Chordomas: diagnosis and management

Area of Science:

• Oncology
• Neurosurgery
• Radiation Oncology

Background:

• Chordomas are rare bone tumors arising from notochordal remnants.
• They can occur in the axial skeleton, commonly in the sacrum and craniocervical region.
• Treatment strategies often involve a multimodal approach.

Observation:

• Six patients with chordomas (five sacral, one craniocervical) were analyzed.
• Two patients received radiation for macroscopic tumors, experiencing symptom palliation and survival prolongation.
• Two patients with sacral chordomas underwent gross tumor resection followed by radiation due to positive margins.

Findings:

• Radiation therapy alone demonstrated palliative benefits and potential survival extension in chordoma patients.
• Adjuvant radiation after incomplete resection of sacral chordomas led to long-term recurrence-free survival (2.5 and 5 years).

Implications:

• Combined modality treatment (surgery and radiation) shows promise for managing sacral chordomas.
• Further research into optimal sequencing and integration of therapies is warranted.
• These findings contribute to understanding chordoma treatment efficacy.