. Author manuscript; available in PMC: 2010 Jul 1.

Published in final edited form as: Int J Radiat Oncol Biol Phys. 2008 Dec 25;74(3):732–739. doi: 10.1016/j.ijrobp.2008.08.058

Table 5.

Radiation-related treatment complications ≥ Grade 3.

TYPE	GRADE	TREATMENT	TIME COURSE	COMMENT

ACUTE

Insufficiency fracture, contralateral sacrum	3	R0 surgery, 70.2 GyRBE for sacral chordoma	1 month after surgery and 19.8 Gy preop XRT	Patient fell and fractured uninvolved sacrum.
				Resolved without surgery or late sequelae

LATE

Sacral neuropathy	3	Bx, 77.4 GyRBE for 5.5 cm sacral chordoma	5.5 years after XRT	Unilateral leg weakness, stress urinary incontinence, poor rectal tone

Sacral neuropathy	3	R2 resection, 77.4 GyRBE for 10.5 cm sacral chordoma	4 years after XRT	Unilateral leg weakness; also received 18Gy IMRT + 27 GyRBE protons after simple hysterectomy for cervix cancer 2.5 years after protocol Rx

Erectile dysfunction	3	Bx, 77.4 GyRBE for 8.4 cm sacral chordoma	3 years after XRT	Patient age 66 at time of XRT.
				Not responsive to sildenafil

Contralateral sacral insufficiency fracture	3	R2 resection, 77.4 GyRBE for 6.2 cm sacral chondrosarcoma	4 months after treatment	Patient fell and fractured uninvolved sacrum.
				Managed by screw fixation.

Rectal bleed	3	R0 resection and 70.2 GyRBE for 4.5 cm sacral chordoma	10 months after treatment	Required transfusion and fulguration.
				History of prior pelvic surgeries (hysterectomy, endometriosis, bowel obstruction).