Published in the Red Journal, this study by the MGH group reported outcomes of 52 pediatric patients with spinal and sacrococcygeal chordomas (CH) and chondrosarcomas (CHS) treated with proton RT. At a median follow-up of 11.4 years, this study reported that at 5-, 10-, and 20-year, OS were 82.7%, 72.3% and 72.3%, respectively; PFS were 72.3%, 70.1% and 70.1%, respectively. Seventeen (32.7%) patients recurred (8 local, 7 distant, and 2 iatrogenic). 

Most acute toxicities were limited to mild-to-moderate skin reactions and cervical dysphagia. No patients experienced above grade 2 acute toxicities. For late toxicities, the study reported that grade 2 hypothyroidism in two patients; radiation myelitis resulting in loss of sensation and temperature in the lower extremity in one patient; severe grade 3 kyphoscoliosis in one patient. No patients experienced late grade 4 and above toxicities. There was no case of a radiation-induced tumor. The authors concluded that this largest series has demonstrated high-dose proton RT following surgical resection offers high disease control rates for CH/CHS.