{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:10:09Z","timestamp":1792001409464,"version":"4.4.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P01CA021239"],"award-info":[{"award-number":["P01CA021239"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To determine if dose escalation improves outcomes for chondrosarcomas (CHS) of the base of the skull (BOS) and the cervical spine (CS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective, randomized, dose-escalation trial was designed for patients with CHS of the BOS and CS. Patients were randomly assigned to 70 Gy (RBE) or 76 Gy (RBE). The primary endpoint was local failure (LF). Secondary endpoints included overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), and treatment-related toxicities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 1987 and 2007, 105 patients were randomized, median follow-up was 29.2 years (IQR, 26.7-32.4). Forty-six patients were assigned to 70 Gy (RBE) and 59 were assigned to 76 Gy (RBE). LF at 5-, 10-, and 20 years were 7%, 9%, and 11% for 70 Gy (RBE), and 10%, 15%, and 19% for 76 Gy (RBE) (P\u2009=\u2009.16). Like LF rates, there was no benefit in dose escalation for OS (P\u2009=\u2009.28) and CSS (P\u2009=\u2009.22). Progression-free survival at 5-, 10-, and 20 years was 93%, 89%, and 77% for the low-dose group and 83%, 71%, and 59% for the high-dose group (P\u2009=\u2009.069). Late RT injury \u2265 grade 3 was reported in a total of 19 (18%) patients across both dose levels, with 11% in the low-dose group and 24% in the high-dose group (P\u2009=\u2009.13).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This is the first and largest trial of patients with grade I\/II BOS and CS CHS evaluating dose escalation for tumor control. Proton-based RT is effective and safe for these tumors, but there is no apparent benefit in dose escalation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Information<\/jats:title>\n                    <jats:p>NCT00592748.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuonc\/noaf289","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T13:05:15Z","timestamp":1765976715000},"page":"968-977","source":"Crossref","is-referenced-by-count":4,"title":["Prospective, randomized dose-escalation trial with proton-based radiation for skull base and cervical spine chondrosarcomas: 30-year outcomes from PROG 85-26"],"prefix":"10.1093","volume":"28","author":[{"given":"Myrsini","family":"Ioakeim-Ioannidou","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Mass General Brigham, Harvard Medical School , Boston, Massachusetts,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beow Y","family":"Yeap","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mass General Brigham, Harvard Medical School , Boston, Massachusetts,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zainab O","family":"Soetan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mass General Brigham, Harvard Medical School , Boston, Massachusetts,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel W","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Inova Scholar Cancer Institute , Alexandria, Virginia,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Packard","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Department of Medicine, Rochester, Minnesota,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rana","family":"Hegazy","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Children\u2019s Cancer Hospital , Cairo,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Engy S","family":"Todary","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Children\u2019s Cancer Hospital , Cairo,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athena","family":"Tejada","sequence":"additional","affiliation":[{"name":"St. George's University School of Medicine , True Blue, Grenada (A.T.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Mass General Brigham, Harvard Medical School , Boston, Massachusetts,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanne","family":"Kooy","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Mass General Brigham, Harvard Medical School , Boston, Massachusetts,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Zieminski","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Mass General Brigham, Harvard Medical School , Boston, Massachusetts,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Depauw","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Mass General Brigham, Harvard Medical School , Boston, Massachusetts,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnlaugur Petur","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Mass General 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Massachusetts,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganesh","family":"Shankar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mass General Brigham, Harvard Medical School , Boston, Massachusetts,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William T","family":"Curry","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mass General Brigham, Harvard Medical School , Boston, Massachusetts,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory M","family":"Cote","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, Mass General Brigham, Harvard Medical School , Boston, Massachusetts,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillary R","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Diagnostic 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Massachusetts,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, NYU Langone Hospital, New York City, New York,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fantine","family":"Giap","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Mass General Brigham, Harvard Medical School , Boston, Massachusetts,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Lin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Mass General Brigham, Harvard Medical School , Boston, Massachusetts,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas F","family":"Delaney","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Mass General Brigham, Harvard Medical School , 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