Photon- and Proton-Beam Radiotherapy in the Treatment of Spine Tumors
Over the last 30 yr, the treatment of primary and metastatic tumors of the cervical, thoracic, and lumbar spine has evolved dramatically. In the case of primary tumors of the spine, advances in neoadjuvant treatments and instrumentation techniques have offered patients with previously inoperable disease new options with reasonable chances of cure. When the overall morbidity of radical resection makes it a poor treatment option, radiation therapy can be combined with more conservative surgical procedures or can be used in lieu of surgery for palliation, or even cure in some instances. With new advances in radiotherapy techniques, greater doses of radiation (often tumorocidal doses) can be administered to the majority of tumor volume with fewer effects on the surrounding structures and, most particularly, minimal risk to the spinal cord. It is imperative for the clinician and surgeon to be familiar with these new techniques so that the care of their patients can be optimized, with the highest potential for long-term survival and reduced morbidity.
KeywordsDose Distribution Proton Beam Radiat Oncol Biol Phys Giant Cell Tumor Proton Therapy
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- 2.Kepka L, Suit HD, Goldberg SI, et al. Radiation therapy for control of soft tissue sarcomas resected with positive margins. Connective Tissue Oncology Society Meeting, Montreal, Canada, November, 2004.Google Scholar
- 3.DeLaney T, Kepka L, Goldberg S, Suit H. Results of radiation therapy for unresected soft tissue sarcomas. ESTRO meeting, Amsterdam, October 2004.Google Scholar
- 9.Regine WF, Tibbs PA, Young A, et al. Metastatic spinal cord compression: a randomized trial of direct decompressive surgical resection plus radiotherapy vs. radiotherapy alone. Int J Radiat Oncol Biol Phys 2004; 57:S125.Google Scholar
- 30.Lin R, Hug EB, Schaefer RA, Miller DW, Slater JM, Slater JD. Conformal proton radiation therapy of the posterior fossa: a study comparing protons with three-dimensional planned photons in limiting dose to auditory structures. Int J Radiat Oncol Biol Phys 2000; 48:1219–1226.PubMedCrossRefGoogle Scholar
- 31.Mirabell R, Lomax A, Bortfeld T, Rouzand M, Carrie C. Potential role of proton therapy in the treatment of pediatric medulloblastoma/ primitive neruo-ectodermal tumors: reduction of the supratentorial target volume. Int J Radiat Oncol Biol Phys 1997; 38:477–484.Google Scholar
- 36b.Smith AR, Loeffler JS, Suit HD. The potential for proton beam therapy to improve clinical outcomes: comparisons of proton and x-ray treatment plans for the purpose of tumor dose escalation and/or reduction of treatment-related mobidity. Int J Radiat Oncol Biol Phys 2000; 48:338.Google Scholar
- 40.Spiro IJ, Smith AR, Lomax A, Loeffler JS: Proton beam radiation therapy. In: DeVita VT, Hellman S, Rosenberg SA eds. Cancer: Principles and Practice of Oncology. Philadelphia, PA: Lippincott Williams and Wilkins; 2001:3229–3235.Google Scholar
- 41.DeLaney TF, Smith AR, Lomax A, Adams J, Loeffler JS. Proton Beam Radiation Therapy. Principles and Practice of Oncology Updates 2003; 17:1–10.Google Scholar