Ravindran Pawan Kishore, Keizer Max E, Kunst Henricus Dirk P M, Compter Inge, Van Aalst Jasper, Eekers Daniëlle B P, Temel Yasin
Department of Neurosurgery, Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands.
Dutch Academic Alliance Skull Base Pathology, Maastricht University Medical Center+, Radboud University Medical Center, 6229 HX Maastricht, The Netherlands.
Cancers (Basel). 2024 Feb 21;16(5):856. doi: 10.3390/cancers16050856.
Surgery and radiotherapy are key elements to the treatment of skull-base chondrosarcomas; however, there is currently no consensus regarding whether or not adjuvant radiotherapy has to be administered. This study searched the EMBASE, Cochrane, and PubMed databases for clinical studies evaluating the long-term prognosis of surgery with or without adjuvant radiotherapy. After reviewing the search results, a total of 22 articles were selected for this review. A total of 1388 patients were included in this cohort, of which 186 received surgery only. With mean follow-up periods ranging from 39.1 to 86 months, surgical treatment provided progression-free survival (PFS) rates ranging from 83.7 to 92.9% at 3 years, 60.0 to 92.9% at 5 years, and 58.2 to 64.0% at 10 years. Postoperative radiotherapy provides PFS rates ranging between 87 and 96.2% at 3 years, 57.1 and 100% at 5 years, and 67 and 100% at 10 years. Recurrence rates varied from 5.3% to 39.0% in the surgery-only approach and between 1.5% and 42.90% for the postoperative radiotherapy group. When considering prognostic variables, higher age, brainstem/optic apparatus compression, and larger tumor volume prior to radiotherapy were found to be significant factors for local recurrence.
手术和放射治疗是颅底软骨肉瘤治疗的关键要素;然而,目前对于是否必须进行辅助放疗尚无共识。本研究在EMBASE、Cochrane和PubMed数据库中检索了评估手术联合或不联合辅助放疗的长期预后的临床研究。在审查检索结果后,共选择了22篇文章进行本综述。该队列共纳入1388例患者,其中186例仅接受了手术。平均随访时间为39.1至86个月,手术治疗的3年无进展生存率(PFS)为83.7%至92.9%,5年为60.0%至92.9%,10年为58.2%至64.0%。术后放疗的3年PFS率为87%至96.2%,5年为57.1%至100%,10年为67%至100%。单纯手术组的复发率为5.3%至39.0%,术后放疗组为1.5%至42.90%。在考虑预后变量时,发现较高年龄、脑干/视器受压以及放疗前肿瘤体积较大是局部复发的重要因素。