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Published on: June 20, 2017
Recent advances in understanding and managing chordomas
Carl Youssef1, Salah G Aoun1, Jessica R Moreno1
1Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas, 75390, USA.
Abstract:
Chordomas are rare primary bone tumors arising from embryonic remnants of the notochord. They are slow-growing, locally aggressive, and destructive and typically involve the axial skeleton. Genetic studies have identified several mutations implicated in the pathogenesis of these tumors. Treatment poses a challenge given their insidious progression, degree of local invasion at presentation, and high recurrence rate. They tend to respond poorly to conventional chemotherapy and radiation. This makes radical resection the mainstay of their treatment. Recent advances in targeted chemotherapy and focused particle beam radiation, however, have improved the management and prognosis of these tumors.
Insights
Chordomas are rare, slow-growing bone tumors originating from notochord remnants. Advances in targeted therapies and radiation are improving management for these aggressive, destructive tumors.
Area of Science:
- Oncology
- Orthopedics
- Genetics
Background:
- Chordomas are rare primary bone tumors originating from embryonic notochord remnants.
- These tumors are characterized by slow growth, local aggressiveness, and destructive potential, primarily affecting the axial skeleton.
- Genetic mutations play a role in chordoma pathogenesis, posing treatment challenges due to insidious progression and high recurrence rates.
Purpose of the Study:
- To review the current understanding of chordoma pathogenesis, clinical presentation, and treatment strategies.
- To highlight the challenges in managing chordomas due to their aggressive nature and poor response to conventional therapies.
- To discuss recent advancements in targeted chemotherapy and radiation therapy for improved chordoma management.
Main Methods:
- Literature review of genetic studies, clinical presentations, and treatment outcomes for chordomas.
- Analysis of the efficacy of radical resection as the primary treatment modality.
- Evaluation of recent advances in targeted chemotherapy and focused particle beam radiation.
Main Results:
- Chordomas are locally aggressive tumors with a high propensity for recurrence.
- Conventional chemotherapy and radiation show limited efficacy in treating chordomas.
- Radical surgical resection remains the cornerstone of treatment.
- Emerging targeted therapies and particle beam radiation show promise in improving outcomes.
Conclusions:
- Chordomas present significant management challenges due to their aggressive behavior and resistance to conventional treatments.
- Radical resection is currently the most effective treatment, but recurrence remains a concern.
- Recent advancements in targeted chemotherapy and focused particle beam radiation offer improved therapeutic options and prognosis for chordoma patients.
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