Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, Florida, USA.
Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA.
Neuro Oncol. 2019 Jun 10;21(6):707-718. doi: 10.1093/neuonc/noz014.
Primary spinal cord tumors represent a hetereogeneous group of central nervous system malignancies whose management is complex given the relatively uncommon nature of the disease and variety of tumor subtypes, functional neurologic deficits from the tumor, and potential morbidities associated with definitive treatment. Advances in neuroimaging; integration of diagnostic, prognostic, and predictive molecular testing into tumor classification; and developments in neurosurgical techniques have refined the current role of radiotherapy in the multimodal management of patients with primary spinal cord tumors, and corroborated the need for prospective, multidisciplinary discussion and treatment decision making. Radiotherapeutic technological advances have dramatically improved the entire continuum from treatment planning to treatment delivery, and the development of stereotactic radiosurgery and proton radiotherapy provides new radiotherapy options for patients treated in the definitive, adjuvant, or salvage setting. The objective of this comprehensive review is to provide a contemporary overview of the management of primary intradural spinal cord tumors, with a focus on radiotherapy.
原发性脊髓肿瘤是一组异质性中枢神经系统恶性肿瘤，由于疾病相对罕见、肿瘤亚型多样、肿瘤引起的功能性神经功能缺损以及与确定性治疗相关的潜在发病率，其治疗较为复杂。神经影像学的进步；将诊断、预后和预测性分子检测纳入肿瘤分类；以及神经外科技术的发展，使放射治疗在原发性脊髓肿瘤的多模态管理中的作用得到了精细化，并证实了需要进行前瞻性的、多学科的讨论和治疗决策。放射治疗技术的进步极大地改善了从治疗计划到治疗实施的整个过程，立体定向放射外科和质子放疗的发展为确定性、辅助性或挽救性治疗的患者提供了新的放疗选择。本综述的目的是提供原发性硬脊膜内脊髓肿瘤治疗的现代概述，重点是放射治疗。
