Figure 9.

Stereotactic body radiotherapy (SBRT) for in-field recurrent high-grade mesenchymal chondrosarcoma (confirmed in next-generation sequencing sarcoma panel). In 2015, the patient underwent neoadjuvant chemotherapy followed by surgery, adjuvant radiochemotherapy (50.4 Gy in 1.8 Gy fractions with vincristine and dactinomycin combination chemotherapy), and chemotherapy according to EIAO regimen (etoposide, ifosfamide, vincristine, and dactinomycin). In 2019, he experienced local recurrence (LR) in the paraspinal area, which was resected in 2020. Five months later, the second LR was observed (A,B). The patients received SBRT (C) planned on fusion with magnetic resonance imaging and previous treatment plan (D). Volumetric arc therapy was used to deliver 30 Gy in five fractions prescribed on 80% isodose (C). Cord tolerance doses were compliant with the report published by Sahgal et al. [162]. Photos by Mateusz J. Spałek.