Intradural extramedullary benign spinal lesions radiosurgery. Medium- to long-term results from a single institution experience

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Surgery represents the first-choice treatment for spinal intradural tumours. On the other hand, whether it is most appropriate in the setting of recurrences, residual or multiple lesions remains an open question. Moreover, some patients are less than ideal candidates for surgery. In this study we report about our own radiosurgery experience in the treatment of benign intradural extramedullary tumours of the spine. Methods: In our study we analyzed the outcomes for 18 patients (21 lesions) treated for benign intradural extramedullary lesions, with a minimum follow-up period of 32 months. The lesions included 11 meningiomas, 9 schwannomas and 1 neurofibroma. Results: The mean follow-up was 43 months (32-73 months). The median tumour volume was 2 cc (0.2-17.7 cc). Eleven lesions underwent single-fraction treatment (mean prescribed dose ranging from 10 to 13 Gy). The others received a multisession radiosurgery treatment (4-6 fractions) with a mean prescription dose ranging from 18.5 to 25 Gy. The maximum dose to the spinal cord ranged from 9.2 to 26 Gy. During the follow-up period, none of the lesions showed radiological evidence of progression. Neurological status was preserved or improved and no permanent sequelae were observed. Significant and durable pain relief was observed. Conclusions: Although surgical excision remains the primary treatment option for most intradural tumours, radiosurgery offers a real alternative therapeutic modality, especially in case of recurrent and residual lesions or when surgery is contraindicated.

Original languageEnglish
Pages (from-to)1215-1222
Number of pages8
JournalActa Neurochirurgica
Volume155
Issue number7
DOIs
Publication statusPublished - Jul 2013

Fingerprint

Radiosurgery
Therapeutics
Neurofibroma
Neoplasms
Neurilemmoma
Meningioma
Tumor Burden
Prescriptions
Spinal Cord
Spine
Outcome Assessment (Health Care)
Recurrence
Pain

Keywords

  • Cyberknife
  • Hypofractioned radiotherapy
  • Meningiomas
  • Neurinomas
  • Neurofibromas
  • Radiosurgery
  • Spine

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

@article{b92feb1b8efe4f56acc123b17917e2de,
title = "Intradural extramedullary benign spinal lesions radiosurgery. Medium- to long-term results from a single institution experience",
abstract = "Background: Surgery represents the first-choice treatment for spinal intradural tumours. On the other hand, whether it is most appropriate in the setting of recurrences, residual or multiple lesions remains an open question. Moreover, some patients are less than ideal candidates for surgery. In this study we report about our own radiosurgery experience in the treatment of benign intradural extramedullary tumours of the spine. Methods: In our study we analyzed the outcomes for 18 patients (21 lesions) treated for benign intradural extramedullary lesions, with a minimum follow-up period of 32 months. The lesions included 11 meningiomas, 9 schwannomas and 1 neurofibroma. Results: The mean follow-up was 43 months (32-73 months). The median tumour volume was 2 cc (0.2-17.7 cc). Eleven lesions underwent single-fraction treatment (mean prescribed dose ranging from 10 to 13 Gy). The others received a multisession radiosurgery treatment (4-6 fractions) with a mean prescription dose ranging from 18.5 to 25 Gy. The maximum dose to the spinal cord ranged from 9.2 to 26 Gy. During the follow-up period, none of the lesions showed radiological evidence of progression. Neurological status was preserved or improved and no permanent sequelae were observed. Significant and durable pain relief was observed. Conclusions: Although surgical excision remains the primary treatment option for most intradural tumours, radiosurgery offers a real alternative therapeutic modality, especially in case of recurrent and residual lesions or when surgery is contraindicated.",
keywords = "Cyberknife, Hypofractioned radiotherapy, Meningiomas, Neurinomas, Neurofibromas, Radiosurgery, Spine",
author = "Marcello Marchetti and {De Martin}, Elena and Ida Milanesi and Laura Fariselli",
year = "2013",
month = "7",
doi = "10.1007/s00701-013-1756-3",
language = "English",
volume = "155",
pages = "1215--1222",
journal = "Acta Neurochirurgica",
issn = "0001-6268",
publisher = "Springer Wien",
number = "7",

}

TY - JOUR

T1 - Intradural extramedullary benign spinal lesions radiosurgery. Medium- to long-term results from a single institution experience

AU - Marchetti, Marcello

AU - De Martin, Elena

AU - Milanesi, Ida

AU - Fariselli, Laura

PY - 2013/7

Y1 - 2013/7

N2 - Background: Surgery represents the first-choice treatment for spinal intradural tumours. On the other hand, whether it is most appropriate in the setting of recurrences, residual or multiple lesions remains an open question. Moreover, some patients are less than ideal candidates for surgery. In this study we report about our own radiosurgery experience in the treatment of benign intradural extramedullary tumours of the spine. Methods: In our study we analyzed the outcomes for 18 patients (21 lesions) treated for benign intradural extramedullary lesions, with a minimum follow-up period of 32 months. The lesions included 11 meningiomas, 9 schwannomas and 1 neurofibroma. Results: The mean follow-up was 43 months (32-73 months). The median tumour volume was 2 cc (0.2-17.7 cc). Eleven lesions underwent single-fraction treatment (mean prescribed dose ranging from 10 to 13 Gy). The others received a multisession radiosurgery treatment (4-6 fractions) with a mean prescription dose ranging from 18.5 to 25 Gy. The maximum dose to the spinal cord ranged from 9.2 to 26 Gy. During the follow-up period, none of the lesions showed radiological evidence of progression. Neurological status was preserved or improved and no permanent sequelae were observed. Significant and durable pain relief was observed. Conclusions: Although surgical excision remains the primary treatment option for most intradural tumours, radiosurgery offers a real alternative therapeutic modality, especially in case of recurrent and residual lesions or when surgery is contraindicated.

AB - Background: Surgery represents the first-choice treatment for spinal intradural tumours. On the other hand, whether it is most appropriate in the setting of recurrences, residual or multiple lesions remains an open question. Moreover, some patients are less than ideal candidates for surgery. In this study we report about our own radiosurgery experience in the treatment of benign intradural extramedullary tumours of the spine. Methods: In our study we analyzed the outcomes for 18 patients (21 lesions) treated for benign intradural extramedullary lesions, with a minimum follow-up period of 32 months. The lesions included 11 meningiomas, 9 schwannomas and 1 neurofibroma. Results: The mean follow-up was 43 months (32-73 months). The median tumour volume was 2 cc (0.2-17.7 cc). Eleven lesions underwent single-fraction treatment (mean prescribed dose ranging from 10 to 13 Gy). The others received a multisession radiosurgery treatment (4-6 fractions) with a mean prescription dose ranging from 18.5 to 25 Gy. The maximum dose to the spinal cord ranged from 9.2 to 26 Gy. During the follow-up period, none of the lesions showed radiological evidence of progression. Neurological status was preserved or improved and no permanent sequelae were observed. Significant and durable pain relief was observed. Conclusions: Although surgical excision remains the primary treatment option for most intradural tumours, radiosurgery offers a real alternative therapeutic modality, especially in case of recurrent and residual lesions or when surgery is contraindicated.

KW - Cyberknife

KW - Hypofractioned radiotherapy

KW - Meningiomas

KW - Neurinomas

KW - Neurofibromas

KW - Radiosurgery

KW - Spine

UR - http://www.scopus.com/inward/record.url?scp=84879225688&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84879225688&partnerID=8YFLogxK

U2 - 10.1007/s00701-013-1756-3

DO - 10.1007/s00701-013-1756-3

M3 - Article

C2 - 23686634

AN - SCOPUS:84879225688

VL - 155

SP - 1215

EP - 1222

JO - Acta Neurochirurgica

JF - Acta Neurochirurgica

SN - 0001-6268

IS - 7

ER -