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Updated: Jun 6, 2026
Stereotactic Radiosurgery for Gynecologic Cancer
Published on: April 17, 2012
Stereotactic radiosurgery for chordoma: a report from the North American Gamma Knife Consortium
Hideyuki Kano1, Fawaad O Iqbal, Jason Sheehan
1Department of Neurological Surgery, and Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Background:
Although considered slow-growing, low-grade malignancies, chordomas are locally aggressive and destructive tumors with high recurrence rates.
Objective:
To assess patient survival, tumor control, complications, and selected variables that predict outcome in patients who underwent Gamma Knife stereotactic radiosurgery (SRS) as primary, adjuvant, or salvage management for chordomas of the skull base.
Methods:
Six participating centers of the North American Gamma Knife Consortium identified 71 patients who underwent SRS for chordoma. The median patient age was 45 years (range, 7-80 years). The median SRS target volume was 7.1 cm³ (range, 0.9-109 cm³), and median margin dose was 15.0 Gy (range, 9-25 Gy).
Results:
At a median follow-up of 5 years (range, 0.6-14 years) after SRS, 23 patients died of tumor progression. The 5-year actuarial overall survival after SRS was 80% for the entire group, 93% for the no prior fractionated radiation therapy (RT) group (n = 50), and 43% for the prior RT group (n = 21). Younger age, longer interval between initial diagnosis and SRS, no prior RT, < 2 cranial nerve deficits, and smaller total tumor volume were significantly associated with longer patient survival. The 5-year treated tumor control rate after SRS was 66% for the entire group, 69% for the no prior RT group, and 62% for the prior RT group. Older age, recurrent group, prior RT, and larger tumor volume were significantly associated with worse tumor control.
Conclusion:
Stereotactic radiosurgery is a potent treatment option for small sized chordomas, especially in younger patients and as part of a multipronged attack that includes surgical resection when possible.
Insights
Stereotactic radiosurgery (SRS) offers potent treatment for skull base chordomas, especially smaller tumors in younger patients. Outcomes improve with no prior radiation therapy, indicating SRS
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Chordomas are locally aggressive, destructive skull base tumors with high recurrence rates despite slow growth.
- Effective management strategies are crucial for improving patient survival and tumor control.
Purpose of the Study:
- To evaluate patient survival, tumor control, complications, and predictive factors following Gamma Knife stereotactic radiosurgery (SRS) for skull base chordomas.
- To assess SRS as primary, adjuvant, or salvage therapy in a multi-institutional cohort.
Main Methods:
- A retrospective analysis of 71 patients with skull base chordomas treated with SRS across six North American Gamma Knife Consortium centers.
- Data collected included patient demographics, tumor characteristics, SRS parameters (volume, dose), and treatment history.
- Follow-up data were analyzed for survival, tumor control, and complications.
Main Results:
- The 5-year overall survival rate was 80%, significantly higher in patients without prior radiation therapy (93%) compared to those with prior RT (43%).
- Factors associated with longer survival included younger age, longer interval to SRS, no prior RT, fewer cranial nerve deficits, and smaller tumor volume.
- The 5-year tumor control rate was 66% overall, with slightly better control in the no prior RT group (69%) versus the prior RT group (62%).
Conclusions:
- Stereotactic radiosurgery (SRS) is an effective treatment for skull base chordomas, particularly for smaller tumors and in younger patients.
- Optimal outcomes are achieved when SRS is part of a multimodal approach, potentially including surgery, and especially in patients without prior radiation therapy.
