Chordoma: Retrospective analysis of patients treated with radiotherapy at a single institution

Abstract

Introduction: Chordoma is a low-grade notochordal tumor of the skull base, mobile spine, and sacrum, which is locally invasive and tends to present late in the disease course and confers a poor prognosis. They usually recur locally and surgery is the mainstay of treatment. Radiotherapy (RT) is often given postoperatively to reduce local recurrence. The purpose of this study is to assess RT treatment given at our center for chordoma patients. Materials and Methods: In this retrospective analysis, 25 patients with chordoma treated with RT between 2013 and 2020 at a single institution were reviewed. Eleven patients had sacrococcygeal tumors, three had clival tumors, two had lumbar, one had sphenoid tumors, one had nasal cavity tumors, two had cervical spine tumors, and two had sellar/suprasellar tumors. Out of 25 patients, 19 patients underwent surgical excision (partial/complete) and in 6 patients only a biopsy was done. Two patients underwent recurrent surgical excision. All patients received RT either postoperative or in recurrent settings or after biopsy only. The median RT dose was 30 Grey (Gy) (range, 16–60 Gy). Results: On analysis, seven patients were lost to follow-up. Three patients were on follow-up till 56, 53, and 41 months and were included in a 4-year survival analysis. Eighteen patients follow-up were available. Out of 18 patients, 8 patients had died and 10 patients were alive. With the median follow-up of 37.5 months, the 4-year overall survival rate was 61.9% in 21 patients. With the median follow-up of 39 months, the 5-year overall survival rate was 55.6% in 18 patients. Conclusions: RT in the postoperative setup may improve the overall survival in chordoma patients. Further detailed analysis is necessary for RT dose and/or higher techniques need to be used for local control of the disease.