Low dose radiotherapy is associated with local complications but not disease control in sacral chordoma.
JOURNAL OF SURGICAL ONCOLOGY(2019)
摘要
BackgroundWe reviewed the disease control and complications of the treatment of sacrococcygeal chordoma from four tertiary cancer centers with emphasis on the effects of radiotherapy in surgically treated patients. MethodsA total of 193 patients with primary sacrococcygeal chordoma from 1990 to 2015 were reviewed. There were 124 males, with a mean age of 5915 years and a mean follow-up of 74 years. Eighty-nine patients received radiotherapy with a mean total dose of 61.8 +/- 10.9Gy. ResultsThe 10-year disease-free and disease-specific survival was 58% and 72%, respectively. Radiation was not associated with local recurrence (hazard ratio [HR], 1.13; 95% confidence interval [CI], 0.59-2.17; P=0.71), metastases (HR, 0.93; 95% CI, 0.45-1.91; P=0.85) or disease-specific survival (HR, 0.96; 95% CI, 0.46-2.00; P=0.91). Higher doses (>= 70Gy; HR, 0.52; 95% CI, 0.20-1.32; P=0.17) may be associated with reduced local recurrence. Radiotherapy was associated with wound complications (HR, 2.76; 95% CI, 1.64-4.82;, P<0.001) and sacral stress fractures (HR, 4.73; 95% CI, 1.88-14.38; P<0.001). ConclusionsIn this multicenter review, radiotherapy was not associated with tumor outcome but associated with complications. The routine use of radiotherapy with en-bloc resection of sacrococcygeal chordomas should be reconsidered in favor of a selective, individualized approach with a radiation dose of >= 70Gy.
更多查看译文
关键词
chordoma,outcome,radiotherapy,sacrum,surgical resection
AI 理解论文
溯源树
样例
生成溯源树,研究论文发展脉络