Sacral chordomas: Impact of high-dose proton/photon-beam radiation therapy combined with or without surgery for primary versus recurrent tumor.

Abstract

PURPOSE:

To assess the efficacy of definitive treatment of sacral chordoma by high-dose proton/photon-beam radiation therapy alone or combined with surgery.

METHODS AND MATERIALS:

The records of 16 primary and 11 recurrent sacral chordoma patients treated from November 1982 to November 2002 by proton/photon radiation therapy alone (6 patients) or combined with surgery (21 patients) have been analyzed for local control, survival, and treatment-related morbidity. The outcome analysis is based on follow-up information as of 2005.

RESULTS:

Outcome results show a large difference in local failure rate between patients treated for primary and recurrent chordomas. Local control results by surgery and radiation were 12/14 vs. 1/7 for primary and recurrent lesions. For margin-positive patients, local control results were 10 of 11 and 0 of 5 in the primary and recurrent groups, respectively; the mean follow-up on these locally controlled patients was 8.8 years (4 at 10.3, 12.8, 17, and 21 years). Radiation alone was used in 6 patients, 4 of whom received > or =73.0 Gy (E); local control was observed in 3 of these 4 patients for 2.9, 4.9, and 7.6 years.

CONCLUSION:

These data indicate a high local control rate for surgical and radiation treatment of primary (12 of 14) as distinct from recurrent (1 of 7) sacral chordomas. Three of 4 chordomas treated by > or =73.0 Gy (E) of radiation alone had local control; 1 is at 91 months. This indicates that high-dose proton/photon therapy offers an effective treatment option.

• Authors: Lily Park, Thomas F Delaney, Norbert J Liebsch, Francis J Hornicek, Saveli Goldberg, Henry Mankin, Andrew E Rosenberg, Daniel I Rosenthal, Herman D Suit
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 65 Issue 5 Pg. 1514-21 (Aug 01 2006) ISSN: 0360-3016 [Print] United States
• PMID: 16757128 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Protons

Topics

• Adult
• Aged
• Aged, 80 and over
• Bone Neoplasms (mortality, radiotherapy, surgery)
• Chordoma (mortality, radiotherapy, surgery)
• Combined Modality Therapy
• Female
• Humans
• Male
• Middle Aged
• Neoplasm Recurrence, Local (mortality, radiotherapy, surgery)
• Photons (therapeutic use)
• Proton Therapy
• Sacrum
• Survival Analysis
• Treatment Outcome