Gamma knife stereotactic radiosurgery for recurrent intracranial chordomaTakahiko Tsugawa1, Yoshimasa Mori2, TATSUYA KOBAYASHI3, CHISA HASHIDUME31Nagoya, Japan 2Aichi, Japan 3Nagoya Radiosurgery Center, Nagoya Kyoritsu Hospital, Nagoya, Japan Keywords: gamma knife, chordoma, radiosurgery, outcome, skull baseInteractive Manuscript
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What is the background behind your study?
Intracranial chordoma is a rare neoplasm that composes under1% of all primary brain tumor. This tumor is thought to arise from the primitive notochord remnants of the axial skeleton. Although slow growing and histologically benign, chordomas are locally aggressive and destructive tumors with high recurrence rates. Surgical resection is the primary treatment standard, but complete resection is difficult due to their invasive nature and critical location.
What is the purpose of your study?
In this study we evaluated the efficacy and the role of gamma knife stereotactic radiosurgery (GKRS) for control of the recurrent intracranial chordomas.
Describe your patient group.
The mean age of these patients at first GKRS was 60.1 (range 45-72) years.
Describe what you did.
Between April 2004 and July 2010, we treated 8 patients with 19tumors of recurrent intracranial chordoma by GKRS. All patients underwent surgical resection before GKRS and had histological confirmation of the diagnosis. Four of these patients received repetitive GKRS and one patient was treated with fractionated external beam radiotherapy before GKRS. The mean volume of the tumors was 5.7 ml (range 0.6-13.4 ml) and the mean prescription dose to tumor margin was 16.2 Gy (range 9-20 Gy).
Describe your main findings.
The median follow-up time was 49 months (range 19-91 months). Of 19 treated tumors which were followed up more than 12 months, 14 were decreased in size, 4 were remained unchanged, and one was progressed. The progression free survival rate were 100, 67 and 50% at 12, 24 and 36months after initial GKRS.
Describe the main limitation of this study.
This was a retrospective study.
Describe your main conclusion.
GKRS is a reasonable management option for patient with recurrent intracranial chordoma.
Describe the importance of your findings and how they can be used by others.
This question was not answered by the author
Intracranial chordoma is a rare neoplasm that composes under1% of all primary brain tumor. This tumor is thought to arise from the primitive notochord remnants of the axial skeleton. Although slow growing and histologically benign, chordomas are locally aggressive and destructive tumors with high recurrence rates. Surgical resection is the primary treatment standard, but complete resection is difficult due to their invasive nature and critical location.
In this study we evaluated the efficacy and the role of gamma knife stereotactic radiosurgery (GKRS) for control of the recurrent intracranial chordomas.
The mean age of these patients at first GKRS was 60.1 (range 45-72) years.
Between April 2004 and July 2010, we treated 8 patients with 19tumors of recurrent intracranial chordoma by GKRS. All patients underwent surgical resection before GKRS and had histological confirmation of the diagnosis. Four of these patients received repetitive GKRS and one patient was treated with fractionated external beam radiotherapy before GKRS. The mean volume of the tumors was 5.7 ml (range 0.6-13.4 ml) and the mean prescription dose to tumor margin was 16.2 Gy (range 9-20 Gy).
The median follow-up time was 49 months (range 19-91 months). Of 19 treated tumors which were followed up more than 12 months, 14 were decreased in size, 4 were remained unchanged, and one was progressed. The progression free survival rate were 100, 67 and 50% at 12, 24 and 36months after initial GKRS.
This was a retrospective study.
GKRS is a reasonable management option for patient with recurrent intracranial chordoma.
Project Roles:
T. Tsugawa (), Y. Mori (), T. KOBAYASHI (), C. HASHIDUME ()
