Radiotherapy for mobile spine and sacral chordoma: A critical review and practical guide from the Spine Tumor Academy Review
| Authors: | Redmond, K. J.; Schaub, S. K.; Lo, S. F. L.; Khan, M.; Lubelski, D.; Bilsky, M.; Yamada, Y.; Fehlings, M.; Gogineni, E.; Vajkoczy, P.; Ringel, F.; Meyer, B.; Amin, A. G.; Combs, S. E.; Lo, S. S. |
| Review Title: | Radiotherapy for mobile spine and sacral chordoma: A critical review and practical guide from the Spine Tumor Academy |
| Abstract: | Chordomas are rare tumors of the embryologic spinal cord remnant. They are locally aggressive and typically managed with surgery and either adjuvant or neoadjuvant radiation therapy. However, there is great variability in practice patterns including radiation type and fractionation regimen, and limited high-level data to drive decision making. The purpose of this manuscript was to summarize the current literature specific to radiotherapy in the management of spine and sacral chordoma and to provide practice recommendations on behalf of the Spine Tumor Academy. A systematic review of the literature was performed using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) approach. Medline and Embase databases were utilized. The primary outcome measure was the rate of local control. A detailed review and interpretation of eligible studies is provided in the manuscript tables and text. Recommendations were defined as follows: (1) consensus: approved by >75% of experts; (2) predominant: approved by >50% of experts; (3) controversial: not approved by a majority of experts. Expert consensus supports dose escalation as critical in optimizing local control following radiation therapy for chordoma. In addition, comprehensive target volumes including sites of potential microscopic involvement improve local control compared with focal targets. Level I and high-quality multi-institutional data comparing treatment modalities, sequencing of radiation and surgery, and dose/fractionation schedules are needed to optimize patient outcomes in this locally aggressive malignancy. © 2023 by the authors. |
| Keywords: | treatment outcome; overall survival; review; cancer recurrence; intensity modulated radiation therapy; postoperative period; follow up; distant metastasis; preoperative period; systematic review; radiation dose fractionation; decompression surgery; radiation therapy; stereotactic body radiation therapy; chordoma; sacral chordoma; proton therapy; ion therapy; heavy ion therapy; human; carbon ion therapy; local progression free survival; spine and sacral chordoma; mobile spine chordoma |
| Journal Title: | Cancers |
| Volume: | 15 |
| Issue: | 8 |
| ISSN: | 2072-6694 |
| Publisher: | MDPI |
| Date Published: | 2023-04-02 |
| Start Page: | 2359 |
| Language: | English |
| DOI: | 10.3390/cancers15082359 |
| PROVIDER: | scopus |
| PMCID: | PMC10136664 |
| PUBMED: | 37190287 |
| DOI/URL: | |
| Notes: | Review -- Export Date: 1 June 2023 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work