Dtsch Arztebl Int. 2009 Feb;106(7):106-12. Epub 2009 Feb 13.
Radiosurgery for spinal malignant tumors.
Wowra B, Muacevic A, Zausinger S, Tonn JC.Europäisches CyberKnife Zentrum München-Grosshadern, München, Germany.
Radiosurgery is a special treatment method that employs highly focused
radiation to destroy tumors with high precision in a single session. A
broad base of scientific evidence already exists for the radiosurgical
treatment of brain metastases. Recent advances in medical technology
now allow radiosurgery to be extended to the spine as well.
Selective literature review based on a PubMed search using the search
terms stereotaxis, radiosurgery, stereotactic radiotherapy, accuracy,
quality assurance, spine, spine metastasis, pain, Novalis, CyberKnife,
Synergy, and robotics. We also present and analyze our own data as an
illustration of the application of spinal radiosurgery.
literature search identified 20 scientific original publications and
one recent review. The data indicate that, within the specific
constraints of the method, radiosurgery can arrest the growth of up to
96% of spinal metastases. Durable pain relief can be achieved in
patients with tumor-associated pain syndromes. The morbidity of spinal
radiosurgery is low, with a less than 1% risk of myelopathy.
CONCLUSIONS: Spinal radiosurgery is an independent, essentially
noninvasive method of treatment. Different types of radiosurgical
treatment apparatus are available. For properly selected patients,
radiosurgery offers a good chance of therapeutic success with
relatively rare complications.