Stereotactic radiosurgery for intracranial chondrosarcoma.

Area of Science:

• Neurosurgery
• Radiation Oncology
• Oncology

Background:

• Chondrosarcomas of the skull base are rare bone tumors.
• Treatment traditionally involves surgery and/or radiation therapy.
• Outcomes for stereotactic radiosurgery (SRS) in this specific population require further evaluation.

Purpose of the Study:

• To assess the efficacy and safety of stereotactic radiosurgery (SRS) for chondrosarcomas of the skull base.
• To identify factors influencing survival and tumor control after SRS.
• To evaluate the role of SRS as a primary or adjuvant therapy.

Main Methods:

• Retrospective review of 22 patients with cranial base chondrosarcomas treated with SRS between 1987 and 2009.
• Analysis of patient demographics, tumor characteristics, treatment details (including prior resections and radiation), and follow-up data.
• Calculation of actuarial overall survival and tumor control rates.

Main Results:

• Actuarial overall survival rates at 1, 3, 5, and 10 years were 95%, 76%, 70%, and 56%, respectively.
• Tumor control rates at 1, 3, 5, and 10 years were 91%, 72%, 72%, and 54%, respectively.
• Factors associated with longer survival included age >40 years, shorter interval to SRS, and fewer prior resections. Adverse radiation effects were infrequent (10%).

Conclusions:

• Stereotactic radiosurgery (SRS) demonstrates potential benefit for skull base chondrosarcomas, acting as primary or adjuvant therapy.
• Optimizing outcomes involves earlier SRS timing post-diagnosis and multimodal management, including resection followed by SRS for residual disease.
• Patient age and treatment history significantly impact survival and progression-free survival following SRS.