Sixty-seven patients with unresected spinal chordomas treated with PBT were evaluated. With a median follow-up of 56.2 months, 5- and 8-year OS were 83.5 % and 65.9%, DFS 64% and 44.1%, LC 81.8% and 63.6%, and distant control 7.4% and 72.5. The most common late side effect was insufficiency fracture. The authors stated that the results of their study continued to support the use of high-dose definitive PBT for this subset of patients, and there was a trend towards better disease-free survival with doses >78 Gy (RBE).