Harvard Radiation Oncology Program, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
Neurosurg Clin N Am. 2020 Apr;31(2):263-288. doi: 10.1016/j.nec.2019.12.002.
Surgery alone provides suboptimal local control of spine and sacral chordomas. Radiotherapy (RT) may improve local control in patients undergoing surgery and be used as definitive-intent treatment in patients not undergoing surgery. Although conventional-dose RT is inadequate for these radioresistant tumors, newer techniques allow treatment of the tumor to higher, more effective doses while limiting spinal cord dose to safe levels. The best local control is achieved when RT is delivered in the primary setting; RT dose is a critical determinant of local control. RT should be considered for all spine and sacral chordoma patients.
单纯手术对脊柱和骶骨脊索瘤的局部控制效果不佳。放疗（RT）可改善手术患者的局部控制效果，也可作为未手术患者的根治性治疗手段。虽然常规剂量的 RT 对这些放射抗拒性肿瘤效果不佳，但新技术可在限制脊髓剂量处于安全水平的同时，将肿瘤的治疗剂量提高到更有效、更高的水平。在原发部位进行 RT 时可获得最佳局部控制效果；RT 剂量是局部控制效果的关键决定因素。所有脊柱和骶骨脊索瘤患者均应考虑行 RT。
