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Long-Term Update of Stereotactic Radiosurgery for Benign Spinal Tumors
- Source :
- Neurosurgery. 85:708-716
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- Background Stereotactic radiosurgery (SRS) for benign intracranial tumors is an established standard of care. The widespread implementation of SRS for benign spinal tumors has been limited by lack of long-term data. Objective To update our institutional experience of safety and efficacy outcomes after SRS for benign spinal tumors. Methods We performed a retrospective cohort study of 120 patients with 149 benign spinal tumors (39 meningiomas, 26 neurofibromas, and 84 schwannomas) treated with SRS between 1999 and 2016, with follow-up magnetic resonance imaging available for review. The primary endpoint was the cumulative incidence of local failure (LF), with death as a competing risk. Secondary endpoints included tumor shrinkage, symptom response, toxicity, and secondary malignancy. Results Median follow-up was 49 mo (interquartile range: 25-103 mo, range: 3-216 mo), including 61 courses with >5 yr and 24 courses with >10 yr of follow-up. We observed 9 LF for a cumulative incidence of LF of 2%, 5%, and 12% at 3, 5, and 10 yr, respectively. Excluding 10 tumors that were previously irradiated or that arose within a previously irradiated field, the 3-, 5-, and 10-yr cumulative incidence rates of LF were 1%, 2%, and 8%, respectively. At last follow-up, 35% of all lesions had decreased in size. With a total of 776 patient-years of follow-up, no SRS-related secondary malignancies were observed. Conclusion Comparable to SRS for benign intracranial tumors, SRS provides longer term local control of benign spinal tumors and is a standard-of-care alternative to surgical resection.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Schwannoma
Radiosurgery
Cohort Studies
Meningioma
03 medical and health sciences
0302 clinical medicine
Interquartile range
parasitic diseases
Humans
Medicine
Neurofibroma
Cumulative incidence
Spinal Cord Neoplasms
Aged
Retrospective Studies
Aged, 80 and over
medicine.diagnostic_test
business.industry
Incidence
Retrospective cohort study
Magnetic resonance imaging
Middle Aged
medicine.disease
Treatment Outcome
030220 oncology & carcinogenesis
Female
Surgery
Neurology (clinical)
Radiology
Neoplasm Recurrence, Local
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15244040 and 0148396X
- Volume :
- 85
- Database :
- OpenAIRE
- Journal :
- Neurosurgery
- Accession number :
- edsair.doi.dedup.....0a60f8129e4c54fabd040043d7392d40