| Abstract: |
As a radioresistant lesion, chordoma has historically been considered a tumor that is not amenable to radiation therapy. However, beginning in the 1980s, evidence began to develop demonstrating that doses >70Gy could improve local control. Since that time, more advanced technologies have been developed that enable the delivery of therapeutic radiation doses while minimizing toxicities to adjacent tissues, such as the spinal cord and bowel. Evidence from series using these new focused modalities now suggests that radiation therapy in the adjuvant setting may improve local tumor control independent of surgical margin – the classic determinant of local progression-free survival. Evidence is also building that supports the use of focused photon radiation modalities in the neoadjuvant, definitive-intent, and salvage therapy roles. Here we review the new technologies and therapeutic paradigms that have enabled radiotherapy to become a routine part of the therapeutic plan for patients with chordoma of the vertebral column and sacrum. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2021. |
