Sciubba Daniel M, Chi John H, Rhines Laurence D, Gokaslan Ziya L
Department of Neurological Surgery, Johns Hopkins University, Meyer 7-109, 600 North Wolfe Street, Baltimore, MD 21287, USA.
Neurosurg Clin N Am. 2008 Jan;19(1):5-15. doi: 10.1016/j.nec.2007.09.006.
Chordomas are the most common primary malignant tumor of the mobile spine and of the sacrum. Although considered not to possess significant metastatic potential, such lesions are locally aggressive, leading to neurologic compromise and lytic destruction of bone. En bloc resection has afforded patients the greatest chance of local control and disease-free survival. Such radical resections may be associated with significant surgical morbidity, however. Although considered generally resistant to radiation therapy and chemotherapy, recent advances in photon and proton radiation therapy and use of monoclonal antibodies may provide improved outcomes for poor surgical candidates and for tumors that recur after surgery.
脊索瘤是活动脊柱和骶骨最常见的原发性恶性肿瘤。尽管认为其不具有显著的转移潜能，但此类病变具有局部侵袭性，可导致神经功能损害和骨质溶解性破坏。整块切除为患者提供了最大的局部控制和无病生存机会。然而，这种根治性切除可能会伴有显著的手术并发症。尽管一般认为其对放射治疗和化疗耐药，但光子和质子放射治疗的最新进展以及单克隆抗体的应用可能会为手术条件差的患者和术后复发的肿瘤带来更好的治疗效果。
