Stereotactic Radiation for Treating Primary and Metastatic Neoplasms of the Spinal Cord

Abstract

Stereotactic radiation treatment can be used to treat spinal cord neoplasms in patients with either unresectable lesions or residual disease after surgical resection. While treatment guidelines have been suggested for epidural lesions, the utility of stereotactic radiation for intradural and intramedullary malignancies is still debated. Prior reports have suggested that stereotactic radiation approaches can be used for effective tumor control and symptom management. Treatment-related toxicity has been documented in rare subsets of patients, though the incidences of injury are not directly correlated with higher radiation doses. Further studies are needed to assess the factors that influence the risk of radiation-induced myelopathy when treating spinal cord neoplasms with stereotactic radiation, which can include, but may not be limited to, maximum dose, dose-fractionation, irradiated volume, tumor location, histology and treatment history. This review will discuss evidence for current treatment approaches.

Image-Guided Robotic Radiosurgery for the Management of Spinal Ependymomas

“…In patients with poor Karnofsky Performance Status (KPS), tumor relapses, widespread disease, and multiple spinal lesions, surgery and conventional radiotherapy may not be repeatable or feasible ( 1 , 2 ). Stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) may be salvage treatment options and help to stop local tumor progression - at least temporarily ( 9 – 11 ). Information on the treatment outcomes after SRS and SBRT for ependymal tumor lesions are scarce, especially concerning spinal ependymomas and robotic radiosurgery (RRS) ( 10 , 12 , 13 ).…”