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.
Highlights
Intradural lesions, which can be further divided into extramedullary (IDEM) and intramedullary (IM), account for 30% of all spinal cord neoplasms [1]
Spinal metastases are seen in 40% of patients with cancer and are often associated with cerebrospinal fluid (CSF) dissemination, portending poor prognosis
Published reports of IDEM and IM metastases arise from a similar set of solid tumors, such as lung, breast, and renal cell carcinoma [21]
Summary
Intradural lesions, which can be further divided into extramedullary (IDEM) and intramedullary (IM), account for 30% of all spinal cord neoplasms [1]. Surgery is the preferred method for symptom relief and tumor control. The safety and efficacy of microsurgical techniques have been well-documented for a variety of spinal cord lesions [1,2,3,4,5]. Surgery is contraindicated by medical comorbidities, performance status, lesion location, or rapidly recurrent/progressive tumor. Gross total resection (GTR), which has been shown to drastically improve tumor outcomes, may not be attainable in all cases [6, 7]. In cases where GTR is unachievable, stereotactic radiotherapy (SRT), or, when treatment is delivered in a single dose, stereotactic radiosurgery (SRS) may be important clinical tools for symptom management and tumor control
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
