Low dose radiotherapy is associated with local complications but not disease control in sacral chordoma Journal Article
| Authors: | Houdek, M. T.; Rose, P. S.; Hevesi, M.; Schwab, J. H.; Griffin, A. M.; Healey, J. H.; Petersen, I. A.; DeLaney, T. F.; Chung, P. W.; Yaszemski, M. J.; Wunder, J. S.; Hornicek, F. J.; Boland, P. J.; Sim, F. H.; Ferguson, P. C.; Other Members of the Sacral Tumor Society |
| Contributors: | Katsoulakis, E.; Yamada, Y. J. |
| Article Title: | Low dose radiotherapy is associated with local complications but not disease control in sacral chordoma |
| Abstract: | Background: We reviewed the disease control and complications of the treatment of sacrococcygeal chordoma from four tertiary cancer centers with emphasis on the effects of radiotherapy in surgically treated patients. Methods: A total of 193 patients with primary sacrococcygeal chordoma from 1990 to 2015 were reviewed. There were 124 males, with a mean age of 59 ± 15 years and a mean follow-up of 7 ± 4 years. Eighty-nine patients received radiotherapy with a mean total dose of 61.8 ± 10.9 Gy. Results: The 10-year disease-free and disease-specific survival was 58% and 72%, respectively. Radiation was not associated with local recurrence (hazard ratio [HR], 1.13; 95% confidence interval [CI], 0.59-2.17; P = 0.71), metastases (HR, 0.93; 95% CI, 0.45-1.91; P = 0.85) or disease-specific survival (HR, 0.96; 95% CI, 0.46-2.00; P = 0.91). Higher doses (≥70 Gy; HR, 0.52; 95% CI, 0.20-1.32; P = 0.17) may be associated with reduced local recurrence. Radiotherapy was associated with wound complications (HR, 2.76; 95% CI, 1.64-4.82;, P < 0.001) and sacral stress fractures (HR, 4.73; 95% CI, 1.88-14.38; P < 0.001). Conclusions: In this multicenter review, radiotherapy was not associated with tumor outcome but associated with complications. The routine use of radiotherapy with en-bloc resection of sacrococcygeal chordomas should be reconsidered in favor of a selective, individualized approach with a radiation dose of ≥70 Gy. © 2019 Wiley Periodicals, Inc. |
| Keywords: | treatment outcome; middle aged; retrospective studies; clinical trial; radiotherapy; pathology; retrospective study; radiation response; dose-response relationship, radiation; multicenter study; spinal neoplasms; outcome; surgical resection; chordoma; sacrum; spine tumor; humans; human; male; female |
| Journal Title: | Journal of Surgical Oncology |
| Volume: | 119 |
| Issue: | 7 |
| ISSN: | 0022-4790 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2019-06-01 |
| Start Page: | 856 |
| End Page: | 863 |
| Language: | English |
| DOI: | 10.1002/jso.25399 |
| PUBMED: | 30734292 |
| PROVIDER: | scopus |
| PMCID: | PMC6746225 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 June 2019 -- Source: Scopus |
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479Yamada -
551Healey -
28Katsoulakis
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