Nagoya University Graduate School of Medicine, Department of Orthopaedic Surgery, 65 Tsurumai-cho, Showa-ku, Nagoya city, Aichi 466-8550, Japan.
Bone Joint J. 2013 Oct;95-B(10):1392-5. doi: 10.1302/0301-620X.95B10.31269.
The main form of treatment of a chordoma of the mobile spine is total en bloc spondylectomy (TES), but the clinical results are not satisfactory. Stand-alone carbon ion radiotherapy (CIRT) for bone and soft-tissue sarcomas has recently been reported to have a high rate of local control with a low rate of local recurrence. We report two patients who underwent TES after CIRT for treating a chordoma in the lumbar spine with good medium-term outcomes. At operation, there remained histological evidence of viable tumour cells in both cases. After the combination use of TES following CIRT, neither patient showed signs of recurrence at the follow-up examination. These two cases suggest that CIRT should be combined with total spondylectomy in the treatment of chordoma of the mobile spine.
移动脊柱脊索瘤的主要治疗形式是整块全脊椎切除术（TES），但临床效果并不理想。最近有报道称，碳离子放疗（CIRT）单独用于骨和软组织肉瘤具有很高的局部控制率，局部复发率很低。我们报告了两例在腰椎脊索瘤接受 CIRT 治疗后行 TES 的患者，他们的中期结果良好。在手术中，这两例均有活肿瘤细胞的组织学证据。在 CIRT 后联合使用 TES 后，这两例患者在随访检查中均未见复发迹象。这两例病例表明，CIRT 应与全脊椎切除术联合应用于移动脊柱脊索瘤的治疗。
