Hypofractionated Shaped Beam Radiosurgery for Cranial and Spinal Chordomas
Chordomas are rare, malignant tumors that account for between 1 and 4% of all malignant spinal tumors and can occur anywhere between the clivus and the coccyx. The majority of chordomas are found in the rostral (skull base 25–35%) and caudal (sacrococcygeal, 50%) regions, but around 15% of chordomas occur in the mobile spine. Histologically, chordomas present as a lobular arrangement of cells with a mucinous matrix and tend to grow in cords, irregular bands or pseudoacinar forms. Chordomas occur about twice as frequently in males as in females and are predominantly found in adults and the elderly (Cohen-Gadol and Al-Mefty 2008; Pamir and Ozduman 2008; McMaster et al. 2001).
KeywordsLocal Tumor Control Conformity Index Proton Beam Therapy Gamma Knife Surgery Marginal Dose
I would like to offer special thanks to Stephen (Steve) Edwards who helped me enormously in the writing of the chapter with encouragement and time and who spent numerous hours poring over the manuscript with me. Thanks are also due to Ms. Park Tae Hyun, (Jennie; student who is studying in Marine biology BSc course at the University of St. Adrews, UK) for her secretarial support and data organization which was particularly helpful.
- Cohen-Gadol AA, Al-Mefty O (2008) Skull base tumors. In: Bernstein M, Berger MS (eds) Neuro-oncology. The essentials, 2nd edn. Thieme, New York, pp 327–329Google Scholar
- Noel G, Habrand JL, Mammar H, Pontvert D, Haie-Meder C, Hasboun D, Moisson P, Ferrand R, Beaudre A, Boisserie G, Gaboriaud G, Mazal A, Kerody K, Schlienger M, Mazeron JJ (2001) Combination of photon and proton radiation therapy for chordomas and chondrosarcomas of the skull base: the centre de protontherapie d’Orsay experience. Int J Radiat Oncol Biol Phys 52:392–398CrossRefGoogle Scholar
- Noel G, Feuvret L, Calugaru V, Dhermain F, Mammar H, Haie-Meder C, Pontvert D, Hasboun D, Ferrand R, Nauray C, Boisserie G, Beaudre A, Gaboriaud G, Mazal A, Habrand JL, Mazeron JJ (2005) Chordomas of the base of the skull and upper cervical spine: one hundred patients irradiated by a 3D conformal technique combining photon and proton beams. Acta Oncol 44:700–708PubMedCrossRefGoogle Scholar
- Tai PT, Craighead P, Liem SK, Jo BH, Stitt L, Tonita J (2000) Management issues in chordoma: a case series. Clin Oncol 12:80–86Google Scholar