Radiosurgery for chordomas and chondrosarcomas of the skull base.

Abstract:

OBJECT:Chordomas and chondrosarcomas of the skull base are aggressive and locally destructive tumors with a high tendency for local progression despite treatment. The authors evaluated the effect of stereotactic radiosurgery (SRS) on local tumor control and survival. METHODS:Twenty-eight patients with histologically confirmed chordomas (18) or chondrosarcomas (10) underwent Gamma Knife SRS either as primary or adjuvant treatment. Their ages ranged from 17 to 72 years (median 44 years). The most common presenting symptom was diplopia (26 patients, 93%). In two patients, SRS was the sole treatment. Twenty-six patients underwent between one and five additional surgical procedures. Two underwent an initial transsphenoidal biopsy. The average tumor volume was 9.8 cm3. The median dose to the tumor margin was 16 Gy. RESULTS:No patient was lost to follow-up. Transient symptomatic adverse radiation effects developed in only one patient. The actuarial local tumor control for chondrosarcomas at 5 years was 80 +/- 10.1%. For chordomas both the actuarial tumor control and survival was 62.9 +/- 10.4%. CONCLUSIONS:Stereotactic radiosurgery is an important option for skull base chordomas and chondrosarcomas either as primary or adjunctive treatment. Multimodal management appears crucial to improve tumor control in most patients.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Martin JJ,Niranjan A,Kondziolka D,Flickinger JC,Lozanne KA,Lunsford LD

doi

10.3171/JNS-07/10/0758

subject

Has Abstract

pub_date

2007-10-01 00:00:00

pages

758-64

issue

4

eissn

0022-3085

issn

1933-0693

journal_volume

107

pub_type

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