Stereotactic Radiotherapy for Residual Tumor after Chondrosarcoma Surgery: Clinical Case

BACKGROUND: The treatment of chondrosarcoma can be challenging due to the rarity of the tumor, the characteristics of the disease progression, and the variability of its anatomical location. Surgical resection of the tumor is not always feasible, particularly complete resection, due to its proximity to vital organs such as the spinal cord. The low cell sensitivity to chemotherapy and radiotherapy further limits treatment options and poses a poor prognosis. These factors contribute to a high incidence of local relapses, with their frequency reaching 58%. Particular emphasis is hereby placed on the recent advancements in high-dose chondrosarcoma irradiation using stereotactic radiotherapy, a technique that has been demonstrated to effectively overcome the radioresistance exhibited by malignant cells and thereby ensure the comprehensive eradication of the tumor. DESCRIPTION OF CLINICAL CASE: A female patient diagnosed with chondrosarcoma Th12 underwent Th11-12 laminectomy with the removal of an extratradural extramedullary tumor located on the anterior surface of the dural sac. Contrast-enhanced magnetic resonance imaging revealed a residual tumor two months post-surgery, accompanied by a clinical progression. The relapsed tumor bed was irradiated in a single dose of 9 Gy daily to a total dose of 45 Gy (116 Gy). Five months after the initiation of radiotherapy, a clinical improvement was observed, as evidenced by a decrease in pain on a visual analog scale. Furthermore, the dose of opioid analgesics was reduced. Objectively, based on magnetic resonance imaging findings, the disease stabilized. At the 13-month follow-up, a decrease in the lesion size was documented. CONCLUSIONS: Stereotactic radiotherapy for residual tumor following chondrosarcoma surgery has been demonstrated to stabilize the patient’s overall condition, reduce the necessity for opioid analgesics, enhance the patient’s quality of life, achieve partial regression of the tumor, and attain long-term disease remission.