Treatments for chordoma

The following are treatment options for chordoma. Your healthcare team will suggest treatments based on your needs and work with you to make a treatment plan.

Surgery

The following types of surgery may be done for chordoma.

Wide resection removes the bone tumour and a wide margin of normal bone and tissue around the tumour. This type of surgery is also called an en bloc resection.

Curettage uses a spoon-shaped tool with a sharp edge (a curette) to scrape a tumour out of the bone. This leaves a hole where the tumour was removed. Curettage may be used in an area where a wide resection can’t be done safely, like in the skull or spine.

Cryosurgery uses very cold liquid to kill cancer cells. It may be used after curettage to kill any cancer cells left behind.

Bone cement is a type of chemical called polymethyl methacrylate that may be used after curettage to fix the hole left in the bone. This special cement heats up as it hardens, so it kills remaining cancer cells. It may be used after curettage to treat some small, low-grade chordoma tumours.

Radiation therapy

External beam radiation therapy may be used to treat chordoma tumours that can’t be removed with surgery. It may also be used to destroy any cancer cells left behind after a wide resection or curettage.

Intensity-modulated radiation therapy (IMRT) delivers radiation to the tumour from many different angles. A higher dose can be given to chordoma that is found in the base of the skull or the spinal bones (vertebrae) with less damage to the tissues around the tumour.

Chemotherapy

Chemotherapy may be offered for chordoma if the cancer has spread into the surrounding tissues but cannot be removed by surgery, or if it has spread to other parts of the body.

The most common chemotherapy drugs used to treat chordoma include:

imatinib (Gleevec)
doxorubicin (Adriamycin)

The most common chemotherapy drug combinations used to treat chordoma are:

imatinib and cisplatin
doxorubicin and cisplatin

Clinical trials

Talk to your doctor about clinical trials for bone cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

Michael Monument, MD, MSc, FRCSC
Kim Tsoi, BASc, MD, PhD, FRCSC

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