Ryu Samuel, Biondo Andrew, Rock Jack, Gates Marilyn, Abdulhak Muwaffak
Department of Radiation Oncology Henry Ford Health System, Detroit, Michigan, USA.
Department of Neurosurgery Henry Ford Health System, Detroit, Michigan, USA.
J Radiosurg SBRT. 2013;2(2):127-133.
Spine radiosurgery requires accurate image-guided stereotactic targeting and intensity-modulated radiation delivery. It can deliver a high radiation dose to spine and spinal cord tumors. The purpose of this study is to demonstrate the clinical effectiveness of radiosurgery for primary spine and cord tumors.
A total of 26 patients with 36 primary spine and cord tumors were treated with radiosurgery. There were 7 patients with spinal cord tumors, and 19 patients with primary spine tumors. Radiosurgery doses were single session of 12-18 Gy in 29 lesions, and fractionated in 6 lesions. Ten lesions were recurrent tumors after the initial therapy of combined surgery and radiation. Median follow-up was 12 months (range 2-42 months) with imaging studies and clinical examinations.
The patients' symptoms and neurological status improved in 56%, and was stable in 28% after radiosurgery. One-year local tumor control rate was 94 %; complete response in 26%, partial response in 26%, and stable in 42%. There were no acute or long-term complications.
This study demonstrates that spine radiosurgery is an effective treatment for symptom improvement and tumor control of primary spine and spinal cord tumors. Spine radiosurgery can be a viable and non-invasive treatment option for primary spine tumors.
脊柱放射外科手术需要精确的图像引导立体定向靶向和调强放射治疗。它可以向脊柱和脊髓肿瘤输送高剂量辐射。本研究的目的是证明放射外科手术对原发性脊柱和脊髓肿瘤的临床疗效。
共有26例患有36个原发性脊柱和脊髓肿瘤的患者接受了放射外科手术治疗。其中7例为脊髓肿瘤患者，19例为原发性脊柱肿瘤患者。29个病灶的放射外科手术剂量为单次12 - 18 Gy，6个病灶为分次照射。10个病灶是在初始手术和放疗联合治疗后的复发性肿瘤。通过影像学检查和临床检查进行随访，中位随访时间为12个月（范围2 - 42个月）。
放射外科手术后，56%的患者症状和神经状态改善，28%稳定。一年局部肿瘤控制率为94%；完全缓解率为26%，部分缓解率为26%，病情稳定率为42%。未出现急性或长期并发症。
本研究表明，脊柱放射外科手术是改善原发性脊柱和脊髓肿瘤症状及控制肿瘤的有效治疗方法。脊柱放射外科手术可以成为原发性脊柱肿瘤可行的非侵入性治疗选择。
