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Multidisciplinary Planning for Treatment of Chordoma

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Chordoma of the Spine

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Abstract

Chordoma is a locally aggressive neoplasm primarily affecting the axial skeleton including the skull base, mobile spine, and sacrum. Given its low-grade nature, slow growth, and tumor location relative to critical neurologic and vascular structures, diagnosis and treatment can be difficult with high rates of recurrence, morbidity, and poor survival. When treating patients with chordoma, multidisciplinary involvement and coordination is essential from the time of diagnosis to final follow-up. Treatment teams are dependent on tumor location but often include pathologists, radiologists, medical oncologists, surgical oncologists, and surgical subspecialists, as well as a variety of patient support structures. Using a coordinated approach, multidisciplinary teams can develop patient-specific treatment algorithms that limit potential morbidity while ensuring the best opportunity for recurrence-free tumor control. As diagnostic and treatment options continue to evolve with the emergence of new technologies and research, so will the need for multidisciplinary coordination in treating chordoma.

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Abbreviations

CT:

Computed tomography

CTV:

Clinical target volume

GyRBE:

Gray-equivalent relative biologic effectiveness

ICA:

Internal carotid artery

LC:

Local control

LR:

Local recurrence

MRI:

Magnetic resonance imaging

OS:

Overall survival

PFS:

Progression-free survival

RT:

Radiation therapy

SBRT:

Stereotactic body radiation therapy

SRS:

Stereotactic radiosurgery

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Midwest Orthopaedics at Rush University Medical Center, Chicago, IL, USA

    Nicholas A. Shepard & Matthew W. Colman

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  1. Nicholas A. Shepard
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  2. Matthew W. Colman
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Correspondence to Matthew W. Colman .

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Editors and Affiliations

  1. Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Daniel M. Sciubba

  2. Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Joseph H. Schwab

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Shepard, N.A., Colman, M.W. (2021). Multidisciplinary Planning for Treatment of Chordoma. In: Sciubba, D.M., Schwab, J.H. (eds) Chordoma of the Spine. Springer, Cham. https://doi.org/10.1007/978-3-030-76201-8_6

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