The use of stereotactic radiosurgery for benign spinal tumors: single institution experience

• Published in: Journal of radiation oncology Vol. 7; no. 2; pp. 157 - 165
• Main Authors: Boyce-Fappiano, David, Elibe, Erinma, Salim Siddiqui, M., Lee, Ian, Rock, Jack, Siddiqui, Farzan
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-06-2018; Springer Nature B.V
• Subjects: Biopsy; Bone cancer; Cancer Research; Control methods; Electronic health records; Imaging; Lesions; Medicine; Medicine & Public Health; Oncology; Original Research; Pain; Patients; Radiology; Radiotherapy; Spinal cancer; Spinal cord; Spine; Surgery; Surgical Oncology; Tumors; Stereotactic body radiation therapy; Spine; SRS; Benign; Radiosurgery; SBRT; Tumors
• ISSN: 1948-7894; 1948-7908
• DOI: 10.1007/s13566-018-0345-8

Objective
Benign tumors of the spine pose unique challenges as they are typically located in proximity to the spinal cord and are relatively radio-resistant. Surgery is usually the first line of treatment, but recurrence can be common. Stereotactic radiosurgery (SRS) is an effective treatment for malignant spine lesions. However, patients with benign tumors generally have longer life expectancies and may develop long-term treatment side-effects. Our institutional experience in treating benign tumors with SRS is presented to display its utility for symptom and local control.
Methods
A retrospective cohort analysis was performed at a single institution between 2001 and 2013. A total of 26 patients (61 vertebral levels) with benign spine tumors were treated. Electronic medical records were queried for clinical, neurological, and radiological examinations. Post-treatment pain, neurological, and radiographic control were the primary endpoints of this study.
Results
Five patients (19.2%) were deceased with a median survival time of 16.9 months. Follow-up to evaluate pain response was available for 23 (88%), neurological for 20 (77%), and radiographic for 23 patients (88%). Median follow-up time was 15.5 months. Total pain response was 82.6%. Neurological improvement and radiographic control were noted in 75 and 87% of patients. One case of radionecrosis of the sacrum and one case of axillary numbness were observed.
Conclusion
The results of SRS for benign tumors of the spine appear to be promising, and as a result SRS may have a role in treating benign spinal tumors for patients who are not surgical candidates.