Keisch M E, Garcia D M, Shibuya R B
Radiation Oncology Center, Mallinckrodt Institute of Radiology, St. Louis, Missouri.
J Neurosurg. 1991 Sep;75(3):374-7. doi: 10.3171/jns.1991.75.3.0374.
Twenty-one patients with chordoma were treated at the Radiation Oncology Center, Mallinckrodt Institute of Radiology, between 1949 and 1986. Thirteen patients had sacrococcygeal tumors, five had clival tumors, two had nasopharyngeal tumors, and one had a lumbar spine tumor. Nine patients were treated with surgery alone, eight patients with subtotal resection and postoperative irradiation, and four patients with radiotherapy alone after biopsy. The 5- and 10-year actuarial survival rates were 74% and 46%, respectively. The 10-year actuarial survival rate was significantly better in patients treated with surgery alone or surgery and irradiation than in those treated with radiotherapy alone (52%, 32%, and 0%, respectively, p = 0.02). Although all patients ultimately suffered a recurrence, those with lumbosacral tumors treated with surgery and irradiation had a longer mean disease-free survival period (6.6 years) than those treated with surgery alone (4.1 years) (p = 0.08). Disease-free survival times of patients with base of the skull tumors was not significantly different between the treatment groups. Irradiation after resection of chordomas appears to increase the time to first relapse in lumbosacral tumors and should be considered after subtotal resection.
1949年至1986年间，21例脊索瘤患者在马林克罗特放射研究所放射肿瘤中心接受了治疗。13例患者患有骶尾部肿瘤，5例患有斜坡肿瘤，2例患有鼻咽部肿瘤，1例患有腰椎肿瘤。9例患者仅接受了手术治疗，8例患者接受了次全切除并术后放疗，4例患者在活检后仅接受了放疗。5年和10年精算生存率分别为74%和46%。仅接受手术或手术加放疗的患者10年精算生存率明显高于仅接受放疗的患者（分别为52%、32%和0%，p = 0.02）。尽管所有患者最终都复发了，但接受手术加放疗的腰骶部肿瘤患者的平均无病生存期（6.6年）比仅接受手术的患者（4.1年）更长（p = 0.08）。治疗组之间，颅底肿瘤患者的无病生存时间没有显著差异。脊索瘤切除后放疗似乎会增加腰骶部肿瘤首次复发的时间，在次全切除后应考虑进行放疗。
