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This study evaluated the efficacy and safety of carbon‐ion radiotherapy (CIRT) for unresectable C1‐2 chordoma. Nineteen eligible patients all completed the planned course of CIRT. Regarding acute toxicity of grade ≥3, there was only one grade 3 mucositis. Late toxicity included radiation‐induced myelitis (grade 3 in 1 patient; 5.3%) and compression fractures (n = 5; 26.3%). High‐dose CIRT is a promising treatment option for unresectable upper cervical chordoma.
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