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Table 1 Timeline of the patient’s clinical course

From: Chordoma dedifferentiation after proton beam therapy: a case report and review of the literature

Date Event
16 Jun 2012 Initial presentation with headaches and emesis prompts magnetic resonance imaging that shows a large heterogeneous skull base mass suspicious for chordoma.
2 Jul 2012 Endonasal surgical resection. Surgical pathology confirms chordoma diagnosis.
2 Nov – 29 Nov 2012 Fractionated proton and photon beam therapy: 77.4 Gy total, 59.4 Gy (cobalt gray equivalent) in 33 fractions with protons and 18 Gy in 10 fractions with photons.
18 Jun – 11 Dec 2013 Interval decrease in tumor size visualized at scheduled magnetic resonance imagings.
3 Jan 2015 Visual disturbances prompt magnetic resonance imaging, which shows an enhancing mass in the resection site suspicious for recurrence with dedifferentiation.
21 Jan 2015 Retrosigmoid craniotomy. Surgical pathology shows complete dedifferentiation.
29 Mar 2015 Begins ifosfamide and etoposide alternating every 2 weeks with vincristine, doxorubicin, and cyclophosphamide.
23 Apr 2015 – 25 Mar 2016 Interval decrease in tumor size visualized at scheduled magnetic resonance imagings. Continues ifosfamide and etoposide alternating every 2 weeks with vincristine, doxorubicin, and cyclophosphamide.
26 Apr 2016 Last of 17 cycles of ifosfamide and etoposide alternating with vincristine, doxorubicin, and cyclophosphamide. Begins maintenance capecitabine.