1. Skull base chondrosarcoma radiosurgery: report of the North American Gamma Knife Consortium.
- Author
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Kano H, Sheehan J, Sneed PK, McBride HL, Young B, Duma C, Mathieu D, Seymour Z, McDermott MW, Kondziolka D, Iyer A, and Lunsford LD
- Subjects
- Adolescent, Adult, Aged, Chondrosarcoma pathology, Combined Modality Therapy, Disease-Free Survival, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Nervous System Diseases epidemiology, Nervous System Diseases etiology, North America, Postoperative Care, Postoperative Complications epidemiology, Skull Base Neoplasms pathology, Survival Analysis, Treatment Outcome, Young Adult, Chondrosarcoma surgery, Radiosurgery methods, Skull Base Neoplasms surgery
- Abstract
Object: Stereotactic radiosurgery (SRS) is a potentially important option for patients with skull base chondrosarcomas. The object of this study was to analyze the outcomes of SRS for chondrosarcoma patients who underwent this treatment as a part of multimodality management., Methods: Seven participating centers of the North American Gamma Knife Consortium (NAGKC) identified 46 patients who underwent SRS for skull base chondrosarcomas. Thirty-six patients had previously undergone tumor resections and 5 had been treated with fractionated radiation therapy (RT). The median tumor volume was 8.0 cm3 (range 0.9-28.2 cm3), and the median margin dose was 15 Gy (range 10.5-20 Gy). Kaplan-Meier analysis was used to calculate progression-free and overall survival rates., Results: At a median follow-up of 75 months after SRS, 8 patients were dead. The actuarial overall survival after SRS was 89% at 3 years, 86% at 5 years, and 76% at 10 years. Local tumor progression occurred in 10 patients. The rate of progression-free survival (PFS) after SRS was 88% at 3 years, 85% at 5 years, and 70% at 10 years. Prior RT was significantly associated with shorter PFS. Eight patients required salvage resection, and 3 patients (7%) developed adverse radiation effects. Cranial nerve deficits improved in 22 (56%) of the 39 patients who deficits before SRS. Clinical improvement after SRS was noted in patients with abducens nerve paralysis (61%), oculomotor nerve paralysis (50%), lower cranial nerve dysfunction (50%), optic neuropathy (43%), facial neuropathy (38%), trochlear nerve paralysis (33%), trigeminal neuropathy (12%), and hearing loss (10%)., Conclusions: Stereotactic radiosurgery for skull base chondrosarcomas is an important adjuvant option for the treatment of these rare tumors, as part of a team approach that includes initial surgical removal of symptomatic larger tumors.
- Published
- 2015
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