Management of Chordoma and Chondrosarcoma with Fractionated Stereotactic Radiotherapy
ObjectiveTo evaluate the efficacy and toxicity of fractionated stereotactic radiotherapy (FSRT) for chordoma and chondrosarcoma.MethodsTwenty consecutive patients with a histopathologic diagnosis of chordoma (n = 16) or chondrosarcoma (n = 4) treated between 2010 and 2016 were retrospectively identi...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2017-06-01
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| Series: | Frontiers in Surgery |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fsurg.2017.00035/full |
| _version_ | 1817990139169734656 |
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| author | Harish N. Vasudevan Harish N. Vasudevan David R. Raleigh Julian Johnson Adam A. Garsa Philip V. Theodosopoulos Manish K. Aghi Christopher Ames Michael W. McDermott Igor J. Barani Steve E. Braunstein |
| author_facet | Harish N. Vasudevan Harish N. Vasudevan David R. Raleigh Julian Johnson Adam A. Garsa Philip V. Theodosopoulos Manish K. Aghi Christopher Ames Michael W. McDermott Igor J. Barani Steve E. Braunstein |
| author_sort | Harish N. Vasudevan |
| collection | DOAJ |
| description | ObjectiveTo evaluate the efficacy and toxicity of fractionated stereotactic radiotherapy (FSRT) for chordoma and chondrosarcoma.MethodsTwenty consecutive patients with a histopathologic diagnosis of chordoma (n = 16) or chondrosarcoma (n = 4) treated between 2010 and 2016 were retrospectively identified. All patients underwent FSRT in five fractions to a median dose of 37.5 Gy (range: 25–40 Gy) and followed with serial magnetic resonance imaging. Overall survival (OS), local recurrence-free survival (LRFS), and event-free survival (EFS) were estimated using the Kaplan–Meier method.ResultsWith a median follow-up of 28 months after FSRT and 40 months after initial surgery, crude OS and LRFS were 90%. Nine patients (45%) reported grade 1–3 acute toxicity, and two patients (10%) experienced grade 4, 5 late toxicity. One patient previously treated with proton therapy died from radiation vasculopathy 9 months after FSRT. The use of FSRT for recurrent disease or in patients with prior radiation therapy was associated with significantly decreased EFS.ConclusionFSRT for chordoma and chondrosarcoma is associated with high rates of OS and local control. Although many patients experience acute toxicity, there is a low incidence of late toxicity or irreversible treatment related morbidity despite the frequency of prior radiotherapy in this population. FSRT is an effective adjuvant or salvage treatment for chordoma and chondrosarcoma. |
| first_indexed | 2024-04-14T00:55:48Z |
| format | Article |
| id | doaj.art-d5a8099fdc4a4a42be98b6e447bebc19 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-14T00:55:48Z |
| publishDate | 2017-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-d5a8099fdc4a4a42be98b6e447bebc192022-12-22T02:21:38ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2017-06-01410.3389/fsurg.2017.00035268355Management of Chordoma and Chondrosarcoma with Fractionated Stereotactic RadiotherapyHarish N. Vasudevan0Harish N. Vasudevan1David R. Raleigh2Julian Johnson3Adam A. Garsa4Philip V. Theodosopoulos5Manish K. Aghi6Christopher Ames7Michael W. McDermott8Igor J. Barani9Steve E. Braunstein10Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, United StatesDepartment of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United StatesDepartment of Radiation Oncology, University of California San Francisco, San Francisco, CA, United StatesDepartment of Radiation Oncology, University of California San Francisco, San Francisco, CA, United StatesDepartment of Radiation Oncology, University of California San Francisco, San Francisco, CA, United StatesDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, United StatesDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, United StatesDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, United StatesDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, United StatesDepartment of Radiation Oncology, University of California San Francisco, San Francisco, CA, United StatesDepartment of Radiation Oncology, University of California San Francisco, San Francisco, CA, United StatesObjectiveTo evaluate the efficacy and toxicity of fractionated stereotactic radiotherapy (FSRT) for chordoma and chondrosarcoma.MethodsTwenty consecutive patients with a histopathologic diagnosis of chordoma (n = 16) or chondrosarcoma (n = 4) treated between 2010 and 2016 were retrospectively identified. All patients underwent FSRT in five fractions to a median dose of 37.5 Gy (range: 25–40 Gy) and followed with serial magnetic resonance imaging. Overall survival (OS), local recurrence-free survival (LRFS), and event-free survival (EFS) were estimated using the Kaplan–Meier method.ResultsWith a median follow-up of 28 months after FSRT and 40 months after initial surgery, crude OS and LRFS were 90%. Nine patients (45%) reported grade 1–3 acute toxicity, and two patients (10%) experienced grade 4, 5 late toxicity. One patient previously treated with proton therapy died from radiation vasculopathy 9 months after FSRT. The use of FSRT for recurrent disease or in patients with prior radiation therapy was associated with significantly decreased EFS.ConclusionFSRT for chordoma and chondrosarcoma is associated with high rates of OS and local control. Although many patients experience acute toxicity, there is a low incidence of late toxicity or irreversible treatment related morbidity despite the frequency of prior radiotherapy in this population. FSRT is an effective adjuvant or salvage treatment for chordoma and chondrosarcoma.http://journal.frontiersin.org/article/10.3389/fsurg.2017.00035/fullchordomachondrosarcomafractionated stereotactic radiotherapyCyberKnifestereotactic body radiotherapy |
| spellingShingle | Harish N. Vasudevan Harish N. Vasudevan David R. Raleigh Julian Johnson Adam A. Garsa Philip V. Theodosopoulos Manish K. Aghi Christopher Ames Michael W. McDermott Igor J. Barani Steve E. Braunstein Management of Chordoma and Chondrosarcoma with Fractionated Stereotactic Radiotherapy Frontiers in Surgery chordoma chondrosarcoma fractionated stereotactic radiotherapy CyberKnife stereotactic body radiotherapy |
| title | Management of Chordoma and Chondrosarcoma with Fractionated Stereotactic Radiotherapy |
| title_full | Management of Chordoma and Chondrosarcoma with Fractionated Stereotactic Radiotherapy |
| title_fullStr | Management of Chordoma and Chondrosarcoma with Fractionated Stereotactic Radiotherapy |
| title_full_unstemmed | Management of Chordoma and Chondrosarcoma with Fractionated Stereotactic Radiotherapy |
| title_short | Management of Chordoma and Chondrosarcoma with Fractionated Stereotactic Radiotherapy |
| title_sort | management of chordoma and chondrosarcoma with fractionated stereotactic radiotherapy |
| topic | chordoma chondrosarcoma fractionated stereotactic radiotherapy CyberKnife stereotactic body radiotherapy |
| url | http://journal.frontiersin.org/article/10.3389/fsurg.2017.00035/full |
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