gms | German Medical Science

From 1981 to 2008, N=105 children (46 males, 59 females) have received postoperative high-dose fractionated photon-proton RT with curative intent at the Massachusetts General Hospital. The median time from the onset of symptoms and signs to diagnosis was 4.9 months. The 105 children underwent 227 tumor resections prior to RT, among them 38 resections for tumor progression. 23 children required dorsal occipital-cervical stabilizations. The median residual tumor volume was 36.8 cc. The median tumor dose was TD=78.5 +/- 3.3 Gy(RBE), delivered in 1.8–2.0 Gy(RBE)/fraction. Dose constraints of normal anatomical structures were: optic pathway: <62 Gy(RBE); brain stem/spinal cord – surface: <67 Gy(RBE), center: <55 Gy(RBE). Median follow-up: 9.5 years. Local tumor control is: 81% at 5 years, 78% at 10 years, 72% at 15 and 20 years. Overall survival is 76% at 10 years, 64% at 20 years. Interdisciplinary management of pediatric chordoma of the cranial base and outcome results will be discussed in detail.