Ents nurses' notes oncolink editor's choice award oncolink library oncolink tv oncolink university pet imaging center resources for young adults risk and prevention clinical trials clinical trials clinical trials matching proton therapy clinical trials matching healthcare professionals healthcare professionals nurses notes patient education center continuing education proton educational modules clinical trials conferences oncolink university resource list donate español related topcis types of cancer cancer treatment cancer support and coping cancer resources nurses' notes what's my cancer risk? Oncopilot: navigating your cancer journey community events calendar oncolink enews abramson cancer center cancer resources / conferences / oncolink scientific meetings coverage / oncolink at ptcog 2008 / highlights from ptcog 2008 carbon ion radiotherapy for skull base and paracervical chordomas reviewer: christine hill, md affiliation: abramson cancer center of the university of pennsylvania last modified: may 23, 2008 presenter: azusa hasegawa presenter's affiliation: research center for charged particle therapy type of session: scientific background chordomas are rare, slow growing, locally aggressive neoplasms of bone that arise from embryonic remnants of the notochord. They typically occur in the axial skeleton and arise most commonly in the skull base and sacral regions. 50% of adult chordomas involve the sacrococcygeal region 35% occur at the base of the skull 15% are found in the vertebral column craniocervical chordomas most often involve the dorsum sella, clivus, and nasopharynx. Treatment of tumors in locations such as these is particularly difficult because of the proximity of other, vital, structures such as the brainstem, spinal cord, optic chiasm, and optic nerves. Complete or near-complete surgical resection is often impossible because of intimate involvement of tumor tissue with vital structures. Achievement of adequate radiotherapy doses is also often limited by the tolerance of these normal structures. Treatment of skull base and spinal cord/ paraspinal chordomas with an approach using a combination of photon and proton-based radiotherapy has been utilized at massachusetts general hospital (mgh) since 1973 (hug, 1995). Dose characteristics of proton beam radiotherapy, including finite range and steep dose fall of beyond the bragg peak, may allow safer tumor dosing while promoting sparing of normal structures. Carbon ion radiotherapy has many of the same dose sculpting benefits as proton beam radiotherapy; however, carbon ion radiotherapy may p. generic viagra online overnight shipping best generic viagra pharmacies buying viagra online without prescription best generic viagra usa cheap viagra cheap viagra online usa buy viagra online from canada drugs buy generic viagra generic viagra for sale online viagra online prescription about us
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