Huang","year":"2019","journal-title":"J Orthop Surg Res"},{"key":"10.1016\/j.radonc.2022.04.007_b0055","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.ejca.2017.06.038","article-title":"Medical treatment of advanced chordomas","volume":"83","author":"Colia","year":"2017","journal-title":"Eur J Cancer"},{"key":"10.1016\/j.radonc.2022.04.007_b0060","doi-asserted-by":"crossref","first-page":"E930","DOI":"10.1097\/BRS.0b013e318296e7d7","article-title":"Definitive high-dose photon\/proton radiotherapy for unresected mobile spine and sacral chordomas","volume":"38","author":"Chen","year":"2013","journal-title":"Spine"},{"key":"10.1016\/j.radonc.2022.04.007_b0065","doi-asserted-by":"crossref","first-page":"1514","DOI":"10.1016\/j.ijrobp.2006.02.059","article-title":"Sacral chordomas: Impact of high-dose proton\/photon-beam radiation therapy combined with or without surgery for primary versus recurrent tumor","volume":"65","author":"Park","year":"2006","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2022.04.007_b0070","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1002\/jso.23617","article-title":"Long-term results of Phase II study of high dose photon\/proton radiotherapy in the management of spine chordomas, chondrosarcomas, and other sarcomas","volume":"110","author":"DeLaney","year":"2014","journal-title":"J Surg Oncol"},{"key":"10.1016\/j.radonc.2022.04.007_b0075","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1016\/j.ijrobp.2008.08.058","article-title":"Phase II study of high-dose photon\/proton radiotherapy in the management of spine sarcomas","volume":"74","author":"DeLaney","year":"2009","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2022.04.007_b0080","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.ijrobp.2016.10.006","article-title":"Updated outcome and analysis of tumor response in mobile spine and sacral chordoma treated with definitive high-dose photon\/proton radiation therapy","volume":"97","author":"Kabolizadeh","year":"2017","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2022.04.007_b0085","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1016\/j.ijrobp.2019.04.015","article-title":"Quantification of acute skin toxicities in patients with breast cancer undergoing adjuvant proton versus photon radiation therapy: a single institutional experience","volume":"104","author":"DeCesaris","year":"2019","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2022.04.007_b0090","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/j.wneu.2017.04.118","article-title":"Prognostic factors and survival outcome in patients with chordoma in the United States: a population-based analysis","volume":"104","author":"Lee","year":"2017","journal-title":"World Neurosurg"},{"key":"10.1016\/j.radonc.2022.04.007_b0095","first-page":"2211","article-title":"Operative management of sacral chordoma","volume":"87","author":"Fuchs","year":"2005","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.radonc.2022.04.007_b0100","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1097\/01.brs.0000200038.30869.27","article-title":"Chordoma of the mobile spine: fifty years of experience","volume":"31","author":"Boriani","year":"2006","journal-title":"Spine"},{"key":"10.1016\/j.radonc.2022.04.007_b0105","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1245\/ASO.2003.06.002","article-title":"Chordoma: natural history and results in 28 patients treated at a single institution","volume":"10","author":"Baratti","year":"2003","journal-title":"Ann Surg Oncol"},{"key":"10.1016\/j.radonc.2022.04.007_b0110","doi-asserted-by":"crossref","first-page":"2122","DOI":"10.1002\/(SICI)1097-0142(20000501)88:9<2122::AID-CNCR19>3.0.CO;2-1","article-title":"Prognostic factors in chordoma of the sacrum and mobile spine: a study of 39 patients","volume":"88","author":"Bergh","year":"2000","journal-title":"Cancer"},{"key":"10.1016\/j.radonc.2022.04.007_b0115","doi-asserted-by":"crossref","first-page":"2217","DOI":"10.1007\/s11999-008-0356-7","article-title":"Sacral chordoma: can local recurrence after sacrectomy be predicted?","volume":"466","author":"Hanna","year":"2008","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.radonc.2022.04.007_b0120","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.2106\/JBJS.D.02533","article-title":"Oncologic and functional outcome following sacrectomy for sacral chordoma","volume":"88","author":"Hulen","year":"2006","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.radonc.2022.04.007_b0125","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1002\/(SICI)1096-9098(199704)64:4<274::AID-JSO5>3.0.CO;2-6","article-title":"Surgical treatment of sacrococcygeal chordoma","volume":"64","author":"Ozaki","year":"1997","journal-title":"J Surg Oncol"},{"key":"10.1016\/j.radonc.2022.04.007_b0130","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.2106\/00004623-199310000-00008","article-title":"Operative treatment of sacrococcygeal chordoma. A review of twenty-one cases","volume":"75","author":"Samson","year":"1993","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.radonc.2022.04.007_b0135","doi-asserted-by":"crossref","first-page":"2700","DOI":"10.1097\/BRS.0b013e3181bad11d","article-title":"The surgical management of sacral chordomas","volume":"34","author":"Schwab","year":"2009","journal-title":"Spine"},{"key":"10.1016\/j.radonc.2022.04.007_b0140","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1002\/(SICI)1097-0142(19990215)85:4<878::AID-CNCR15>3.0.CO;2-7","article-title":"The surgical management of sacrococcygeal chordoma","volume":"85","author":"Yonemoto","year":"1999","journal-title":"Cancer"},{"key":"10.1016\/j.radonc.2022.04.007_b0145","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1002\/bjs.1800630713","article-title":"Anorectal function after major resections of the sacrum with bilateral or unilateral sacrifice of sacral nerves","volume":"63","author":"Gunterberg","year":"1976","journal-title":"Br J Surg"},{"key":"10.1016\/j.radonc.2022.04.007_b0150","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1002\/jso.20477","article-title":"Level-adjusted perioperative risk of sacral amputations","volume":"94","author":"Devin","year":"2006","journal-title":"J Surg Oncol"},{"key":"10.1016\/j.radonc.2022.04.007_b0155","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/j.jor.2018.04.001","article-title":"Sacral chordoma : A review of literature","volume":"15","author":"Pillai","year":"2018","journal-title":"J Orthop"},{"key":"10.1016\/j.radonc.2022.04.007_b0160","doi-asserted-by":"crossref","first-page":"2574","DOI":"10.1002\/1097-0142(19840601)53:11<2574::AID-CNCR2820531136>3.0.CO;2-5","article-title":"Clinicopathologic study of sacrococcygeal chordoma","volume":"53","author":"Kaiser","year":"1984","journal-title":"Cancer"},{"key":"10.1016\/j.radonc.2022.04.007_b0165","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1016\/j.ijrobp.2008.02.037","article-title":"Accuracy of the local effect model for the prediction of biologic effects of carbon ion beams in vitro and in vivo","volume":"71","author":"Els\u00e4sser","year":"2008","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2022.04.007_b0170","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.ijrobp.2016.02.012","article-title":"Carbon ion radiation therapy for unresectable sacral chordoma; an analysis of 188 cases","volume":"95","author":"Imai","year":"2016","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2022.04.007_b0175","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.ijrobp.2005.04.019","article-title":"Cauda equina tolerance to high-dose fractionated irradiation","volume":"64","author":"Pieters","year":"2006","journal-title":"Int J Radiat Oncol Biol Phys"}],"container-title":["Radiotherapy and Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0167814022001888?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0167814022001888?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T05:21:58Z","timestamp":1759123318000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0167814022001888"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6]]},"references-count":35,"alternative-id":["S0167814022001888"],"URL":"https:\/\/doi.org\/10.1016\/j.radonc.2022.04.007","relation":{},"ISSN":["0167-8140"],"issn-type":[{"value":"0167-8140","type":"print"}],"subject":[],"published":{"date-parts":[[2022,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Definitive high-dose, proton-based radiation for unresected mobile spine and sacral chordomas","name":"articletitle","label":"Article Title"},{"value":"Radiotherapy and Oncology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.radonc.2022.04.007","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2022 Elsevier B.V. All rights reserved.","name":"copyright","label":"Copyright"}]}}