Combination Short-Course Preoperative Irradiation, Surgical Resection, and Reduced-Field High-Dose Postoperative Irradiation in the Treatment of Tumors Involving the Bone

Wagner, Timothy D.; Kobayashi, Wendy; Dean, Susan; Goldberg, Saveli; Kirsch, David G.; Suit, Herman D.; Hornicek, Francis J.; Pedlow, Francis X.; Raskin, Kevin A.; Springfield, Dempsey S.; Yoon, Sam S.; Gebhardt, Marc C.; Mankin, Henry J.; DeLaney, Thomas F.

doi:10.1016/j.ijrobp.2008.03.074

Cited by 61 publications

(21 citation statements)

References 27 publications

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“…We think that in order to improve survivorship of patients with sacral chordoma we need to add something to surgery. Park et al showed a higher local control with proton/photon‐beam radiation in combination with surgery in patients with primary sacral chordoma than in those with recurrence, and this aspect was confirmed in more recent studies with large series . Recently Delaney et al reported the results of a prospective phase II trial with a series of 50 patients with sarcomas of the spine (29 chordomas) where the strategy of treatment included the use of surgery in conjunction with a lower adjuvant dose of RT (median 77 Gy).…”

Section: Discussionmentioning

confidence: 90%

Prognostic factors in surgical resection of sacral chordoma

Angelini

Pala

Calabrò

et al. 2015

Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 90%

Prognostic factors in surgical resection of sacral chordoma

Angelini

Pala

Calabrò

et al. 2015

Journal of Surgical Oncology

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“…In patients who have not previously received high-dose RT at the time of primary treatment, pre- and/or post-operative treatment with RT may also be appropriate [12, 13]. This approach is currently the standard treatment strategy in primary disease at some referral centers [14] and may be particularly well suited for treating local recurrences as the chance of achieving a true R0 resection after prior surgical procedures is low. It is currently not possible to make any recommendations regarding the role of adjuvant re-irradiation after macroscopically complete resection of recurrent chordoma.…”

Section: Treatment Strategymentioning

confidence: 99%

Best practices for the management of local-regional recurrent chordoma: a position paper by the Chordoma Global Consensus Group

Stacchiotti¹,

et al. 2017

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Chordomas are rare, malignant bone tumors of the skull-base and axial skeleton. Until recently, there was no consensus among experts regarding appropriate clinical management of chordoma, resulting in inconsistent care and suboptimal outcomes for many patients. To address this shortcoming, the European Society of Medical Oncology (ESMO) and the Chordoma Foundation, the global chordoma patient advocacy group, convened a multi-disciplinary group of chordoma specialists to define by consensus evidence-based best practices for the optimal approach to chordoma. In January 2015, the first recommendations of this group were published, covering the management of primary and metastatic chordomas. Additional evidence and further discussion were needed to develop recommendations about the management of local-regional failures. Thus, ESMO and CF convened a second consensus group meeting in November 2015 to address the treatment of locally relapsed chordoma. This meeting involved over 60 specialists from Europe, the United States and Japan with expertise in treatment of patients with chordoma. The consensus achieved during that meeting is the subject of the present publication and complements the recommendations of the first position paper.

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“…Significant improvements in patient survival rates have been achieved in recent years, largely due to multimodal therapeutic approaches combining high-dose chemotherapy and surgical resection [2]. Radiotherapy, although not a primary choice for treatment, is frequently applied for local control in patients for whom surgical resection with sufficient margins is not achievable [3,4]. Despite these advances, the overall relapse free-survival rate over 5-years has stagnated at approximately 65% to 75% and the intensification of chemotherapy regimens has improved histological response but not survival [5,6].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic implications of an enriched cancer stem-like cell population in a human osteosarcoma cell line

et al. 2012

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BackgroundOsteosarcoma is a bone-forming tumor of mesenchymal origin that presents a clinical pattern that is consistent with the cancer stem cell model. Cells with stem-like properties (CSCs) have been identified in several tumors and hypothesized as the responsible for the relative resistance to therapy and tumor relapses. In this study, we aimed to identify and characterize CSCs populations in a human osteosarcoma cell line and to explore their role in the responsiveness to conventional therapies.MethodsCSCs were isolated from the human MNNG/HOS cell line using the sphere formation assay and characterized in terms of self-renewal, mesenchymal stem cell properties, expression of pluripotency markers and ABC transporters, metabolic activity and tumorigenicity. Cell's sensitivity to conventional chemotherapeutic agents and to irradiation was analyzed and related with cell cycle-induced alterations and apoptosis.ResultsThe isolated CSCs were found to possess self-renewal and multipotential differentiation capabilities, express markers of pluripotent embryonic stem cells Oct4 and Nanog and the ABC transporters P-glycoprotein and BCRP, exhibit low metabolic activity and induce tumors in athymic mice. Compared with parental MNNG/HOS cells, CSCs were relatively more resistant to both chemotherapy and irradiation. None of the treatments have induced significant cell-cycle alterations and apoptosis in CSCs.ConclusionsMNNG/HOS osteosarcoma cells contain a stem-like cell population relatively resistant to conventional chemotherapeutic agents and irradiation. This resistant phenotype appears to be related with some stem features, namely the high expression of the drug efflux transporters P-glycoprotein and BCRP and their quiescent nature, which may provide a biological basis for resistance to therapy and recurrence commonly observed in osteosarcoma.

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Combination Short-Course Preoperative Irradiation, Surgical Resection, and Reduced-Field High-Dose Postoperative Irradiation in the Treatment of Tumors Involving the Bone

Cited by 61 publications

References 27 publications

Prognostic factors in surgical resection of sacral chordoma

Prognostic factors in surgical resection of sacral chordoma

Best practices for the management of local-regional recurrent chordoma: a position paper by the Chordoma Global Consensus Group

Therapeutic implications of an enriched cancer stem-like cell population in a human osteosarcoma cell line

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