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Endoscopic endonasal resection and radiotherapy as treatment for skull base chordomas.

Abstract：

BACKGROUND:The role of endonasal endoscopic surgery and radiotherapy in the treatment of skull base chordomas remains unclear. OBJECTIVE:We investigated the effect of endonasal endoscopic surgery and radiotherapy as treatment for skull base chordomas. METHOD:We investigated 46 patients (2006-2018) treated at the Affiliated Eye Ear Nose and Throat Hospital, Fudan University. We documented demographics, clinical presentation, operative resection, complications, postoperative radiotherapy, follow-up time, and survival in all patients. RESULT:Complete tumour resection was performed in 18 (39.1%), subtotal tumour resection in 16 (34.8%), and partial tumour resection in 12 (26.1%) patients. Most common clinical manifestations included nasal obstruction (41%), headaches (30%), and visual impairment (20%). The median duration of progression-free survival (PFS) and overall survival (OS) was 21.5 and 33.5 months, respectively. Primary vs. recurrent disease (p = .043), partial resection (PR) vs. subtotal resection (STR) (p = .006), STR vs. gross total resection (GTR) (p = .020), GTR vs. PR (p = .001), and complicated vs. uncomplicated status (p = .002) were significantly associated with PFS. Primary vs. recurrent disease (p = .002), PR vs. STR (p = .001), GTR vs. PR (p = .001), surgery alone vs. surgery concomitant with radiotherapy (p = .048), and complicated vs. uncomplicated status (p = .017) were significantly associated with OS. CONCLUSION:Surgery is the primary treatment for chordoma; higher tumour resection rates are associated with higher OS and PFS. Surgeons should aim to resect as much tumour as is safely possible. Postoperative radiotherapy is useful adjuvant treatment to improve OS, and IMRT serves as an effective alternative to PBRT.The optimal radiotherapeutic technique is determined by cost, accessibility, availability of the modality, and tumour volume.

journal_name

Acta Otolaryngol

journal_title

Acta oto-laryngologica

authors

Li H,Zhang H,Hu L,Wang H,Wang D

doi

10.1080/00016489.2020.1748225

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

789-794

issue

eissn

0001-6489

issn

1651-2251

journal_volume

140

pub_type

杂志文章

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Endoscopic endonasal resection and radiotherapy as treatment for skull base chordomas.