Santegoeds, René G C; Alahmari, Mohammed; Postma, Alida A; Liebsch, Norbert J; Weber, Damien Charles; Mammar, Hamid; Eekers, Daniëlle B P; Temel, Yasin (2022). Ectopic Recurrence of Skull Base Chordoma after Proton Therapy. Current oncology, 29(4), pp. 2364-2375. MDPI 10.3390/curroncol29040191
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BACKGROUND
Chordoma are rare tumors of the axial skeleton. The treatment gold standard is surgery, followed by particle radiotherapy. Total resection is usually not achievable in skull base chordoma (SBC) and high recurrence rates are reported. Ectopic recurrence as a first sign of treatment failure is considered rare. Favorable sites of these ectopic recurrences remain unknown.
METHODS
Five out of 16 SBC patients treated with proton therapy and surgical resection developed ectopic recurrence as a first sign of treatment failure were critically analyzed regarding prior surgery, radiotherapy, and recurrences at follow-up imaging.
RESULTS
Eighteen recurrences were defined in five patients. A total of 31 surgeries were performed for primary tumors and recurrences. Seventeen out of eighteen (94%) ectopic recurrences could be related to prior surgical tracts, outside the therapeutic radiation dose. Follow-up imaging showed that tumor recurrence was difficult to distinguish from radiation necrosis and anatomical changes due to surgery.
CONCLUSIONS
In our cohort, we found uncommon ectopic recurrences in the surgical tract. Our theory is that these recurrences are due to microscopic tumor spill during surgery. These cells did not receive a therapeutic radiation dose. Advances in surgical possibilities and adjusted radiotherapy target volumes might improve local control and survival.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology |
UniBE Contributor: |
Weber, Damien Charles |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1718-7729 |
Publisher: |
MDPI |
Language: |
English |
Submitter: |
Basak Ginsbourger |
Date Deposited: |
28 Dec 2022 07:34 |
Last Modified: |
28 Dec 2022 23:07 |
Publisher DOI: |
10.3390/curroncol29040191 |
PubMed ID: |
35448165 |
Uncontrolled Keywords: |
chordoma proton therapy recurrence skull base surgery |
BORIS DOI: |
10.48350/176375 |
URI: |
https://boris.unibe.ch/id/eprint/176375 |
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