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04-09-2023 | Chondrosarcoma | Research

Management of chordoma and chondrosarcoma with definitive dose-escalated single-fraction spine stereotactic radiosurgery

Authors: Alexander D. Sherry, Sean Maroongroge, Brian De, Behrang Amini, Anthony P. Conley, Andrew J. Bishop, Chenyang Wang, Thomas Beckham, Martin Tom, Tina Briere, Jing Li, Debra N. Yeboa, Mary Frances McAleer, Robert North, Claudio E. Tatsui, Laurence D. Rhines, Amol J. Ghia

Published in: Journal of Neuro-Oncology | Issue 2/2023

Abstract

Purpose

The management of chordoma or chondrosarcoma involving the spine is often challenging due to adjacent critical structures and tumor radioresistance. Spine stereotactic radiosurgery (SSRS) has radiobiologic advantages compared with conventional radiotherapy, though there is limited evidence on SSRS in this population. We sought to characterize the long-term local control (LC) of patients treated with SSRS.

Methods

We retrospectively reviewed patients with chordoma or chondrosarcoma treated with dose-escalated SSRS, defined as 24 Gy in 1 fraction to the gross tumor volume. Overall survival (OS) was calculated by Kaplan-Meier functions. Competing risk analysis using the cause-specific hazard function estimated LC time.

Results

Fifteen patients, including 12 with chordoma and 3 with chondrosarcoma, with 22 lesions were included. SSRS intent was definitive, single-modality in 95% of cases (N = 21) and post-operative in 1 case (5%). After a median censored follow-up time of 5 years (IQR 4 to 8 years), median LC time was not reached (IQR 8 years to not reached), with LC rates of 100%, 100%, and 90% at 1 year, 2 years, and 5 years. The median OS was 8 years (IQR 3 years to not reached). Late grade 3 toxicity occurred after 23% of treatments (N = 5, fracture), all of which were managed successfully with stabilization.

Conclusion

Definitive dose-escalated SSRS to 24 Gy in 1 fraction appears to be a safe and effective treatment for achieving durable local control in chordoma or chondrosarcoma involving the spine, and may hold particular importance as a low-morbidity alternative to surgery in selected cases.

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Title: Management of chordoma and chondrosarcoma with definitive dose-escalated single-fraction spine stereotactic radiosurgery
Authors: Alexander D. Sherry
Sean Maroongroge
Brian De
Behrang Amini
Anthony P. Conley
Andrew J. Bishop
Chenyang Wang
Thomas Beckham
Martin Tom
Tina Briere
Jing Li
Debra N. Yeboa
Mary Frances McAleer
Robert North
Claudio E. Tatsui
Laurence D. Rhines
Amol J. Ghia
Publication date: 04-09-2023
Publisher: Springer US
Keyword: Chondrosarcoma
Published in: Journal of Neuro-Oncology / Issue 2/2023
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-023-04432-1

At a glance: The STEP trials

Springer Medicine

Management of chordoma and chondrosarcoma with definitive dose-escalated single-fraction spine stereotactic radiosurgery

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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