Chordoma : Treatment
Chordoma - Conventional Treatment: The primary treatment for chordomas consists of complete surgical resection with negative margins, followed by adjuvant radiation with proton beam therapy. Radiation helps minimize the chance for local recurrences. There is no effective chemotherapy regimen available at this time. Complete resection is achieved in only about one-third of cases due to the large tumor size, complex anatomy at the site of origin, and proximity of the tumor (especially in intracranial location) to critical structures. This leads to relatively high rate of local recurrences and distant metastases. For skull base lesions, endoscopic endonasal trans-sphenoid approach is commonly used as it is minimally invasive and produces acceptable outcomes. Intracranial tumors are often removed in a piecemeal fashion, which precludes assessment of margins. This image shows locally destructive nature of chordomas. The bony trabeculae are surrounded and being destroyed by the tumor.