Summary
Background. The purpose of this study is to clarify the latest long-term therapeutic result for cranial base chordomas. We are seeking an improvement of long term therapeutic outcome through a review of cranial base chordomas treated in our institute and of the published literature in the era of multimodality therapy.
Materials and methods. We retrospectively reviewed 13 consecutive patients with cranial base chordoma, including ten males and three females with mean age of 39.5 years (range 5–76 years).
Results. The method of initial treatment included surgery and post-operative conventional local irradiation (IR) in 9 patients, surgery and IR followed by post-operative stereotactic radiosurgery (SRS) in 2 patients, surgery as well as SRS in one patients, and surgery as well as SRS followed by IR in one patient. Subtotal removal (over 95%) was accomplished in eight patients. The mean follow-up period after completion of surgery and initial radiotherapy was 122 months (median 108 months). According to the Kaplan-Meier estimate method, the 5-year survival rate was 82.5%: 11 out of 13 patients survived longer than 5 years and five patients survived longer than 10 years. With a longer follow-up period than the previous reports, our series has provided a 5-year survival rate comparable to that of proton beam therapy. Although our series indicates a favourable outcome, surgical resection followed by IR or SRS failed to control tumour growth in five patients.
Conclusions. IR and/or SRS provided results comparable with proton beam or heavy particle therapy in our series of cranial base chordomas probably because the radiation field must have covered the target of the tumour volume sufficiently, and reduction of gross tumour volume reduced the target size for radiotherapy. Pursuit of further effective combinations of IR and stereotactic radiotherapy (SRS, proton beam, heavy particle) after tangible resection, especially for residual and recurrent lesions, will be an acceptable framework to achieve a better therapeutic outcome for cranial base chordomas than at present.
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References
O Al-Mefty LA Borba (1997) ArticleTitleSkull base chordomas: a management challenge J Neurosurg 86 182–189 Occurrence Handle9010416 Occurrence Handle1:STN:280:DyaK2s7mtlKjuw%3D%3D Occurrence Handle10.3171/jns.1997.86.2.0182
JR Castro DE Linstadt JP Bahary PL Petti I Daftari JM Collier PH Gutin G Gauger TL Phillips (1994) ArticleTitleExperience in charged particle irradiation of tumours of the skull base: 1977–1992 Int J Radiat Oncol Biol Phys 29 647–655 Occurrence Handle8040010 Occurrence Handle1:STN:280:DyaK2czhsVGrsg%3D%3D
E Gay LN Sekhar E Rubinstein DC Wright C Sen IP Janecka CH Snyderman (1995) ArticleTitleChordomas and chondrosarcomas of the cranial base: results and follow-up of 60 patients Neurosurgery 36 887–896 Occurrence Handle7791978 Occurrence Handle10.1097/00006123-199505000-00001 Occurrence Handle1:STN:280:DyaK2Mzht1Wqsw%3D%3D
EB Hug LN Loredo JD Slater A DeVries RI Grove RA Schaefer AE Rosenberg JM Slater (1999) ArticleTitleProton radiation therapy for chordomas and chondrosarcomas of the skull base J Neurosurg 91 432–439 Occurrence Handle10470818 Occurrence Handle1:STN:280:DyaK1MzpslCiuw%3D%3D
H Igaki K Tokuuye T Okumura S Sugahara K Kagei M Hata K Ohara T Hashimoto K Tsuboi S Takano A Matsumura Y Akine (2004) ArticleTitleClinical results of proton beam therapy for skull base chordoma Int J Radiat Oncol Biol Phys 60 1120–1126 Occurrence Handle15519783
S Krishnan RL Foote PD Brown BE Pollock MJ Link YI Garces (2005) ArticleTitleRadiosurgery for cranial base chordomas and chondrosarcomas Neurosurgery 56 777–784 Occurrence Handle15792516 Occurrence Handle10.1227/01.NEU.0000156789.10394.F5
G Maira R Pallini C Anile E Fernandez F Salvinelli LM La Rocca GF Rossi (1996) ArticleTitleSurgical treatment of clival chordomas: the transsphenoidal approach revisited J Neurosurg 85 784–792 Occurrence Handle8893715 Occurrence Handle1:STN:280:DyaK2s%2FkvV2rtw%3D%3D
WM Mendenhall CM Mendenhall SB Lewis DB Villaret NP Mendenhall (2005) ArticleTitleSkull base chordoma Head Neck 27 159–165 Occurrence Handle15641104 Occurrence Handle10.1002/hed.20144
G Noel L Feuvret F Dhermain H Mammar C Haie-Meder D Ponvert D Hasboun R Ferrand C Nauraye G Boisserie A Beaudre G Gaboriaud A Mazal E Touboul JL Habrand JJ Mazeron (2005) ArticleTitleChordomas of the base of the skull and upper cervical spine. 100 patients irradiated by a 3D conformal technique combining photon and proton beams Cancer Radiother 9 161–174 Occurrence Handle15979920 Occurrence Handle1:STN:280:DC%2BD2MzmsF2ktw%3D%3D
G Noel JL Habrand E Jauffret R de Crevoisier S Dederke H Mammar C Haie-Meder D Pontvert D Hasboun R Ferrand G Boisserie A Beaudre G Gaboriaud F Guedea L Petriz JJ Mazeron (2003) ArticleTitleRadiation therapy for chordoma and chondrosarcoma of the skull base and the cervical spine. Prognostic factors and patterns of failure Strahlenther Onkol 179 241–248 Occurrence Handle12707713 Occurrence Handle10.1007/s00066-003-1065-5
C Raffel DC Wright PH Gutin CB Wilson (1985) ArticleTitleCranial chordomas: clinical presentation and results of operative and radiation therapy in twenty-six patients Neurosurgery 17 703–710 Occurrence Handle4069325 Occurrence Handle10.1097/00006123-198511000-00002 Occurrence Handle1:STN:280:DyaL28%2FmsFOntQ%3D%3D
D Schulz-Ertner A Nikoghosyan B Didinger J Debus (2004) ArticleTitleCarbon ion radiation therapy for chordomas and low grade chondrosarcomas – current status of the clinical trials at GSI Radiother Oncol 73 IssueIDSuppl 2 S53–S56 Occurrence Handle15971310 Occurrence Handle10.1016/S0167-8140(04)80014-8
A Terahara A Niemierko M Goitein D Finkelstein E Hug N Liebsch D O’Farrell S Lyons J Munzenrider (1999) ArticleTitleAnalysis of the relationship between tumour dose inhomogeneity and local control in patients with skull base chordoma Int J Radiat Oncol Biol Phys 45 351–358 Occurrence Handle10487555 Occurrence Handle1:STN:280:DyaK1MvhsFCqtA%3D%3D
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Correspondence: Yuichiro Yoneoka, MD., PhD., Department of Neurosurgery, Brain Research Institute, University of Niigata, 1-757 Asahimachi-dori Chuo-ku Niigata 951-8585 Japan.
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Yoneoka, Y., Tsumanuma, I., Fukuda, M. et al. Cranial base chordoma – long term outcome and review of the literature. Acta Neurochir (Wien) 150, 773–778 (2008). https://doi.org/10.1007/s00701-008-1600-3
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DOI: https://doi.org/10.1007/s00701-008-1600-3