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Sacrococcygeal chordomas: potential role of high LET therapy
N Breteau1, M Demasure, J Lescrainier
1CHR Service D'Oncologie et de Radiothérapy, Orléans, France.
Abstract:
Chordomas are rare malignant neoplasms representing less than 3% of all primary bone tumors. They usually have a benign histological appearance and a slow growth rate. Their locoregional progression nearly always causes suffering and eventually death. Efforts to increase local control have included aggressive surgery, radiation therapy or combined approaches but locally free survival rates remain relatively low and have not exceeded 30% at 5 years. Sacrococcygeal chordomas, which represent approximately 50% of the localizations, have been investigated less frequently than those at the base of the skull or cervical region with primary or post-operative radiation therapy. The disappointing results with photon therapy in a multimodality approach and the good results reported by Schoenthaler with charged particles in the Lawrence Berkeley laboratory led us to propose fast neutron therapy in the management of inoperable or recurrent sacrococcygeal chordomas. Preliminary results obtained from only 12 patients indicate that high linear energy transfer (LET) therapy seems to be a good alternative for radical treatment of chordomas in the case of microscopic or macroscopic residual tumor.
Insights
Fast neutron therapy shows promise for treating sacrococcygeal chordomas, a rare bone cancer. This high linear energy transfer (LET) therapy may offer a better alternative for patients with residual tumors after other treatments.
Area of Science:
- Oncology
- Radiation Oncology
- Skeletal System Neoplasms
Background:
- Chordomas are rare, slow-growing malignant bone tumors comprising <3% of primary bone neoplasms.
- Locoregional progression of chordomas often leads to significant morbidity and mortality.
- Current treatments including surgery and photon therapy yield limited 5-year survival rates (<30%).
Purpose of the Study:
- To evaluate the efficacy of fast neutron therapy for inoperable or recurrent sacrococcygeal chordomas.
- To explore high linear energy transfer (LET) therapy as an alternative treatment modality.
Main Methods:
- Retrospective analysis of 12 patients with sacrococcygeal chordomas treated with fast neutron therapy.
- Focus on patients with microscopic or macroscopic residual tumor post-treatment.
Main Results:
- Preliminary results in 12 patients suggest fast neutron therapy is a viable option.
- High LET therapy demonstrated potential for radical treatment of residual chordomas.
Conclusions:
- Fast neutron therapy may be a beneficial treatment for challenging sacrococcygeal chordoma cases.
- Further research is warranted to confirm the efficacy of high LET radiation in chordoma management.