Chemotherapeutic Treatment of Malignant Chordoma in Children

Scimeca, Philip G.; James-Herry, Angelica G.; Black, Karen; Kahn, Ellen; Weinblatt, Mark E.

doi:10.1097/00043426-199605000-00032

Cited by 59 publications

(37 citation statements)

References 8 publications

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“…56 Symptomatic improvement in some patients has been shown after administration of vincristine, 51,98 but this agent has failed in combination therapy with others. 31,112 Single-agent chemotherapy (carboplatin, 37 cisplatin, 37 or methotrexate 25 ) has been found to be ineffective in terms of tumor response and pain relief. Combination therapies that are associated with varying degrees of success include hydroxyurea with 5-fluorouracil; 5 cisplatin, vinblastine, and bleomycin with concurrent radiotherapy; 6 preoperative cyclophosphamide, vincristine, doxorubicin, and decarbazine together with radiotherapy; 62 vincristine and methotrexate with leucovorin rescue; 37 and ifosfamide and doxorubicin with intrathecal or intraventricular therapy with hydrocortisone, ara-C, and methotrexate.…”

Section: Neurosurg Focus / Volume 12 / May 2002mentioning

confidence: 99%

“…Combination therapies that are associated with varying degrees of success include hydroxyurea with 5-fluorouracil; 5 cisplatin, vinblastine, and bleomycin with concurrent radiotherapy; 6 preoperative cyclophosphamide, vincristine, doxorubicin, and decarbazine together with radiotherapy; 62 vincristine and methotrexate with leucovorin rescue; 37 and ifosfamide and doxorubicin with intrathecal or intraventricular therapy with hydrocortisone, ara-C, and methotrexate. 112 No benefit has been reported with the combination of actinomycin-D, cyclophosphamide, and vincristine, nor with cisplatin and 5-fluorouracil or highdose methotrexate.…”

Section: Neurosurg Focus / Volume 12 / May 2002mentioning

confidence: 99%

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Tumors of the skull base in children: review of tumor types and management strategies

Tsai¹,

Santoreneos²,

Rutka³

2002

FOC

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Although many treatment strategies for skull base tumors in adults have been reported, relatively little has been reported regarding such therapies in the pediatric population. Skull base tumors in children present a therapeutic challenge because of their unique pathological composition, the constraints of the maturing skull and brain, and the small size of the patients. In this review, the authors examine the pediatric skull base lesions that occur in the anterior, middle, and posterior cranial base, focusing on unique pediatric tumors such as encepahalocele, fibrous dysplasia, esthesioneuroblastoma, craniopharyngioma, juvenile nasopharyngeal angiofibroma, cholesteatoma, chordoma, chondrosarcoma, and Ewing sarcoma. They review management strategies that include radio- and chemotherapy, as well as surgical approaches with emphasis on the modifications and complications associated with the procedures as they apply in children. Evidence for the advantages and limitations of radiotherapy, chemotherapy, and surgery as it pertains to the pediatric population will be examined. With a working knowledge of skull base anatomy and special considerations of the developing craniofacial skeleton, neurosurgeons can treat skull base lesions in children with acceptable morbidity and mortality rates. Outcomes in this population may be better than those in adults, in part because of the benign histopathology that frequently affects the pediatric skull base, as well as the plasticity of the maturing nervous system.

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Section: Neurosurg Focus / Volume 12 / May 2002mentioning

confidence: 99%

Section: Neurosurg Focus / Volume 12 / May 2002mentioning

confidence: 99%

Tumors of the skull base in children: review of tumor types and management strategies

Tsai¹,

Santoreneos²,

Rutka³

2002

FOC

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“…However, given the static nature of the bone structures, several authors have suggested that frameless stereotactic guidance can be helpful in the case of lesions such as chordomas that extensively invade the base of the skull. 62,84 Indeed, in a number of situations we have found frameless stereotaxis to be helpful in providing intraoperative feedback regarding surgical orientation and, indirectly, extent of resection during anterior extradural approaches to cranial base lesions. 29 With further technological advancements and continuing refinements intraoperative neuroimaging and guidance will likely assume a critical role during resection of such tumors.…”

Section: Surgical Approachesmentioning

confidence: 99%

Skull base chordomas: overview of disease, management options, and outcome

Lanzino¹,

As²,

Mb³

et al. 2001

FOC

103

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Cranial base chordomas are locally invasive tumors that, from a midline, clival location, extend in different directions and display various patterns of skull base invasion. Although histologically benign, their invasive nature makes true “oncological” resection virtually impossible to achieve in most cases, despite modern skull base surgical techniques. Moreover, because of the tumor's location and proximity to critical neural and vascular structures, surgery-related morbidity can be significant when an aggressive resection is undertaken. Cytoreductive surgery assumes a critical role in the management of these lesions. The choice of surgical approach and the extent of resection are dependent on several factors: location and extension of the tumor, the surgeon's philosophy and familiarity with a specific approach, and the patient's preexisting clinical status. Proton-beam radiotherapy seems to be effective as an adjunct to surgery in achieving local tumor control. The timing of radiation therapy, however, remains controversial. Gamma knife surgery has been proposed as an adjunctive therapy, but the limited experience and short follow-up periods do not permit formulation of meaningful conclusions at this time. Recurrences are common, although in a subset of patients prolonged disease-free survival is demonstrated.

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“…7,11,30,60 Polychemotherapy regimens have been administered with drugs similar to soft part sarcomas (ifosfamide, doxorubicin, etoposide), and again mainly indicated where local treatment had failed previously. Few very young children have been managed with upfront chemotherapy, due to an extensive presentation of the disease locally and/or distantly.…”

Section: Review Of Literaturementioning

confidence: 99%

Reprint of “Chordoma in children: Case-report and review of literature”

Habrand

Datchary

Bolle

et al. 2016

Reports of Practical Oncology & Radiotherapy

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Sarcoma Protontherapy Children a b s t r a c tWe report an exceptional case of a very late local failure in a 9-year-old boy presenting with a chordoma of the cranio-cervical junction. The child was initially treated with a combination of surgical resection followed by high dose photon-proton radiation therapy. This aggressive therapy allowed a 9-year remission with minimal side-effects. Unfortunately, he subsequently presented with a local failure managed with a second full-dose course of protons. The child died one year later from local bleeding of unclear etiology.© 2015 Greater Poland Cancer Centre. Published by Elsevier Sp. z o.o. All rights reserved. IntroductionChordomas ( with the brachyury gene, a gene involved in the notochord development. 5,6 In the adults, they are located typically in the sacrococcygeal (SC) (50%), the intra cranial (IC), at the skull base (SB) (35%), and the intermediate spinal (S) regions (15%). Only 5% of cases have been described in the pediatric age, with unclear specificities concerning presentation, and outcome. We report in this paper a clinical case of skull base CH http://dx

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Chemotherapeutic Treatment of Malignant Chordoma in Children

Cited by 59 publications

References 8 publications

Tumors of the skull base in children: review of tumor types and management strategies

Tumors of the skull base in children: review of tumor types and management strategies

Skull base chordomas: overview of disease, management options, and outcome

Reprint of “Chordoma in children: Case-report and review of literature”

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