| Diskectomy, Percutaneous, Endoscopes, Intervertebral disc, Spine |
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Seung Hoon Ji1 , Bong Jin Park1 , Young Jin Lim1 , Chang Kyu Park1 , Man Kyu Choi2 |
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1Department of Neurosurgery, Kyung Hee University College of Medicine, Seoul,
2Department of Neurosurgery, Daegu Catholic University College of Medicine, Daegu, Korea |
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| Abstract |
Objective
Chordomas are rare neoplasms, and complete resection without morbidity is rarely feasible because tumors tend to encase critical vessels and nerves or adhere to the brainstem. Therefore, most patients require adjuvant radiation therapy to prevent recurrence. In this study, we assessed survival rate and tumor control in patients with chordomas treated with Gamma Knife surgery(GKS) and investigated the prognostic factors affecting local tumor control to determine which lesions are suitable for treatment with this modality.
Methods
We performed a retrospective analysis of 11 patients with chordomas treated with GKS between January 2002 and January 2017. The median age at the time of GKS was 54 years. The patients were followed for a median of 39 months. To analyze the prognostic factors correlated with chordoma treated with GKS, we assessed age, sex, prior surgery, target volume, and prescription dose.
Results
The mean target volume was 4.7cm3 and mean prescription dose was 14.1Gy. Control of the chordoma was achieved in seven patients(64%) during the follow-up period. The tumor volume decreased by >50% on follow-up images in four patients, and did not change in three patients. Four patients experienced tumor progression after GKS. Statistical analysis revealed that the follow-up periods had a significant association with tumor aggravation(p=0.037). Age, sex, prior surgery, target volume, and prescription dose were not statistically significant.
Conclusion
In patients with skull base chordomas, GKS provides a reasonable rate of local tumor control. Long-term follow-up is necessary in order to detect any late tumor progression. |
| Key Words:
Gamma Knife radiosurgery, Skull base, Chordoma |
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