Radiation recall dermatitis (RRD) is an acute inflammatory reaction that is localized to an area of skin previously exposed to radiation and is known to be triggered by various systemic drugs. It can be observed weeks to years after the cessation of radiotherapy, and the time interval between administration of the reaction‐triggering drug to the onset of lesions varies from minutes to days.

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AIM: To discuss the optimal and recent treatment options based on clinical review of 16 chordoma patients. MATERIAL and METHODS: Data of the patients diagnosed and treated between 1999 and 2017 in Gazi University School of Medicine has been collected through patients' files and the electronic database of hospital records. Statistical analysis was applied to evaluate the correlation between the progression free survival and treatment modalities. RESULTS: Nine of the 16 patients were women (56.3%). Half of the patients had intracranially located tumors, whereas the other 50% of the sample had spinal (n=5) and sacral (n=3) chordomas. The median follow-up time was 51.7 months. Recurrence was observed in 50% of patients, while the median recurrence time equaled to 27.6 months. Multivariate analysis results showed that age, gender tumor size, intra or extracranial location of tumor, treatment modalities, subtotal or grosstotal resection of tumor, radiotherapy dose, and techniques were not associated with recurrence. On the other hand, 2 patients are still under chemoterapy (imatinib, bevacizumab) without evident of recurrent disease. CONCLUSION: Despite the fact that surgery remains to be the cornerstone of treatment, total resection is not reasonable for all patients with chordomas. For this reason, adjuvant treatment for ensuring local control is highly important. If the residual tumor is of a small volume, SBRT may provide more advantages. Targeted treatment or chemotheapeutic agents may also be benificial for maintanence therapy. As the clinical awareness about chordomas is based on our series, aggressive multi-modality treatment options should be applied in the adjuvant therapy.

12, 24, and 60 months post RT. Parameters analyzed included perfusion defects, wall thickening (WT), wall motion abnormalities (WM) and dyssynchronous contractions (DS). Analyses were done using spearman R correlation analysis, Mann-Whitney U test and Dunnett's multiple comparisons test. Results: There were no significant differences seen in baseline characteristics (age, pathology, hormone status, technique, use of adjuvant chemo, or cardiac risk factors) between left-sided (n Z 102) and rightsided (n Z 79) RT patients. As expected, those receiving RT to left side had significantly greater mean cardiac dose (4.3 vs. 0.9Gy; p<0.001) and Dmax (45.4 vs. 6.3Gy; p<0.001). Radiation to the left breast did not significantly alter end diastolic volume, end systolic volume or ejection fraction at any timepoint. There was a significant increase in total perfusion defects seen post RT compared to baseline in left sided patients (4.1% vs. 2.8% p Z 0.042) which was not seen in right sided patients. The perfusion defect returned to baseline by 1-year post RT, and remains normal at 2-and 5-years post RT. The global scoring of myocardial perfusion as measured by summed rest score (SRS) also showed a significant increase by 1.35 pts (4.1 vs. 2.8; p Z 0.006) post RT for left sided patients. These changes were significantly correlated with max cardiac dose (p Z 0.03). No localized perfusion defect, DS, WT, WM changes were seen. No adverse cardiac outcomes were reported. Conclusion: Patients receiving left breast RT did not show differ in standard measures of cardiac function such as ESV, EDV, and EF at any timepoint. There were mild perfusion defects seen post-RT, evidenced by worsened global non-gated SRS and total perfusion defect post RT in left sided patients. Worsened non-gated SRS was correlated with mean cardiac dose. Perfusion deficits normalized by 1-year post RT, and remained unchanged out to 5 years, suggesting a potential for cardiac remodeling post-RT.