علاج الحبلوم مع الانتكاس المحلي-الإقليمي المعزول في العمود الفقري المتحرك أو العجز

References

• Mobile spine/sacrum isolated local-regional relapse. A prior history of piecemeal resection (except for skull-base tumors where resection may be necessarily piecemeal), prior high-dose RT (in case of mobile spine and sacral chordoma), and/or tumor rupture are obvious exclusion criteria for re-resection with curative intent (IV-B).
• 'Salvage palliative/supportive treatment choices' include debulking surgery, low-dose RT, stereotactic body RT (SBRT), including radiosurgery to small volume, radiofrequency ablation (RFA) and other loco-regional approaches (i.e. cryotherapy), systemic therapy, PC and observation.
• Imatinib and sorafenib are the agents with the greatest evidence of efficacy in advanced chordoma and represent reasonable palliative treatment options to slow disease progression or alleviate symptoms (V*-B).
• In addition, several case reports have noted activity of sunitinib and EGFR inhibitors (cetuximab, erlotinib, gefitinib).
• Retrospective data suggest that cryoablation and RFA can be safe and useful palliative treatments in recurrent extracranial chordomas with a benefit in pain control.