ClinicalTrials.gg
RecruitingNCT02986516SACROUpdated Jan 2, 2026

Sacral Chordoma: Surgery Versus Definitive Radiation Therapy in Primary Localized Disease

An interventional study of Randomized Cohort and Prospective cohort in Chordoma, sponsored by Italian Sarcoma Group. Recruiting at 28 sites in 10 countries. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-01-02.

Sponsored by Italian Sarcoma Group · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Mar 2017; still recruiting 9 years 7 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
100
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

Comparative study on surgery versus definitive radiation therapy in primary localized sacral chordoma

Read the detailed description

International, multicenter, comparative, open-label, parallel-group, mixed Observational-Randomized Controlled Trial.

All the patients, who are candidate for the study will receive full information on the characteristics, potential effectiveness and side effects of the two alternatives treatments: radiotherapy (RT) and surgical treatment Eligible patients will be asked to be randomized in order to receive treatment A (surgery, with or without RT) or treatment B (definitive RT) Who will refuse randomization will be included in the Prospective Cohort Study (PCS) and will be treated accordingly to their choice (treatment option A or treatment option B).

The same radiotherapy and surgical regimen will be administered in the PCS and in the Randomized Clinical Trial (RCT) cohort

02

Conditions studied

  • Chordoma

Browse trials for

03

In context

Chordoma

68 studies on the registry are indexed under Chordoma; 15 are open to participants now.

This study's planned enrollment of 100 is above the median of 38 across 50 interventional studies indexed under Chordoma.

Browse Chordoma studies →

Lead sponsor

Italian Sarcoma Group is the lead sponsor of 31 studies on the registry; 11 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • confirmed diagnosis (brachyury expression) of primary sacral chordoma,of any diameter and arising at any site from S1 to coccyx.
  • Age≥18years
  • -performance status (PS) 0-2
  • No previous antineoplastic therapy
  • Macroscopic tumor detectable at MRI/CT scan
  • Patient amenable for surgery
  • Patient amenable for RT
  • Written given before the enrolment, according to International Conference on Harmonisation/good clinical practice (ICH/GCP).

Exclusion criteria

Exclusion Criteria:

  • Distant
  • Inability to maintain treatment position
  • Prior radiotherapy to the pelvic region
  • Prior therapy for sacral chordoma (including surgery, cryoablation, hyperthermia, etc)
  • Local conditions that increase the risk of RT toxicity (tumor ulcerated skin infiltration, non-healing soft tissue infection, fistula in treatment field)
  • Rectal wall infiltration
  • General conditions that increase the risk of RT toxicity (active sclerodermia, xeroderma pigmentosum, cutaneous porphyria)
  • Presence of a second active cancer (with the exception of non-melanoma skin cancer in-situ cervix neoplasia and other in-situ neoplasia)
  • Severe comorbidities resulting in a prognosis of less than 6 months
  • Inability to give
  • Other within the last 5 years
  • Performance status ≥ 2 ().
  • Significant cardiovascular disease (for example, dyspnea > 2 )
  • Significant systemic diseases grade >3 on the v4.03 scale, that limit patient availability, or according to investigator judgment may contribute significantly to treatment toxicity
  • Women who are pregnant or breast-feeding
  • Psychological, familial, social or geographic circumstances that limit the patient's ability to comply with the protocol or informed consent
Terms in these criteria, in plain language(7)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
100 participants (estimated)

Study arms

  • Experimental
    Randomized Cohort

    Participants who will decided to undergo to randomization, will receive surgical treatment or definitive radiotherapy according with randomization assignment

    Other: Randomized Cohort

  • Active comparator
    Prospective Cohort

    Participants who will not decide to be randomized, will received the surgical or definite radiotherapy treatment according to their choice

    Radiation: Prospective cohort

Interventions

  • OtherRandomized Cohort

    Surgical treatment with different approach, based on the characteristics of the tumor or definitive high dose radiotherapy (carbon ion radiotherapy, proton-therapy, mixed photons-proton therapy) will be assigned by randomization

  • RadiationProspective cohort

    Surgical treatment or definitive high dose radiotherapy will be selected by the patients and will be prospectively evaluated

06

What researchers measure

Primary outcomes

  1. Relapse Free Survival (RFS)

    The time from randomization or treatment start date to the date of local disease relapse, distant disease relapse, second primary malignancy or death from any cause, whichever occurred first.

    Time frame: 5 years

Secondary outcomes

  1. Overall Survival (OS)

    The time from randomization or treatment start date to the date of death from any cause

    Time frame: The patients will be followed in term of Overall Survival, for all the study period (expected average: 10 years)

  2. Survival Post Progression (SPP)

    The time from local disease relapse, distant disease relapse or second primary malignancy, whichever occurred first, to the date of death from any cause

    Time frame: Expected average: 36 months

  3. Local Relapse Failure (LRF)

    The time from randomization or treatment start date to the date of local disease relapse

    Time frame: Expected average: 60 months

  4. Distant Relapse Failure (DRF)

    The time from randomization or treatment start date to the date of distant disease relapse

    Time frame: Expected average: 60 months

  5. Best Response rate to definitive radiotherapy

    Best Response rate to definitive radiotherapy

    Time frame: At 12 months, 2 years and 5 years after radiotherapy

  6. Time to best response rate to definitive radiotherapy

    Time to best response rate to definitive radiotherapy

    Time frame: At 12 months, 2 years and 5 years after radiotherapy

  7. Adverse Events Incidence

    Adverse Events incidence

    Time frame: At end of treatment , 6 months , 12 months 2 years and 5 years after surgery or radiotherapy

  8. Evaluation of quality of life measured with Functional Assessment of Cancer Therapy General

    Evaluation of quality of life measured with Functional Assessment of Cancer Therapy General

    Time frame: every 6 months (expected average: 5 years)

  9. Evaluation of quality of life measured with Brief Inventory Pain questionnaires

    Evaluation of quality of life measured with Brief Inventory Pain questionnaires

    Time frame: every 6 months (expected average: 5 years)

07

Study locations

13 of 28 sites recruiting
  • Medical University of Graz
    Graz, Austria
    Recruiting
    • Andreas Leithner, MD · Contact
    • Andreas Leithner, MD · Principal investigator
  • EBG GmbH MedAustron
    Wiener Neustadt, Österreich 2700, Austria
    Recruiting
  • Medical Faculty Carl Gustav Carus Faculty of Medicine, Department of Radiation Oncology,
    Dresden, Germany
    Not yet recruiting
    • Mechthild Krause, Prof/MD · Contact
    • Mechthild Krause, Prof/MD · Principal investigator
  • University Hospital Carl Gustav Carus Dresden
    Dresden, Germany
    Not yet recruiting
    • Mechthild Krause, MD · Contact
    • Mechthild Krause, MD · Principal investigator
  • University Hospital Essen. West German Proton Therapy Center Essen
    Essen, Germany
    Recruiting
    • Beate Timmermann, MD · Contact
    • Beate Timmermann, MD · Principal investigator
  • Heidelberg Ion-Beam Therapy Center - HIT
    Heidelberg, Germany
    Not yet recruiting
    • Matthias Uhl, MD · Contact
    • Matthias Uhl, MD · Principal investigator
  • National Center for Spinal Disorders
    Budapest, Hungary
    Not yet recruiting
    • Peter P Varga, MD · Contact
    • Peter P Varga, MD · Principal investigator
  • Fondazione IRCCS Istituto Nazionale dei Tumori
    Milan, MI 20133, Italy
    Recruiting
  • Istituto Ortopedico Rizzoli
    Bologna, 40136, Italy
    Recruiting
  • Azienda Ospedaliero-Universitaria Careggi
    Florence, 50134, Italy
    Not yet recruiting
    • Domenico A Campanacci, MD · Contact
    • Domenico A Campanacci, MD · Principal investigator
  • Istituto Clinico Humanitas
    Milan, 20089, Italy
    Recruiting
  • I.R.C.C.S. Istituto Ortopedico Galeazzi
    Milan, 20161, Italy
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Centro Nazionale di Adroterapia Oncologica - CNAO
    Pavia, 27100, Italy
    Recruiting
  • II Clinica Universitaria Ortopedia e Traumatologia AO Pisa
    Pisa, 56124, Italy
    Recruiting
  • Istituto Regina Elena - IFO
    Rome, 00100, Italy
    Recruiting
  • Agenzia Provinciale per la Protonterapia - AtreP
    Trento, 38122, Italy
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Saitama Medical Center
    Saitama, Japan
    Recruiting
    • Toru Akiyama, MD · Contact
    • Toru Akiyama, MD · Principal investigator
  • Netherlands Cancer Institute
    Amsterdam, Netherlands
    Not yet recruiting
    • R LM Haas, MD · Contact
    • R LM Haas, MD · Principal investigator
  • Leiden University Medical Center
    Leiden, Netherlands
    Not yet recruiting
    • Sander Dijkstra, MD · Contact
    • Sander Dijkstra, MD · Principal investigator
  • Norwegian Radium Hospital/Oslo Univeristi Hospital
    Oslo, N-0424, Norway
    Recruiting
    • Øyvind S. Bruland, MD · Contactosb@ous-hf.no · +47 22 93 47
    • Øyvind S. Bruland, MD · Contact
  • Centrum Onkologii-Instytut im. Marii Skłodowskiej-Curie
    Warsaw, Poland
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • H. Val D'Hebron
    Barcelona, Spain
    Recruiting
    • Ramona V. Capdevila, MD · Contact
    • Ramona V. Capdevila, MD · Principal investigator
  • Hosptial San Pau
    Barcelona, Spain
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • H. San Carlos
    Madrid, Spain
    Not yet recruiting
    • Gloria M. Ospina, MD · Contact
    • Gloria M. Ospina · Principal investigator
  • Hospital Universitario Virgen del Rocío
    Seville, Spain
    Recruiting
    • Nadia Hindi, MD · Contact
    • Nadia Hindi, MD · Principal investigator
  • Hospital Universitario Doctor Peset
    Valencia, 46017, Spain
    Not yet recruiting
    • Antonio M. Benlloch, MD · Contactantonio.martin@uv.es
    • Antonio M. Benlloch, MD · Principal investigator
  • The Royal Orthopaedic Hospital
    Birmingham, United Kingdom
    Not yet recruiting
    • Lee Jeys, MD · Contact
    • Lee Jeys, MD · Principal investigator
  • Royal National Orthopaedic Hospital
    London, United Kingdom
    Not yet recruiting
    • Rob Pollock, MD · Contact
    • Rob Pollock, MD · Principal investigator
08

References and documents

Publications

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  • Imai R, Kamada T, Sugahara S, Tsuji H, Tsujii H. Carbon ion radiotherapy for sacral chordoma. Br J Radiol. 2011 Dec;84 Spec No 1(Spec Iss 1):S48-54. doi: 10.1259/bjr/13783281. Epub 2011 Mar 22. PubMed 21427182 ↗
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  • Staab A, Rutz HP, Ares C, Timmermann B, Schneider R, Bolsi A, Albertini F, Lomax A, Goitein G, Hug E. Spot-scanning-based proton therapy for extracranial chordoma. Int J Radiat Oncol Biol Phys. 2011 Nov 15;81(4):e489-96. doi: 10.1016/j.ijrobp.2011.02.018. Epub 2011 Apr 15. PubMed 21497457 ↗
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  • Royston P, Parmar MK. The use of restricted mean survival time to estimate the treatment effect in randomized clinical trials when the proportional hazards assumption is in doubt. Stat Med. 2011 Aug 30;30(19):2409-21. doi: 10.1002/sim.4274. Epub 2011 May 25. PubMed 21611958 ↗
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Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 2, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT02986516
Lead sponsor
Italian Sarcoma Group
Responsible party
Sponsor
First posted
Dec 8, 2016
Start date
Mar 16, 2017
Primary completion
Dec 31, 2026 (estimated)
Completion
Dec 31, 2026 (estimated)
Last update
Jan 2, 2026

Study contacts

Alessandro Gronchi, MD
Contact
alessandro.gronchi@istitutotumori.mi.it
+390223903714
ISG Clinical Trial Center
Contact
clinicaltrials@italiansarcomagroup.org
Alessandro Gronchi, MD
principal investigator · Istituto Nazionale Tumori Milan-Italy
Piero Fossati, MD
principal investigator · MedAustron Graz-Austria

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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