Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan, 33305, Taiwan (R.O.C.).
Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan, 33305, Taiwan (R.O.C.).
Sci Rep. 2024 Oct 3;14(1):23012. doi: 10.1038/s41598-024-74317-4.
The research retrospectively analyzed cases of spinal chordoma and chondrosarcoma involving patients who received treatment at the two hospitals between 2001 and 2023. Among the 48 patients studied (39 chordoma and 9 chondrosarcoma cases), the average age was 53.9 ± 15.8 years, with a range of 17 to 86 years. Out of these patients, 43 underwent excision surgery and were categorized based on tumor margin into negative (R0) or microscopically positive (R1) margin (n = 14) and macroscopically positive (R2) margin (n = 29) groups. The mean overall survival (OS) for R0/R1 and R2 groups was 156.5 ± 19.3 and 79.2 ± 11.9 months, respectively (p value = 0.012). The mean progression-free survival (PFS) for R0/R1 and R2 was 112.9 ± 24.4 and 25.5 ± 5.5 months (p value < 0.001). The study showed that regardless of whether patients in the R0/R1 or R2 groups received radiation therapy (RT) or not, there was no significant improvement in OS or PFS. Specifically, the OS and PFS for the RT only group were 75.9 ± 16.6 and 73.3 ± 18.0 months. In conclusion, the recommended treatment approach for spinal chordoma and chondrosarcoma remains en bloc resection surgery with an appropriate margin. Patients who are unsuitable for or decline surgery may find a beneficial disease control rate with traditional external beam photon/proton therapy.
这项研究回顾性分析了 2001 年至 2023 年间在这两家医院接受治疗的脊索瘤和软骨肉瘤患者的病例。在 48 名研究患者中（39 例脊索瘤和 9 例软骨肉瘤），平均年龄为 53.9±15.8 岁，年龄范围为 17 岁至 86 岁。其中 43 例患者接受了切除术，并根据肿瘤边界分为阴性（R0）或显微镜下阳性（R1）边界（n=14）和大体阳性（R2）边界（n=29）组。R0/R1 和 R2 组的总生存期（OS）平均值分别为 156.5±19.3 和 79.2±11.9 个月（p 值=0.012）。R0/R1 和 R2 组的无进展生存期（PFS）平均值分别为 112.9±24.4 和 25.5±5.5 个月（p 值<0.001）。研究表明，无论 R0/R1 组或 R2 组的患者是否接受放疗（RT），OS 或 PFS 均无显著改善。具体来说，仅接受 RT 的患者的 OS 和 PFS 分别为 75.9±16.6 和 73.3±18.0 个月。总之，对于脊髓脊索瘤和软骨肉瘤，推荐的治疗方法仍然是整块切除术，辅以适当的边界。不适合手术或拒绝手术的患者可能会通过传统的外束光子/质子治疗获得有益的疾病控制率。
