Mini Review

Stereotactic radiotherapy for intramedullary spinal lesions


Yoshimasa Mori

Center for Advanced IGRT, Shin Yurigaoka General Hospital, Kanagawa, Japan


Abstract


The role of stereotactic radiotherapy (SRT) for intramedullary spinal lesions was reviewed. Intramedullary spinal vascular disorders include arteriovenous malformation (AVM) and cavernous malformation (CM). Neoplasms include hemangioblastoma, gliomas (i.e., ependymoma and astrocytoma), lymphoma, and metastases. Some studies including ours have reported favorable treatment results in AVMs, though the patient numbers in each study were small. Regarding CMs, there have been no reports showing treatment results of SRT. SRT even for brain CMs is controversial. In contrast, not a few reports have been published showing good results of surgical resection. Some studies including ours have reported good results of small isolated intramedullary spinal metastases treated by SRT. Some papers have reported good results of SRT for hemangioblastoma. Though good results have been published showing surgical resection, SRT may be a good option for small hemangioblastoma in certain situations as well. Intensity-modulated radiation therapy with a wide field including peritumoral margin area, other than small localized field SRT, is thought to be better for infiltrating gliomas and lymphomas.

Keywords: arteriovenous malformation; ependymoma; glioma; hemangioblastoma; metastasis