The Treatment of Chordoma and Chondrosarcoma of the Skull Base with Particular Attention to Radiotherapy

Clinics in Oncology, 2017, Volume 2, Article 1195

Maurizio Amichetti¹, Dante Amelio¹, Marco Cianchetti¹, Irene Giacomelli¹ and Daniele Scartoni¹.
1    Department of Oncology, Azienda Provinciale per i Servizi Sanitari, Italy

Chordoma and Chondrosarcoma are rare, locally aggressive, tumors occurring in one third of cases in the base of the skull. Although the risk of distant metastasis is low, without adequate therapy, these tumors often recur locally with significant morbidity and mortality.

The mainstay of treatment is maximal tumor debunking. A gross total resection, however, is difficult to achieve, often leaving residual tumor. Adjuvant radiation is considered a standard therapeutic option postoperatively to reduce the risk of local recurrence and increase survival. High doses of radiation are required, as these tumors are considered relatively radioresistant but the presence of several organs at risks a major challenge with respect to covering the target with the prescribed high dose. In this regards, protons, for their physical and dosimetric advantages, have become a standard of care. Even though some reports have shown clinical activity with the use of chemotherapy or biologic drugs, there is no role at the moment for medical treatment.