The role for adjuvant radiotherapy in the treatment of hemangiopericytoma: a Surveillance, Epidemiology, and End Results analysis

2014 ◽  
Vol 120 (2) ◽  
pp. 300-308 ◽  
Author(s):  
Adam M. Sonabend ◽  
Brad E. Zacharia ◽  
Hannah Goldstein ◽  
Samuel S. Bruce ◽  
Dawn Hershman ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Radiation Therapy ◽  
Survival Data ◽  
Survival Benefit ◽  
Radiation Treatment ◽  
Univariate Analysis ◽  
Adjuvant Radiation ◽  
Significant Difference ◽  
End Results

Object Central nervous system (CNS) hemangiopericytomas are relatively uncommon and unique among CNS tumors as they can originate from or develop metastases outside of the CNS. Significant difference of opinion exists in the management of these lesions, as current treatment paradigms are based on limited clinical experience and single-institution series. Given these limitations and the absence of prospective clinical trials within the literature, nationwide registries have the potential to provide unique insight into the efficacy of various therapies. Methods The authors queried the Surveillance Epidemiology and End Results (SEER) database to investigate the clinical behavior and prognostic factors for hemangiopericytomas originating within the CNS during the years 2000–2009. The SEER survival data were adjusted for demographic factors including age, sex, and race. Univariate and multivariate analyses were performed to identify characteristics associated with overall survival. Results The authors identified 227 patients with a diagnosis of CNS hemangiopericytoma. The median length of follow-up was 34 months (interquartile range 11–63 months). Median survival was not reached, but the 5-year survival rate was 83%. Univariate analysis showed that age and radiation therapy were significantly associated with survival. Moreover, young age and supratentorial location were significantly associated with survival on multivariate analysis. Most importantly, multivariate analysis using the Cox proportional hazards model showed a statistically significant survival benefit for patients treated with gross-total resection (GTR) in combination with adjuvant radiation treatment (HR 0.31 [95% CI 0.01–0.95], p = 0.04), an effect not appreciated with GTR alone. Conclusions The authors describe the epidemiology of CNS hemangiopericytomas in a large, national cancer database, evaluating the effectiveness of various treatment paradigms used in clinical practice. In this study, an overall survival benefit was found when GTR was accomplished and combined with radiation therapy. This finding has not been appreciated in previous series of patients with CNS hemangiopericytoma and warrants future investigations into the role of upfront adjuvant radiation therapy.

Stage II Oral Tongue Cancer: Survival Impact of Adjuvant Radiation Based on Depth of Invasion

2018 ◽  
Vol 160 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Samuel J. Rubin ◽  
Ellen B. Gurary ◽  
Muhammad M. Qureshi ◽  
Andrew R. Salama ◽  
Waleed H. Ezzat ◽  
...  
Keyword(s):  
Overall Survival ◽  
Radiation Therapy ◽  
Oral Cavity ◽  
Tongue Cancer ◽  
Univariate Analysis ◽  
Adjuvant Radiation ◽  
Depth Of Invasion ◽  
Postoperative Radiation ◽  
Postoperative Radiation Therapy ◽  
Significant Difference

Objective To determine if adjuvant radiation therapy for patients with pT2N0 oral cavity tongue cancer affects overall survival. Study Design Retrospective cohort study. Setting National Cancer Database. Subjects and Methods Cases diagnosed between 2004 and 2013 with pathologic stage pT2N0 oral cavity tongue cancer with negative surgical margins were extracted from the National Cancer Database. Data were stratified by treatment received, including surgery only and surgery + postoperative radiation therapy. Univariate analysis was performed with a 2-sample t test, chi-square test, or Fisher exact test and log-rank test, while multivariate analysis was performed with Cox regression models adjusted for individual variables as well as a propensity score. Results A total of 934 patients were included in the study, with 27.5% of patients receiving surgery with postoperative radiation therapy (n = 257). In univariate analysis, there was no significant difference in 3-year overall survival between the patient groups ( P = .473). In multivariate analysis, there was no significant difference in survival between the treatment groups, with adjuvant radiation therapy having a hazard ratio of 0.93 (95% CI, 0.60-1.44; P = .748). Regarding tumors with a depth of invasion >5 mm, there was no survival benefit for the patients who received postoperative radiation therapy as compared with those who received surgery alone (hazard ratio = 0.93; 95% CI, 0.57-1.53; P = .769). Conclusion An overall survival benefit was not demonstrated for patients who received postoperative radiation therapy versus surgery alone for pT2N0 oral cavity tongue cancer, irrespective of depth of tumor invasion.

Improved survival with radiation therapy in early pancreatic adenocarcinoma

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15036-15036
Author(s):  
A. Artinyan ◽  
M. Hellan ◽  
P. Mojica-Manosa ◽  
J. Ellenhorn ◽  
J. Kim
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Radiation Therapy ◽  
Pancreatic Adenocarcinoma ◽  
Radiation Treatment ◽  
Prognostic Significance ◽  
Adjuvant Radiation ◽  
Cox Regression Analysis ◽  
Adjuvant Radiation Therapy

15036 Background: Although chemoradiation is often used following pancreatic cancer resection, recent studies have questioned the role of radiation therapy in this setting. The objective of this study was to determine the effect of adjuvant radiation therapy following pancreatectomy in patients with node-negative (N0) pancreatic cancer. Methods: The Surveillance, Epidemiology, and End Results (SEER) registry was used to identify patients with N0 pancreatic adenocarcinoma who had undergone curative-intent resection between 1988–2003. Kaplan-Meier survival curves were constructed to compare overall survival between patients ± adjuvant radiation therapy. Multivariate Cox regression analysis was performed to determine the prognostic significance of radiation therapy when additional clinicopathologic factors were assessed. The analysis also examined the potential treatment selection bias of patients with survival <3 months. Results: Query of the SEER database identified 2342 surgical patients with N0 disease. The median survival for these patients was 18 months. 889 (60.1%) patients were treated with radiation. There was no difference in gender or grade between radiation and non-radiation groups; however, radiation patients were younger (63 vs. 67 years, p<0.001) and had a greater proportion of T3 lesions (p=0.002). Radiation patients had significantly improved survival compared to non-radiation patients (20.0 vs. 15.0 months, p<0.001). On multivariate analysis, radiation therapy (HR 0.72, p<0.001), age, grade, T-stage, and tumor location were independent predictors of survival. When patients with survival <3 months were excluded from analysis, no difference in survival between radiation and non- radiation was noted (20.0 vs. 19.0 months, p=0.096). However, on subset analysis, patients with T3 tumors demonstrated improved survival with the addition of radiation (24.0 vs 16.0 months, p=0.002) and on multivariate analysis radiation therapy was an independent predictor of improved overall survival (HR 0.87, p=0.027). Conclusions: Radiation treatment is associated with improved survival in operable N0 pancreatic cancer and its use should be considered in patients with early stage N0 disease. The greatest impact of radiation therapy use appears to occur with T3 tumors. No significant financial relationships to disclose.

scholarly journals RADT-29. EFFECT OF RADIATION THERAPY ON OVERALL SURVIVAL FOLLOWING SUBTOTAL RESECTION OF ADULT PILOCYTIC ASTROCYTOMA

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii187-ii188
Author(s):  
Adham Khalafallah ◽  
Adrian Jimenez ◽  
Henry Brem ◽  
Debraj Mukherjee
Keyword(s):  
Overall Survival ◽  
Radiation Therapy ◽  
Pilocytic Astrocytoma ◽  
Radiation Treatment ◽  
Cox Proportional Hazards Model ◽  
Adult Patients ◽  
Subtotal Resection ◽  
Adjuvant Radiation ◽  
Low Grade ◽  
Risk Of Death

Abstract BACKGROUND Pilocytic astrocytoma (PCA) is a low-grade glioma common in children but also rarely diagnosed in adults. The role of adjuvant radiation therapy (RT) in treating these tumors remains unclear. OBJECTIVE We investigated the effect of RT on overall survival, specifically among adult patients who had undergone subtotal PCA resection. METHODS Information on adult patients (age 18 years old) who had undergone subtotal PCA resection between 2004 and 2016 was collected from the National Cancer Database (NCDB). A multivariate Cox proportional hazards model was utilized to determine factors independently associated with overall survival. RESULTS A total of 451 patients were identified. The mean age of our patient cohort was 36.8 years old, and the majority of patients (83.4%) did not receive radiation treatment following subtotal PCA resection. Overall median survival was 93.8 months. Survival was longer (p &lt; 0.001) in the patients who did not receive post-surgical RT (median: 98.3 months) compared to patients who did (median: 54.8 months). Patients who had older age at diagnosis (hazard ratio [HR]=1.05, 95% confidence interval [CI]=1.03-1.07, p &lt; 0.01), were Black or African American (HR=2.76, CI=1.12-6.46, p=0.019), received radiation during their initial treatment (HR=4.53, CI=2.08-9.89, p &lt; 0.01), or had a Charlson/Deyo score of &gt; 1 (HR=3.68, CI=1.55, p=0.003) had a significantly higher risk of death following subtotal PCA resection. CONCLUSION Postoperative RT is independently associated with a significantly higher risk of death among adults who underwent subtotal PCA resection. Our findings provide a rationale for further investigation into the efficacy and safety of RT within this patient population.

Primary pancreatic lymphoma: A population-based analysis using the Surveillance, Epidemiology and End Results database.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 303-303
Author(s):  
M. V. Mishra ◽  
S. W. Keith ◽  
X. Shen ◽  
T. Biswas
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Radiation Therapy ◽  
B Cell Lymphoma ◽  
Treatment Modalities ◽  
Tumor Characteristics ◽  
Histologic Subtype ◽  
Pancreatic Lymphoma ◽  
Primary Pancreatic Lymphoma ◽  
End Results

303 Background: Primary pancreatic lymphoma (PPL) is a rare disease, accounting for only 0.5% of all pancreatic masses. The clinical presentation of PPL is similar to that of pancreatic adenocarcinoma and the two are difficult to distinguish radiographically. A paucity of literature exists on the epidemiology and outcomes of PPL. Given the limited case reports published on PPL, a comparison of the different treatment modalities has previously not been possible. Here, we present a series of 523 cases of PPL obtained from the Surveillance, Epidemiology, and End Results (SEER) database to investigate the tumor characteristics and compare the different treatment modalities. Methods: Patients diagnosed with a primary pancreatic lymphoma from 1973-2007 were identified. Data on patient and tumor characteristics as well as initial treatment with surgery or radiation was extracted. Chemotherapy information is not available through SEER. Overall survival was calculated using the Kaplan-Meier method. A multivariate analysis was performed to determine independent prognostic factors predicting for survival using a Cox proportional hazards model. Results: Fifty-eight percent of patients identified were male. The median age range at diagnosis was 65-69 years (range, 10-14 years – greater than 85 years). The most common histologic subtype in the present series was diffuse large B-cell lymphoma (DLBCL), which accounted for 71% of all patients. The 5-year overall survival for the group was 47%. Multivariate analysis indicates that age >60 and a marital status of single were predictive of a decreased cause-specific and overall-survival specific survival (p<0.05). Radiation therapy, but not surgery, was predictive of an improved overall survival (p<0.05). Conclusions: PPL is a rare form of extra-nodal NHLs of the GI tract. Adjuvant radiation therapy for patients with a PPL should be strongly considered and a surgical treatment should be avoided if an early diagnosis is established. A prospective study evaluating this patient population will be difficult given the rarity PPL. We hope that this case series will provide a context in evaluating and treating patients with PPL. No significant financial relationships to disclose.

Adherence to the BCLC guidelines and impact on overall survival.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 345-345 ◽  
Author(s):  
Jesna Mathew ◽  
Sasha Slipak ◽  
Anil Kotru ◽  
Joseph Blansfield ◽  
Nicole Woll ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Benefit ◽  
Cox Regression ◽  
Early Stage ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Treatment Recommendations ◽  
Rank Test ◽  
P Value ◽  
Significant Difference

345 Background: Multiple studies exist that validate the prognostic value of the Barcelona Clinic Liver Cancer (BCLC) staging. However, none have established a survival benefit to the treatment recommendations. The aim of this study was to evaluate the adherence to the BCLC guidelines at a rural tertiary care center, and to determine the effect of following the treatment recommendations on overall survival. Methods: A retrospective chart review was conducted for 97 patients newly diagnosed with hepatocellular carcinoma (HCC) from 2000 to 2012. The treatment choice was compared with the BCLC guidelines and percentage adherence calculated. Overall survival was estimated using the Kaplan-Meier method and the log rank test was used to test the difference between the two groups. Cox regression tests were used to determine independent effects of stage, treatment aggressiveness, and guideline adherence on survival. A p-value <0.05 was considered statistically significant. Results: Of 97 patients, 75% (n=73) were male. Median overall survival was 12.9 months. In 59.8% (n=58) of the patients, treatment was adherent to stage specific guidelines proposed by the BCLC classification. There was no significant difference in overall survival between the adherent and non-adherent groups (11.2 vs 14.1 months, p<0.98). However on stage specific survival analysis, we noted a significant survival benefit for adherence to the guidelines for early stage HCC (27.9 vs 14.1 months, p<0.05), but a decrease in survival for adherence in the end stage (20 days vs 9.3 months, p<0.01). On univariate analysis, more aggressive treatment was associated with increased survival (hazard ratio [HR], 0.4; 95% confidence interval [CI], 0.22 to 0.87; p = 0.018). Multivariate analysis revealed that adherence did not independently affect survival when stage and aggressiveness of treatment were included in the model (HR, 1.3; 95% CI, 0.76 to 2.2, p = 0.34). Conclusions: Although the BCLC guidelines serve as a practical guide to the management of patients with HCC, they are not universally practiced. These results indicate that survival of patients with hepatocellular cancer is determined by stage and aggressiveness of treatment, not adherence to BCLC guidelines.

Stage I-II endometrial adenocarcinoma evolution of therapeutic paradigms: the role of surgery and adjuvant radiation

2002 ◽  
Vol 12 (3) ◽  
pp. 237-249 ◽  
Author(s):  
K Look
Keyword(s):  
Overall Survival ◽  
Radiation Therapy ◽  
Adjuvant Radiotherapy ◽  
Survival Benefit ◽  
Older Patients ◽  
Endometrial Adenocarcinoma ◽  
Stage I ◽  
Surgical Staging ◽  
Adjuvant Radiation

Abstract.Look K. Stage I-II endometrial adenocarcinoma evolution of therapeutic paradigms: the role of surgery and adjuvant radiation.The objective was to review the English-language literature regarding the utility of adjuvant radiation therapy following surgery for endometrial adenocarcinoma. An OVID software (Ovid Technologies, Inc., New York, NY) search of Medline articles from 1975 to 2001 was conducted using the keywords “endometrial neoplasm,”“surgery,” and “radiation therapy.” The papers were assessed with regard to (a) extent of surgical staging (b) type of adjuvant radiotherapy utilized: external vs. brachytherapy vs. combination therapy; and (c) whether the patients were treated as part of prospective trial or reported as a descriptive series reflecting an institution's practice pattern. Survival rates are excellent for patients with early stage disease treated in either paradigm of extended-surgical staging with more restricted use of the adjuvant therapy or simple hysterectomy bilateral salpingoophorectomy with more frequent use of adjvuant radiotherapy. All three prospecctive-randomized trials (PRCT) have shown an improvement in local control but no overall survival benefit for the entire accrued group. All three PRCTs have shown a higher risk of disease recurrence in older patients or those with grade 3 histology or deep invasion. Each suggests there may be a survival benefit for the subset of patients with such high-risk features, but at present there is no prospective data that demonstrates adjuvant radiotherapy will improve the overall survival for the highest-risk subset of older patients with high-grade deeply invasive disease.

Contemporary breast conservation patient outcomes for ductal carcinoma in situ and margins < 2 mm.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 559-559
Author(s):  
Audree Tadros ◽  
Benjamin D. Smith ◽  
Yu Shen ◽  
Heather Y. Lin ◽  
Savitri Krishnamurthy ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Locoregional Recurrence ◽  
Univariate Analysis ◽  
Breast Conservation ◽  
Adjuvant Radiation ◽  
Adjuvant Radiation Therapy ◽  
Margin Width ◽  
Additional Surgery ◽  
Significant Difference ◽  
The Relationship

559 Background: Recent national consensus guidelines regarding optimal margin width for the management of DCIS have been published; however, controversy remains for managing margins <2mm. The relationship between margin width and locoregional recurrence (LRR) was determined in a contemporary cohort of patients. Methods: 1504 patients with DCIS undergoing definitive breast conserving surgery from 1996 to 2010 were analyzed for clinical and pathologic characteristics from a prospectively managed comprehensive academic cancer center database. Cox proportional hazard models were used to examine the relationship between margin width (<2mm or ≥2mm) and LRR by adjuvant radiation therapy (RT). Patients with positive margins (n=11) were excluded. Results: Overall, 3.4% of patients had a LRR at a median follow-up of 8.7 years. Univariate analysis of age, family history, grade, tumor size, comedonecrosis, RT, adjuvant hormonal therapy, ER status, and margin width found younger age (< 40 yr, p=0.02), no RT (n=299, p=0.005), and margin width <2mm(n=138, p=0.005) to be associated with LRR. The association between margin width and LRR differed by adjuvant radiation therapy status (p=0.02 for the interaction). There was no statistical significant difference in LRR for patients with margins <2mm vs ≥2 mm who received RT, (10-year LRR 6.0% vs 3.2%, respectively; HR 1.5, 95% CI 0.5-4.2, p=0.48). For patients who did not receive RT (n=299), those with margins < 2 mm were significantly more likely to develop a LRR than those with margins ≥2mm (10-year LRR 35.7% vs. 4.6%, respectively; HR 7.2, 95%CI 2.6-19.4, p=0.0001). Conclusions: In patients with <2mm margins receiving adjuvant radiation therapy, there is no difference in locoregional recurrence when compared to patients with ≥2mm margins. Additional surgery for wider margins of resection are not routinely justified in this group of patients but should be obtained for patients with <2mm margins who forego radiotherapy.

Outcomes of adjuvant radiotherapy and lymph node dissection in elderly patients with pancreatic cancer treated with surgery and chemotherapy.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 332-332
Author(s):  
Jessica Freilich ◽  
Eric Albert Mellon ◽  
Gregory M. Springett ◽  
Ken Meredith ◽  
Pamela Joy Hodul ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Radiation Therapy ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Univariate Analysis ◽  
Adjuvant Radiation ◽  
Lower Grade ◽  
Postoperative Radiation Therapy ◽  
T Stage ◽  
Significant Difference

332 Background: To determine the effects of postoperative radiation therapy (PORT) and lymph node resection (LNR) on survival in patients age ≥ 70 with pancreatic cancer treated with surgery and chemotherapy. Methods: An analysis of patients with surgically resected pancreatic cancer who received chemotherapy from the SEER database from 2004-2008 was performed to determine association of PORT and LNR on survival. Survival curves were calculated according to the Kaplan-Meier method and log-rank analysis. Multivariate analysis (MVA) was performed by the Cox proportional hazard model. Results: We identified 961 patients who met inclusion criteria. The only significant difference between PORT patients and no PORT patients was age, median 75 and 76 years, respectively (p=0.007). Overall survival (OS) in PORT versus no PORT was not statistically different in the whole cohort (p=0.064), N0 (p=0.803) or N1 (p=0.0501). On univariate analysis (UVA) there was increased OS in patients with lower T stage (p<0.001), N0 status (p<0.001), lower AJCC stage (p<0.001) and lower grade (p<0.001). No OS difference was seen based on gender, location, or PORT. There was no difference in OS based on number of lymph nodes removed in all patients (p=0.74), N0 (p=0.59), and N1 (p=0.07). MVA for all patients revealed higher T stage, N1, and high grade were prognostic for worse mortality, while there was a trend for decreased mortality with PORT (p=0.052). In N0 patients, increased T-stage and grade were prognostic for worse survival, while PORT and number of lymph nodes removed were not. In N1 patients, higher T-stage and grade were prognostic for increased mortality, while increasing number of lymph nodes removed was associated with decreased mortality. PORT trended towards improved survival in N1 patients (p=0.06). Age, gender and tumor location were not prognostic for survival. Conclusions: Adjuvant radiation therapy and number of lymph nodes removed in patients age ≥70 does not seem to correlate with increased OS in surgically resected pancreatic cancer treated with chemotherapy. Future clinical trials will need to address age as a stratification factor for pancreatic cancer in the adjuvant setting.

Anaemia in patients with transitional cell carcinoma (TCC) of the bladder treated with radiotherapy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14569-14569
Author(s):  
C. Joynson ◽  
P. Symonds ◽  
S. Sundar
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Local Recurrence ◽  
Haemoglobin Level ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Transitional Cell ◽  
Prognostic Indicators ◽  
Significant Difference ◽  
The Impact

14569 Background: Treatment of muscle invasive TCC of the bladder with radiotherapy allows organ preservation and is frequently used in the UK especially in patients not medically fit for cystectomy. Anaemia is known to be an indicator of poor response to radiotherapy in head and neck and cervical carcinomas. This study describes the prevalence and type of anaemia in patients with TCC of the bladder and looks at the impact anaemia has on treatment outcome. Methods: Retrospective review of notes was performed on patients treated radically between 1992 and1997. Potential patient, tumour and treatment prognostic indicators were reported. Patients were labelled as being anaemic if their pre treatment haemoglobin level was below the normal range (below 13.5g/dl for men and below 11.5g/dl for women). Time to local recurrence, metastases and overall survival was recorded. Recurrence free survival and overall survival actuarial estimations were done using the Kaplan Meier method and compared by log rank testing. Multivariate analysis was carried out using Cox Regression method, correcting for potential confounding factors. Results: Data on 100 patients were available for analysis. 52 patients were anaemic with 75% of these having a normochromic, normocytic anaemia. Univariate analysis showed no significant difference in time to local recurrence, a trend to shorter time to metastases, and a significant reduction in overall survival in anaemic patients (p = 0.04). Two year survival was 43% and 22% for non anaemic and anaemic patients respectively. Multivariate analysis using covariates tumour stage, grade, and serum creatinine found anaemia to be poor prognostic indicator for overall survival (p = 0.005) and time to metastases (p = 0.003). Conclusions: Anaemia is highly prevalent in patients with bladder cancer. This retrospective study shows anaemic patients to have a worse outcome with radiotherapy treatment than patients with a normal haemoglobin level. This is not accounted for by a difference in local control which may be expected from hypoxic radiobiological principles. Anaemia may be indicative of more aggressive malignancy or sub clinical metastases. No significant financial relationships to disclose.

Multicentric randomized phase II trial of gamma knife surgery (GKS) versus image-guided, intensity-modulated radiation therapy (IG-IMRT) in patients with sacrococcygeal chordoma.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 11033-11033
Author(s):  
Shun Lu ◽  
Jin Yi Lang ◽  
Weidong Wang ◽  
Mei Feng ◽  
Bingwen Zou ◽  
...  
Keyword(s):  
Overall Survival ◽  
Radiation Therapy ◽  
Surgical Resection ◽  
Local Control ◽  
High Recurrence Rate ◽  
Adjuvant Radiation ◽  
Adjuvant Radiation Therapy ◽  
Initial Surgery ◽  
First Choice ◽  
Significant Difference

11033 Background: Chordoma is a rare slow-growing neoplasm arisen from cellular remnants of the notochord. About 30% occur in the sacrococcygeal region. Surgical resection is recommended treatment. Due to the high recurrence rate, adjuvant radiation therapy was suggested to receive as an effective method to improve local control rates. Methods: Thirty eight patients were pathologically diagnosed as non-metastatic sacrococcygeal chordoma from Aug. 2003 to May. 2015 were recruited retrospectively to analysis. All patients received surgical resection after diagnosed. Initial surgery included subtotal resection (24% of patients), and gross total resection (76% of patients). Among these patients, 25 patients treated with adjuvant IG-IMRT, while 13 patients treated GKS after surgical resection. The median follow-up was 40 months (range, 6–151 month) for all patients, The PTV of IG-IMRT group received total doses were 60 Gy (range, 56-74Gy), delivered with 2-2.2 Gy/fraction, while GKS group underwent a total of 6-8 sessions treatment. Results: For the IG-IMRT group and the GKS group, the 5-year overall survival and local control rates were 87.5% and 67.7%, respectively. And 5-year local control rates were 35% and 22.2%, respectively. In total, 18 patients progressed locally: 11 were in the IG-IMRT group and 7 in the GKS group. In comparison with GKS group, the IG-IMRT group has a better overall recurrence-free survival (p = 0.03), the significance remained after adjusted for surgery results, age and gender. Moreover, there is no significant difference of overall survival was found between these two groups. Conclusions: We report favorable local control and adverse event rates following IG-IMRT, and suggested IG-IMRT is the first choice of adjuvant radiation therapy for sacrococcygeal chordoma treatment.

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