(Stereotactic) radiosurgery XIX: spinal radiosurgery - two year experience in a UK centre

Abstract Introduction. Modern radiotherapy image guidance enables the treatment of extracranial targets with the required accuracy for safe delivery of radiosurgical treatments. The first two years' experience of spinal radiosurgery in a UK radiotherapy centre is reported. Materials and methods...

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Bibliographic Details
Published in:British journal of neurosurgery 2012-02, Vol.26 (1), p.53-58
Main Authors: Martin, A.G.R., Cowley, I.R., Taylor, B.A., Cassoni, A.M., Landau, D.B., Plowman, P.N.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Back surgery
CyberKnife
Female
Humans
Male
Middle Aged
Pain management
Postoperative Complications - etiology
Radiation therapy
radiosurgery
Radiosurgery - adverse effects
Radiosurgery - methods
Radiotherapy Dosage
Spinal cord injuries
Spinal Neoplasms - secondary
Spinal Neoplasms - surgery
spinal tumour
spine
stereotactic body radiotherapy
Surgical outcomes
Treatment Outcome
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Summary:Abstract Introduction. Modern radiotherapy image guidance enables the treatment of extracranial targets with the required accuracy for safe delivery of radiosurgical treatments. The first two years' experience of spinal radiosurgery in a UK radiotherapy centre is reported. Materials and methods. Patients with primary or metastatic spinal lesions were treated using the CyberKnife stereotactic radiotherapy system. Xsight Spine (fiducial-free) tumour tracking software was used in all cases. Treatment was delivered using either a single or a three-fraction schedule, between February 2009 and March 2011. Results. Fifty-three spinal lesions were treated, comprising 14 primary lesions in 12 patients, and 39 metastases in 29 patients. The prescription dose ranged from 8 to 30 Gy in 1-3 fractions. Fifty-nine percent of patients experienced no acute side effects from treatment. There were three cases of acute grade 3 back or nerve root pain, all of which responded to a short course of oral corticosteroids. At a median follow-up of 11.1 months, local control and overall survival were 91 and 65%, respectively. Pain improvement was seen in 75% of symptomatic metastases at 6 months post treatment. Conclusions. Early UK experience confirms that radiosurgery is well tolerated with excellent local control rates. Longer-term prospective data are needed to clarify the role of spinal radiosurgery for patients in this country.
ISSN:0268-8697
1360-046X
DOI:10.3109/02688697.2011.603857