Hideyuki Kano1, Jason Sheehan2, Penny K Sneed3, Heyoung L McBride4, Byron Young5, Christopher Duma6, David Mathieu7, Zachary Seymour3, Michael W McDermott3, Douglas Kondziolka8, Aditya Iyer9, L Dade Lunsford1. 1. Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania; 2. Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia; 3. Departments of Radiation Oncology and Neurological Surgery, University of California, San Francisco, San Francisco, California; 4. Departments of Radiation Oncology and Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona; 5. Department of Neurological Surgery, University of Kentucky, Lexington, Kentucky; 6. Department of Neurological Surgery, Hoag Memorial Hospital, Newport Beach, California; 7. Department of Neurological Surgery, Université de Sherbrooke, Centre de Recherche Clinique Étienne-LeBel, Sherbrooke, Quebec, Canada; 8. Department of Neurological Surgery, New York University Langone Medical Center, New York, New York; and. 9. Department of Neurological Surgery, Stanford University, Stanford, California.
Abstract
OBJECT: Stereotactic radiosurgery (SRS) is a potentially important option for patients with skull base chondrosarcomas. The object of this study was to analyze the outcomes of SRS for chondrosarcoma patients who underwent this treatment as a part of multimodality management. METHODS: Seven participating centers of the North American Gamma Knife Consortium (NAGKC) identified 46 patients who underwent SRS for skull base chondrosarcomas. Thirty-six patients had previously undergone tumor resections and 5 had been treated with fractionated radiation therapy (RT). The median tumor volume was 8.0 cm3 (range 0.9-28.2 cm3), and the median margin dose was 15 Gy (range 10.5-20 Gy). Kaplan-Meier analysis was used to calculate progression-free and overall survival rates. RESULTS: At a median follow-up of 75 months after SRS, 8 patients were dead. The actuarial overall survival after SRS was 89% at 3 years, 86% at 5 years, and 76% at 10 years. Local tumor progression occurred in 10 patients. The rate of progression-free survival (PFS) after SRS was 88% at 3 years, 85% at 5 years, and 70% at 10 years. Prior RT was significantly associated with shorter PFS. Eight patients required salvage resection, and 3 patients (7%) developed adverse radiation effects. Cranial nerve deficits improved in 22 (56%) of the 39 patients who deficits before SRS. Clinical improvement after SRS was noted in patients with abducens nerve paralysis (61%), oculomotor nerve paralysis (50%), lower cranial nerve dysfunction (50%), optic neuropathy (43%), facial neuropathy (38%), trochlear nerve paralysis (33%), trigeminal neuropathy (12%), and hearing loss (10%). CONCLUSIONS: Stereotactic radiosurgery for skull base chondrosarcomas is an important adjuvant option for the treatment of these rare tumors, as part of a team approach that includes initial surgical removal of symptomatic larger tumors.
OBJECT: Stereotactic radiosurgery (SRS) is a potentially important option for patients with skull base chondrosarcomas. The object of this study was to analyze the outcomes of SRS for chondrosarcomapatients who underwent this treatment as a part of multimodality management. METHODS: Seven participating centers of the North American Gamma Knife Consortium (NAGKC) identified 46 patients who underwent SRS for skull base chondrosarcomas. Thirty-six patients had previously undergone tumor resections and 5 had been treated with fractionated radiation therapy (RT). The median tumor volume was 8.0 cm3 (range 0.9-28.2 cm3), and the median margin dose was 15 Gy (range 10.5-20 Gy). Kaplan-Meier analysis was used to calculate progression-free and overall survival rates. RESULTS: At a median follow-up of 75 months after SRS, 8 patients were dead. The actuarial overall survival after SRS was 89% at 3 years, 86% at 5 years, and 76% at 10 years. Local tumor progression occurred in 10 patients. The rate of progression-free survival (PFS) after SRS was 88% at 3 years, 85% at 5 years, and 70% at 10 years. Prior RT was significantly associated with shorter PFS. Eight patients required salvage resection, and 3 patients (7%) developed adverse radiation effects. Cranial nerve deficits improved in 22 (56%) of the 39 patients who deficits before SRS. Clinical improvement after SRS was noted in patients with abducens nerve paralysis (61%), oculomotor nerve paralysis (50%), lower cranial nerve dysfunction (50%), optic neuropathy (43%), facial neuropathy (38%), trochlear nerve paralysis (33%), trigeminal neuropathy (12%), and hearing loss (10%). CONCLUSIONS: Stereotactic radiosurgery for skull base chondrosarcomas is an important adjuvant option for the treatment of these rare tumors, as part of a team approach that includes initial surgical removal of symptomatic larger tumors.
Entities:
Keywords:
ARE = adverse radiation effects; EORTC = European Organization for Research and Treatment of Cancer; Gamma Knife; NAGKC = North American Gamma Knife Consortium; PFS = progression-free survival; PTV = (SRS) planning tumor volume; RT = fractionated radiation therapy; RTOG = Radiation Therapy Oncology Group; SRS = stereotactic radiosurgery; UPMC = University of Pittsburgh Medical Center; chondrosarcoma; oncology; skull base tumor; stereotactic radiosurgery
Authors: Paolo Palmisciano; Ali S Haider; Mohammadmahdi Sabahi; Chibueze D Nwagwu; Othman Bin Alamer; Gianluca Scalia; Giuseppe E Umana; Aaron A Cohen-Gadol; Tarek Y El Ahmadieh; Kenny Yu; Omar N Pathmanaban Journal: Cancers (Basel) Date: 2021-11-26 Impact factor: 6.639