CyberKnife Radiosurgery for Benign Intradural Extramedullary Spinal Tumors
| Autor: | Mi-Ryeong Ryu, Steven D. Chang, Iris C. Gibbs, Pimkhuan Kamnerdsupaphon, John R. Adler, Robert L. Dodd |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Schwannoma Radiosurgery Meningioma Myelopathy Cyberknife medicine Humans Neurofibroma Prospective Studies Spinal Cord Neoplasms Neurofibromatosis Child Aged Aged 80 and over business.industry Middle Aged medicine.disease Surgery Radiography Female Neurology (clinical) CyberKnife Radiosurgery business Follow-Up Studies |
| Zdroj: | Neurosurgery. 58:674-685 |
| ISSN: | 0148-396X |
| DOI: | 10.1227/01.neu.0000204128.84742.8f |
| Popis: | Objective Microsurgical resection of benign intradural extramedullary spinal tumors is generally safe and successful, but patients with neurofibromatosis, recurrent tumors, multiple lesions, or medical problems that place them at higher surgical risk may benefit from alternatives to surgery. In this prospective study, we analyzed our preliminary experience with image-guided radiosurgical ablation of selected benign spinal neoplasms. Methods Since 1999, CyberKnife (Accuray, Inc., Sunnyvale, CA) radiosurgery was used to manage 51 patients (median age, 46 yr; range, 12-86 yr) with 55 benign spinal tumors (30 schwannomas, nine neurofibromas, 16 meningiomas) at Stanford University Medical Center. Total treatment doses ranged from 1600 to 3000 cGy delivered in consecutive daily sessions (1-5) to tumor volumes that varied from 0.136 to 24.6 cm. Results Less than 1 year postradiosurgery, three of the 51 patients in this series (one meningioma, one schwannoma, and one neurofibroma) required surgical resection of their tumor because of persistent or worsening symptoms; only one of these lesions was larger radiographically. However, 28 of the 51 patients now have greater than 24 months clinical and radiographic follow-up. After a mean follow-up of 36 months, all of these later lesions were either stable (61%) or smaller (39%). Two patients died from unrelated causes. Radiation-induced myelopathy appeared 8 months postradiosurgery in one patient. Conclusion Although more patients studied over an even longer follow-up period are needed to determine the long-term efficacy of spinal radiosurgery for benign extra-axial neoplasms, short-term clinical benefits were observed in this prospective analysis. The present study demonstrates that CyberKnife radiosurgical ablation of such tumors is technically feasible and associated with low morbidity. |
| Databáze: | OpenAIRE |
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