How is a chordoma managed and treated?
Surgery is the best option for chordomas located at the sacrum and in the mobile spine. Complete surgical removal tends to delay reoccurrence and is associated with longer survival rates. In these procedures, the tumors are removed along with tissue around it. This is generally followed by external-beam radiation treatments.
For clival chordomas and other skull-base chordomas, great effort is taken to save nerve function. This often involves doing surgery with special instruments and entering through the nose. It might not be possible to remove all of the tumor. Radiotherapy is used after surgery. However, the doses that are effective against the tumors are higher than can be tolerated by the spinal and brain tissues. Stereotactic radiosurgery, however, can deliver such high-dose radiation with lower risk to brain and nerve tissue than conventional fractionated radiotherapy, and may be an effective treatment in some cases.
Although tests are underway, chemotherapy does not seem to be effective against chordomas.