Role of Proton Beam Therapy in Spinal Chordomas: A Narrative Review of The Literature

Chordomas are rare malignant neoplasms arising from vestigial remnants of the embryonic notochord. Approximately 55-70% of chordomas develop within the vertebral column. Their affinity to develop within the bones of the axial skeleton and propensity to locally invade and recur makes them challenging...

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Bibliographic Details
Published in:Journal of the Pakistan Medical Association 2024-09, Vol.74 (9), p.1718-1720
Main Authors: Nadeem, Syed Faisal, Khan, Ahsan Ali, Shamim, Muhammad Shahzad
Format: Article
Language:English
Subjects:
Care and treatment
Chordoma - radiotherapy
Humans
Medical research
Medicine, Experimental
Physiological aspects
Proton beam radiotherapy
Proton Therapy - methods
Radiotherapy, Adjuvant - methods
Spinal diseases
Spinal Neoplasms - radiotherapy
Tumors, Embryonal
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Summary:Chordomas are rare malignant neoplasms arising from vestigial remnants of the embryonic notochord. Approximately 55-70% of chordomas develop within the vertebral column. Their affinity to develop within the bones of the axial skeleton and propensity to locally invade and recur makes them challenging candidates for complete surgical excision. Adjuvant therapies are hence necessary to improve outcomes; for which chemotherapy has been observed to be largely ineffective, owing to the tumour being resistant to it. Radiotherapy is the current adjuvant therapy of choice for chordoma management. Over the years, proton beam therapy (PBT) has been the subject of medical attention, given the dosimetric benefits it confers over traditional radiotherapy, allowing more concentrated radiation to be given to the target of interest and reducing damage to surrounding normal tissue. A review of the current literature reveals PBT offers significantly better outcomes when used as an adjuvant to maximal surgical resection rather than as a definitive therapy.
ISSN:0030-9982
0030-9982
DOI:10.47391/JPMA.24-72