Defining Optimal Imaging Strategies for Diagnosis, Treatment, and Treatment Evaluation of Chordomas and Chondrosarcomas of the Axial Skeleton

What this Trial Is About

Researchers are studying chordomas and chondrosarcomas, which are malignant bone tumors located in the axial skeleton including the clivus, spine, and sacrum. These tumors mainly cause problems due to their local aggressive growth rather than spreading to other parts of the body. The study focuses on using advanced imaging techniques to evaluate the changes in tumor components early during proton beam therapy, aiming to improve treatment decisions and outcomes. This is a prospective cohort study involving patients with these tumors who are treated at Leiden University Medical Center. Participants will undergo standard proton beam therapy for their tumor treatment. During the therapy, additional imaging assessments will be performed, including two extra MRI scans and one PET-CT scan. These functional imaging techniques will measure parameters such as tumor permeability and activity to detect changes within six months of starting treatment. The study will also compare imaging findings with surgical specimens in patients undergoing surgery after neo-adjuvant therapy to better understand tumor viability. Throughout the study, participants will have imaging and clinical evaluations at multiple time points: at inclusion, 4 and 8 weeks, and then at 5, 11, 17, and 23 months after starting proton therapy. Researchers will monitor functional MRI parameters and PET-CT measures, as well as clinical outcomes like survival, tumor progression, metastasis development, and treatment side effects. Data from imaging, treatment details, and clinical follow-up will be collected to assess how early imaging changes relate to patient outcomes. Participation involves minimal additional risk, as treatment and care remain standard.

Image Assisted Optimization of Proton Radiation Therapy in Chordomas and Chondrosarcomas