Stereotactic body radiotherapy for benign spinal tumors: Meningiomas, schwannomas, and neurofibromas

Lindsay Hwang; Christian C Okoye; Ravi B Patel; Arjun Sahgal; Matthew Foote; Kristin J Redmond; Christoph Hofstetter; Rajiv Saigal; Mahmud Mossa-Basha; William Yuh; Nina A Mayr; Samuel T Chao; Eric L Chang; Simon S Lo

Stereotactic body radiotherapy for benign spinal tumors: Meningiomas, schwannomas, and neurofibromas

J Radiosurg SBRT. 2019;6(3):167-177.

Authors

Lindsay Hwang¹, Christian C Okoye², Ravi B Patel³, Arjun Sahgal⁴, Matthew Foote⁴, Kristin J Redmond⁵, Christoph Hofstetter⁶, Rajiv Saigal⁶, Mahmud Mossa-Basha⁷, William Yuh⁷, Nina A Mayr⁸, Samuel T Chao⁹, Eric L Chang¹⁰, Simon S Lo¹¹

Affiliations

¹ Department of Radiation Oncology, University of Southern California, Los Angeles, CA, USA.
² Department of Radiation Oncology, St. Bernards Cancer Center, Jonesboro, AR, USA.
³ Department of Human Oncology, University of Wisconsin, Madison, WI, USA.
⁴ Department of Radiation Oncology, Sunnybrook Health Science Centre, University of Toronto, 2075 Bayview Ave, Toronto, ON, Canada.
⁵ Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, 401 North Broadway, Suite 144, Baltimore, MD, USA.
⁶ Department of Neurological Surgery, University of Washington, Seattle, WA, USA.
⁷ Department of Radiology, University of Washington, Harborview Medical Center, 325 9th Ave, Box 359728, Seattle, WA, USA.
⁸ Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA, USA.
⁹ Department of Radiation Oncology, Cleveland Clinic, Lerner College of Medicine, 9500 Euclid Ave, CA-50, Cleveland, OH, USA.
¹⁰ Department of Radiation Oncology, Norris Cancer Center and Keck School of Medicine at University of Southern California, 1441 Eastlake Ave, NOR G356, Los Angeles, CA, USA.
¹¹ Department of Radiation Oncology, Princess Alexandra Hospital, University of Queensland, Woolloongabba, QLD, Australia.

PMID: 31998537
PMCID: PMC6774487

Abstract

Stereotactic body radiation therapy (SBRT) is a relatively new technology, and its use among patients with benign spinal tumors has limited prospective data. Similar to intracranial benign tumors treated successfully with SBRT, benign spinal tumors of the same histology can also develop, and SBRT may be an effective treatment alternative in inoperable or recurrent cases. Outcomes in patients with neurofibromatosis type 1, neurofibromatosis type 2, or schwannomatosis treated with SBRT have also been reported. Single institution reports have shown local control rates over 90% and improvement in clinical symptoms. The optimum dose and fractionation to maximize local control and minimize toxicity is unknown, with few incidences of radiation treatment-related toxicities. Given the location and benign nature of these tumors, careful management of dose to critical organs is essential. With continued follow-up, the optimum use of SBRT in patients with benign spinal tumors can be better defined.

Keywords: SBRT; benign tumor; neurofibroma; radiosurgery; schwannoma; spinal meningioma.

Publication types

Review