Base of skull and cervical spine chordomas in children treated by high-dose irradiation.
OBJECTIVE
To evaluate the outcome of children with base of skull or cervical spine chordomas treated by high dose irradiation.


METHODS
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.


RESULTS
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.


CONCLUSIONS
Chordomas in children behave similarly to those in adults: children can receive the same high-dose irradiation as adults with acceptable morbidity.
Department of Radiation Oncology, Massachusetts General Hospital, Boston 02114.
V
V
Benk
N J
NJ
Liebsch
J E
JE
Munzenrider
J
J
Efird
P
P
McManus
H
H
Suit
D000293:Adolescent; D002574:Cervical Vertebrae; D002648:Child; D002675:Child, Preschool; D002817:Chordoma / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D011878:Radiotherapy / Q000009:adverse effects; D012888:Skull Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D013125:Spinal Neoplasms / Q000401:mortality / Q000532:radiotherapy*