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Adult CNS Radiation Oncology pp 129–145Cite as

Astrocytic Tumors of the Spinal Cord

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Abstract

Primary spinal cord tumors are rare and account for 2–4% of all adult central nervous system tumors. Astrocytomas comprise approximately 6–8% of all spinal cord tumors. Tumor histology and grade are the most significant prognostic factors of primary spinal cord astrocytomas affecting overall survival.

MRI is the primary imaging modality used to diagnose intramedullary spinal tumors.

Achieving a good resection can be very difficult in spinal astrocytomas due to the involvement of the spinal cord itself. However, maximal safe surgical resection or biopsy is beneficial in diagnosing the patient and potentially providing symptom relief and improved outcomes.

Adjuvant radiation therapy is a useful yet controversial treatment modality in the treatment of spinal astrocytomas given the low rates of gross total resection. It is generally accepted to treat high-grade spinal astrocytomas with postoperative radiation therapy as well as in cases of subtotally resected grade II spinal astrocytomas. Whereas, resected spinal pilocytic astrocytomas and gross totally resected grade II spinal astrocytomas may be observed. The role and benefit of chemotherapy require additional studies; however, extracting from intracranial data, temozolomide and bevacizumab are commonly used, particularly in high-grade tumors.

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Abbreviations

2-D:

Two-dimensional

3-D:

Three-dimensional

AA:

Anaplastic astrocytoma

AP-PA:

Anterior/posterior-posterior/anterior

Cm:

Centimeters

CNS:

Central nervous system

CSF:

Cerebrospinal fluid

CT:

Computerized tomography

CTV:

Clinical target volume

CTx:

Chemotherapy

GBM:

Glioblastoma

GTV:

Gross tumor volume

HGA:

High-grade astrocytoma

IMRT:

Intensity-modulated radiation therapy

LGA:

Low-grade astrocytoma

MS:

Median survival

MV:

Megavoltage

NR:

Not reported

OS:

Overall survival

PCV:

Procarbazine, lomustine, and vincristine

PFS:

Progression-free survival

PTV:

Planning target volume

RFS:

Recurrence-free survival

RT:

Radiation therapy

RTOG:

Radiation Therapy Oncology Group

TD:

Tolerance dose

VEGF:

Vascular endothelial growth factor

WHO:

World Health Organization

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Authors and Affiliations

  1. Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, USA

    Tania Kaprealian

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  1. Tania Kaprealian
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Correspondence to Tania Kaprealian .

Editor information

Editors and Affiliations

  1. Department of Radiation Oncology, Keck School of Medicine of USC, Norris Cancer Hospital, Los Angeles, California, USA

    Eric L. Chang

  2. Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA

    Paul D. Brown

  3. Department of Radiation Oncology, University of Washington Medical Center, Seattle, Washington, USA

    Simon S. Lo

  4. Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

    Arjun Sahgal

  5. Department of Radiation Oncology, Taussig Cancer Institute Cleveland Clinic, Cleveland, Ohio, USA

    John H. Suh

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Kaprealian, T. (2018). Astrocytic Tumors of the Spinal Cord. In: Chang, E., Brown, P., Lo, S., Sahgal, A., Suh, J. (eds) Adult CNS Radiation Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-42878-9_9

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  • DOI: https://doi.org/10.1007/978-3-319-42878-9_9

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