Spinal lesions treated with Novalis shaped beam intensity-modulated radiosurgery and stereotactic radiotherapy

Antonio A F De Salles, Alessandra G. Pedroso, Paul Medin, Nzhde Agazaryan, Timothy Solberg, Cynthia Cabatan-Awang, Dulce M. Espinosa, Judith Ford, Michael T. Selch

Research output: Contribution to journalArticle

87 Citations (Scopus)

Abstract

Object. Spinal radiosurgery was implemented to improve quality of life (QOL) in patients with malignancies. It may also be applicable to the treatment of benign lesions. Methods. Between July 2002 and January 2004, 14 patients harboring 22 lesions were treated; 13 received single-dose stereotactic radiosurgery. Six were women. The mean age was 60.2 years (range 48-82 years). There were 11 metastases, two neurofibromas, and one meningioma. Six lesions were cervical, 10 thoracic, and six lumbar. Ten patients suffered pain, three paresthesias, two weakness, and three were asymptomatic. Seven patients underwent spinal surgery, with four receiving instrumentation. Twelve patients underwent conventional irradiation before stereotactic radiosurgery/stereotactic radiotherapy. A mean dose of 12 ± 2.7 Gy (range 8-21 Gy) was prescribed to the 91% isodose line (range 85-97%). The mean tumor volume was 25 ± 27.1 ml (range 0.75-91.8 ml). Treatment was planned using intensity-modulated radiosurgery (IMRS) fields in 15 cases, dynamic arcs in five, and conformal beams in two. The mean follow-up period was 6.1 ± 3.9 months (range 1-16 months). Three patients became pain free and four experienced considerable relief. Weakness improved in the two patients with this preoperative symptom and the asymptomatic patients remained so. Four lesions decreased in size, five remained stable, seven progressed, and six were not followed up (two patients died before follow up). Four patients in all died, three of systemic disease and one of thoracic lesion progression. No complications due to shaped beam and IMRS/intensity-modulated radiotherapy (IMRT) techniques were observed. Conclusions. Shaped beam and IMRS/IMRT involving the Novalis system may delay neurological deterioration, improving QOL. The lack of complication suggests that higher doses can be delivered to improve the control rate in patients with metastases.

Original languageEnglish (US)
Pages (from-to)435-440
Number of pages6
JournalJournal of Neurosurgery
Volume101
Issue numberSUPPL. 3
StatePublished - Nov 2004

Fingerprint

Radiosurgery
Radiotherapy
Intensity-Modulated Radiotherapy
Quality of Life
Thoracic Diseases
Neoplasm Metastasis
Neurofibroma
Paresthesia
Meningioma
Tumor Burden
Thorax
Pain

Keywords

  • Image-guided surgery
  • Meningioma
  • Metastasis
  • Neuroma
  • Radiation treatment
  • Radiosurgery
  • Spine

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

De Salles, A. A. F., Pedroso, A. G., Medin, P., Agazaryan, N., Solberg, T., Cabatan-Awang, C., ... Selch, M. T. (2004). Spinal lesions treated with Novalis shaped beam intensity-modulated radiosurgery and stereotactic radiotherapy. Journal of Neurosurgery, 101(SUPPL. 3), 435-440.

Spinal lesions treated with Novalis shaped beam intensity-modulated radiosurgery and stereotactic radiotherapy. / De Salles, Antonio A F; Pedroso, Alessandra G.; Medin, Paul; Agazaryan, Nzhde; Solberg, Timothy; Cabatan-Awang, Cynthia; Espinosa, Dulce M.; Ford, Judith; Selch, Michael T.

In: Journal of Neurosurgery, Vol. 101, No. SUPPL. 3, 11.2004, p. 435-440.

Research output: Contribution to journalArticle

De Salles, AAF, Pedroso, AG, Medin, P, Agazaryan, N, Solberg, T, Cabatan-Awang, C, Espinosa, DM, Ford, J & Selch, MT 2004, 'Spinal lesions treated with Novalis shaped beam intensity-modulated radiosurgery and stereotactic radiotherapy', Journal of Neurosurgery, vol. 101, no. SUPPL. 3, pp. 435-440.
De Salles AAF, Pedroso AG, Medin P, Agazaryan N, Solberg T, Cabatan-Awang C et al. Spinal lesions treated with Novalis shaped beam intensity-modulated radiosurgery and stereotactic radiotherapy. Journal of Neurosurgery. 2004 Nov;101(SUPPL. 3):435-440.
De Salles, Antonio A F ; Pedroso, Alessandra G. ; Medin, Paul ; Agazaryan, Nzhde ; Solberg, Timothy ; Cabatan-Awang, Cynthia ; Espinosa, Dulce M. ; Ford, Judith ; Selch, Michael T. / Spinal lesions treated with Novalis shaped beam intensity-modulated radiosurgery and stereotactic radiotherapy. In: Journal of Neurosurgery. 2004 ; Vol. 101, No. SUPPL. 3. pp. 435-440.
@article{0c2f8d2586fd4d15a1e31caea9b819b5,
title = "Spinal lesions treated with Novalis shaped beam intensity-modulated radiosurgery and stereotactic radiotherapy",
abstract = "Object. Spinal radiosurgery was implemented to improve quality of life (QOL) in patients with malignancies. It may also be applicable to the treatment of benign lesions. Methods. Between July 2002 and January 2004, 14 patients harboring 22 lesions were treated; 13 received single-dose stereotactic radiosurgery. Six were women. The mean age was 60.2 years (range 48-82 years). There were 11 metastases, two neurofibromas, and one meningioma. Six lesions were cervical, 10 thoracic, and six lumbar. Ten patients suffered pain, three paresthesias, two weakness, and three were asymptomatic. Seven patients underwent spinal surgery, with four receiving instrumentation. Twelve patients underwent conventional irradiation before stereotactic radiosurgery/stereotactic radiotherapy. A mean dose of 12 ± 2.7 Gy (range 8-21 Gy) was prescribed to the 91{\%} isodose line (range 85-97{\%}). The mean tumor volume was 25 ± 27.1 ml (range 0.75-91.8 ml). Treatment was planned using intensity-modulated radiosurgery (IMRS) fields in 15 cases, dynamic arcs in five, and conformal beams in two. The mean follow-up period was 6.1 ± 3.9 months (range 1-16 months). Three patients became pain free and four experienced considerable relief. Weakness improved in the two patients with this preoperative symptom and the asymptomatic patients remained so. Four lesions decreased in size, five remained stable, seven progressed, and six were not followed up (two patients died before follow up). Four patients in all died, three of systemic disease and one of thoracic lesion progression. No complications due to shaped beam and IMRS/intensity-modulated radiotherapy (IMRT) techniques were observed. Conclusions. Shaped beam and IMRS/IMRT involving the Novalis system may delay neurological deterioration, improving QOL. The lack of complication suggests that higher doses can be delivered to improve the control rate in patients with metastases.",
keywords = "Image-guided surgery, Meningioma, Metastasis, Neuroma, Radiation treatment, Radiosurgery, Spine",
author = "{De Salles}, {Antonio A F} and Pedroso, {Alessandra G.} and Paul Medin and Nzhde Agazaryan and Timothy Solberg and Cynthia Cabatan-Awang and Espinosa, {Dulce M.} and Judith Ford and Selch, {Michael T.}",
year = "2004",
month = "11",
language = "English (US)",
volume = "101",
pages = "435--440",
journal = "Journal of Neurosurgery",
issn = "0022-3085",
publisher = "American Association of Neurological Surgeons",
number = "SUPPL. 3",

}

TY - JOUR

T1 - Spinal lesions treated with Novalis shaped beam intensity-modulated radiosurgery and stereotactic radiotherapy

AU - De Salles, Antonio A F

AU - Pedroso, Alessandra G.

AU - Medin, Paul

AU - Agazaryan, Nzhde

AU - Solberg, Timothy

AU - Cabatan-Awang, Cynthia

AU - Espinosa, Dulce M.

AU - Ford, Judith

AU - Selch, Michael T.

PY - 2004/11

Y1 - 2004/11

N2 - Object. Spinal radiosurgery was implemented to improve quality of life (QOL) in patients with malignancies. It may also be applicable to the treatment of benign lesions. Methods. Between July 2002 and January 2004, 14 patients harboring 22 lesions were treated; 13 received single-dose stereotactic radiosurgery. Six were women. The mean age was 60.2 years (range 48-82 years). There were 11 metastases, two neurofibromas, and one meningioma. Six lesions were cervical, 10 thoracic, and six lumbar. Ten patients suffered pain, three paresthesias, two weakness, and three were asymptomatic. Seven patients underwent spinal surgery, with four receiving instrumentation. Twelve patients underwent conventional irradiation before stereotactic radiosurgery/stereotactic radiotherapy. A mean dose of 12 ± 2.7 Gy (range 8-21 Gy) was prescribed to the 91% isodose line (range 85-97%). The mean tumor volume was 25 ± 27.1 ml (range 0.75-91.8 ml). Treatment was planned using intensity-modulated radiosurgery (IMRS) fields in 15 cases, dynamic arcs in five, and conformal beams in two. The mean follow-up period was 6.1 ± 3.9 months (range 1-16 months). Three patients became pain free and four experienced considerable relief. Weakness improved in the two patients with this preoperative symptom and the asymptomatic patients remained so. Four lesions decreased in size, five remained stable, seven progressed, and six were not followed up (two patients died before follow up). Four patients in all died, three of systemic disease and one of thoracic lesion progression. No complications due to shaped beam and IMRS/intensity-modulated radiotherapy (IMRT) techniques were observed. Conclusions. Shaped beam and IMRS/IMRT involving the Novalis system may delay neurological deterioration, improving QOL. The lack of complication suggests that higher doses can be delivered to improve the control rate in patients with metastases.

AB - Object. Spinal radiosurgery was implemented to improve quality of life (QOL) in patients with malignancies. It may also be applicable to the treatment of benign lesions. Methods. Between July 2002 and January 2004, 14 patients harboring 22 lesions were treated; 13 received single-dose stereotactic radiosurgery. Six were women. The mean age was 60.2 years (range 48-82 years). There were 11 metastases, two neurofibromas, and one meningioma. Six lesions were cervical, 10 thoracic, and six lumbar. Ten patients suffered pain, three paresthesias, two weakness, and three were asymptomatic. Seven patients underwent spinal surgery, with four receiving instrumentation. Twelve patients underwent conventional irradiation before stereotactic radiosurgery/stereotactic radiotherapy. A mean dose of 12 ± 2.7 Gy (range 8-21 Gy) was prescribed to the 91% isodose line (range 85-97%). The mean tumor volume was 25 ± 27.1 ml (range 0.75-91.8 ml). Treatment was planned using intensity-modulated radiosurgery (IMRS) fields in 15 cases, dynamic arcs in five, and conformal beams in two. The mean follow-up period was 6.1 ± 3.9 months (range 1-16 months). Three patients became pain free and four experienced considerable relief. Weakness improved in the two patients with this preoperative symptom and the asymptomatic patients remained so. Four lesions decreased in size, five remained stable, seven progressed, and six were not followed up (two patients died before follow up). Four patients in all died, three of systemic disease and one of thoracic lesion progression. No complications due to shaped beam and IMRS/intensity-modulated radiotherapy (IMRT) techniques were observed. Conclusions. Shaped beam and IMRS/IMRT involving the Novalis system may delay neurological deterioration, improving QOL. The lack of complication suggests that higher doses can be delivered to improve the control rate in patients with metastases.

KW - Image-guided surgery

KW - Meningioma

KW - Metastasis

KW - Neuroma

KW - Radiation treatment

KW - Radiosurgery

KW - Spine

UR - http://www.scopus.com/inward/record.url?scp=7244223298&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=7244223298&partnerID=8YFLogxK

M3 - Article

C2 - 15537201

AN - SCOPUS:7244223298

VL - 101

SP - 435

EP - 440

JO - Journal of Neurosurgery

JF - Journal of Neurosurgery

SN - 0022-3085

IS - SUPPL. 3

ER -