Stereotactic Radiosurgery for Chordoma: A Report From the North American Gamma Knife Consortium

摘要

Although considered slow-growing, low-grade malignancies, chordomas are locally aggressive and destructive tumors with high recurrence rates. They arise in the sacrococcygeal region (50%-60%), the skull base (25%-35%), and the vertebrae (15%).1 The overall incidence is approximately 1 per 1 000 000. Traditionally, surgical resection is the most common initial management for these tumors. Recent advances in neuroimaging techniques play an important role in improving the prognosis of chordoma.2"5 Complete resection without significant morbidity is rarely feasible because these tumors tend to encase critical vessels and cranial nerves or to adhere to the brainstem. " Recurrent tumors are even more challenging for extirpation. Most patients undergo adjuvant fractionated radiation therapy (RT) to reduce the risk of tumor recurrence.