Base of skull and cervical spine chordomas in children treated by high-dose irradiation

• Published in: International journal of radiation oncology, biology, physics Vol. 31; no. 3; p. 577
• Main Authors: Benk, V, Liebsch, N J, Munzenrider, J E, Efird, J, McManus, P, Suit, H
• Format: Journal Article
• Language: English
• Published: United States 01-02-1995
• Subjects: Adolescent; Cervical Vertebrae; Child; Child, Preschool; Chordoma - mortality; Chordoma - radiotherapy; Female; Humans; Male; Prognosis; Radiotherapy - adverse effects; Skull Neoplasms - mortality; Skull Neoplasms - radiotherapy; Spinal Neoplasms - mortality; Spinal Neoplasms - radiotherapy
• ISSN: 0360-3016
• DOI: 10.1016/0360-3016(94)00395-2

To evaluate the outcome of children with base of skull or cervical spine chordomas treated by high dose irradiation.
Eighteen children, 4 to 18 years of age, with base of skull or cervical spine chordomas, received fractionated high-dose postoperative radiation using mixed photon and 160 MeV proton beams. The median tumor dose was 69 Cobalt Gray-equivalent (CGE) with a 1.8 CGE daily fraction.
The median follow-up was 72 months. The 5-year actuarial survival was 68% and the 5-year disease-free survival (DFS) was 63%. The only significant prognostic factor was the location: patients with cervical spine chordomas had a worse survival than those with base of skull lesions (p = 0.008). The incidence of treatment-related morbidity was acceptable: two patients developed a growth hormone deficit corrected by hormone replacement, one temporal lobe necrosis, and one fibrosis of the temporalis muscle, improved by surgery.
Chordomas in children behave similarly to those in adults: children can receive the same high-dose irradiation as adults with acceptable morbidity.