Abstract
Stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) have emerged over the last decade as effective and safe approaches to the treatment of tumors of the spine and spinal cord. In this chapter we describe one of the technologies that have been involved in the development of this treatment modality, the CyberKnife® System (Accuray Incorporated, Sunnyvale, CA, USA). We also briefly review its use in the treatment of spinal metastases, primary malignant and benign tumors, and intramedullary tumors. The precise radiation delivery capability of the CyberKnife makes it uniquely valuable in the re-irradiation of lesions that have recurred or progressed after conventional radiotherapy. Although optimal treatment doses and radiation tolerance of the spinal cord are not known with certainty, published outcomes have shown very high levels of tumor control, pain relief, and halting and reversal of neurological deficit after spinal SBRT.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Adler JR, Bath J, Chang SD et al. (1999) Image-guided neurosurgery using the optical tracking system (OTS). In: Warnick RE (ed) Procedure Technique, Series Radionics, pp 1–19
Castelli J, Thariat J, Benezery K, Padovani B, Ducreux D, Venissac N, Poudenx M, Otto J, Mouroux J, Bondiau PY (2008) Feasibility and efficacy of cyberknife radiotherapy for lung cancer: early results. Cancer Radiother 12(8): 793–799
Chang EL, Shiu AS, Mendel E, Mathews LA, Mahajan A, Allen PK, Weinberg JS, Brown BW, Wang XS, Woo SY, Cleeland C, Maor MH, Rhines LD (2007) Phase I/II study of stereotactic body radiotherapy for spinal metastasis and its pattern of failure. J Neurosurg Spine 7:151–160
Chang UK, Youn SM, Park SQ, Rhee CH (2009) Clinical results of cyberknife(r) radiotherapy for spinal metastases. J Korean Neurosurg Soc 46:538–544
Choi CY, Adler JR, Gibbs IC, Chang SD, Jackson PS, Minn AY, Lieberson RE, Soltys SG (2010) Stereotactic radiotherapy for treatment of spinal metastases recurring in close proximity to previously irradiated spinal cord. Int J Radiat Oncol Biol Phys 78(2):548–553
Dodd RL, Ryu MR, Kamnerdsupaphon P, Gibbs IC, Chang SD Jr, Adler JR Jr (2006) CyberKnife radiotherapy for benign intradural extramedullary spinal tumors. Neurosurgery 58:674–685; discussion 674–685
Emami B, Lyman J, Brown A, Coia L, Goitein M, Munzenrider JE, Shank B, Solin LJ, Wesson M (1991) Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 21:109–122
Gagnon GJ, Nasr NM, Liao JJ, Molzahn I, Marsh D, McRae D, Henderson FC Sr (2009) Treatment of spinal tumors using cyberknife fractionated stereotactic radiotherapy: pain and quality-of-life assessment after treatment in 200 patients. Neurosurgery 64:297–306; discussion 306–297
Gerszten PC, Burton SA, Welch WC, Brufsky AM, Lembersky BC, Ozhasoglu C, Vogel WJ (2005) Single-fraction radiotherapy for the treatment of spinal breast metastases. Cancer 104:2244–2254
Gerszten PC, Burton SA, Ozhasoglu C, Welch WC (2007) Radiotherapy for spinal metastases: clinical experience in 500 cases from a single institution. Spine 32:193–199
Gerszten PC, Burton SA, Ozhasoglu C, McCue KJ, Quinn AE (2008) Radiotherapy for benign intradural spinal tumors. Neurosurgery 62:887–895; discussion 895–886
Gerszten PC, Mendel E, Yamada Y (2009) Radiotherapy and radiotherapy for metastatic spine disease: what are the options, indications, and outcomes? Spine (Phila Pa 1976) 34:S78–S92
Gibbs IC (2007) Spinal and paraspinal lesions: the role of stereotactic body radiotherapy. Front Radiat Ther Oncol 40:407–414
Gibbs IC, Kamnerdsupaphon P, Ryu MR, Dodd R, Kiernan M, Chang SD, Adler JR Jr (2007) Image-guided robotic radiotherapy for spinal metastases. Radiother Oncol 82:185–190
Gibbs IC, Patil C, Gerszten PC, Adler JR Jr, Burton SA (2009) Delayed radiation-induced myelopathy after spinal radiotherapy. Neurosurgery 64:A67–A72
Gwak HS, Yoo HJ, Youn SM, Chang U, Lee DH, Yoo SY, Rhee CH (2005) Hypofractionated stereotactic radiation therapy for skull base and upper cervical chordoma and chondrosarcoma: preliminary results. Stereotact Funct Neurosurg 83:233–243
Hamilton AJ, Lulu BA, Fosmire H, Stea B, Cassady JR (1995) Preliminary clinical experience with linear accelerator-based spinal stereotactic radiotherapy. Neurosurgery 36:311–319
Harrop JS, Ganju A, Groff M, Bilsky M (2009) Primary intramedullary tumors of the spinal cord. Spine (Phila Pa 1976) 34:S69–S77
Henderson FC, McCool K, Seigle J, Jean W, Harter W, Gagnon GJ (2009) Treatment of chordomas with CyberKnife: Georgetown university experience and treatment recommendations. Neurosurgery 64:A44–A53
Ho AK, Fu D, Cotrutz C, Hancock SL, Chang SD, Gibbs IC, Maurer CR Jr, Adler JR Jr (2007) A study of the accuracy of Cyberknife spinal radiotherapy using skeletal structure tracking. Neurosurgery 60:147–156
Levine AM, Coleman C, Horasek S (2009) Stereotactic radiotherapy for the treatment of primary sarcomas and sarcoma metastases of the spine. Neurosurgery 64:A54–A59
Nasr NM, Gagnon GJ, Collins BT, Henderson FC, McRae D, Harter KW (2006) The use of cyberknife radiotherapy in the treatment of soft tissue sarcomas. Int J Radiat Biol Phys 66:S719
Nieder C, Grosu AL, Andratschke NH, Molls M (2005) Proposal of human spinal cord reirradiation dose based on collection of data from 40 patients. Int J Radiat Oncol Biol Phys 61:851–855
Patchell RA, Tibbs PA, Regine WF, Payne R, Saris S, Kryscio RJ, Mohiuddin M, Young B (2005) Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet 366:643–648
Price P, Hoskin PJ, Easton D, Austin D, Palmer SG, Yarnold JR (1986) Prospective randomised trial of single and multifraction radiotherapy schedules in the treatment of painful bony metastases. Radiother Oncol 6:247–255
Rades D, Stalpers LJ, Veninga T, Schulte R, Hoskin PJ, Obralic N, Bajrovic A, Rudat V, Schwarz R, Hulshof MC, Poortmans P, Schild SE (2005) Evaluation of five radiation schedules and prognostic factors for metastatic spinal cord compression. J Clin Oncol 23:3366–3375
Rades D, Dunst J, Schild SE (2008) The first score predicting overall survival in patients with metastatic spinal cord compression. Cancer 112:157–161
Roh KW, Jang JS, Kim MS, Sun DI, Kim BS, Jung SL, Kang JH, Yoo EJ, Yoon SC, Jang HS, Chung SM, Kim YS (2009) Fractionated stereotactic radiotherapy as reirradiation for locally recurrent head and neck cancer. Int J Radiat Oncol Biol Phys 74:1348–1355
Ryu S, Jin R, Jin JY, Chen Q, Rock J, Anderson J, Movsas B (2008) Pain control by image-guided radiotherapy for solitary spinal metastasis. J Pain Symptom Manage 35:292–298
Sahgal A, Chou D, Ames C, Ma L, Lamborn K, Huang K, Chuang C, Aiken A, Petti P, Weinstein P, Larson D (2007) Image-guided robotic stereotactic body radiotherapy for benign spinal tumors: the University of California San Francisco preliminary experience. Technol Cancer Res Treat 6:595–604
Sahgal A, Ames C, Chou D, Ma L, Huang K, Xu W, Chin C, Weinberg V, Chuang C, Weinstein P, Larson DA (2009) Stereotactic body radiotherapy is effective salvage therapy for patients with prior radiation of spinal metastases. Int J Radiat Oncol Biol Phys 74:723–731
Sahgal A, Ma L, Gibbs I, Gerszten PC, Ryu S, Soltys S, Weinberg V, Wong S, Chang E, Fowler J, Larson DA (2010) Spinal cord tolerance for stereotactic body radiotherapy. Int J Radiat Oncol Biol Phys 77(2):548–553
Thariat J, Castelli J, Chanalet S, Marcie S, Mammar H, Bondiau PY (2009a) CyberKnife stereotactic radiotherapy for spinal tumors: value of computed tomographic myelography in spinal cord delineation. Neurosurgery 64:A60–A66
Thariat J, Li G, Angellier G, Marchal S, Palamini G, Rucka G, Benezery K, Castelli J, Trimaud R, Mammar H, Marcie S, Gerard JP, Bondiau PY (2009b) Current indications and ongoing clinical trials with CyberKnife stereotactic radiotherapy in France in 2009. Bull Cancer 96:853–864
Wowra B, Zausinger S, Drexler C, Kufeld M, Muacevic A, Staehler M, Tonn JC (2008) CyberKnife radiotherapy for malignant spinal tumors: characterization of well-suited patients. Spine 33:2929–2934
Wowra B, Muacevic A, Tonn JC (2009a) Quality of radiotherapy for single brain metastases with respect to treatment technology: a matched-pair analysis. J Neurooncol 94:69–77
Wowra B, Muacevic A, Zausinger S, Tonn JC (2009b) Radiotherapy for spinal malignant tumors. Dtsch Arztebl Int 106:106–112
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Science+Business Media B.V.
About this chapter
Cite this chapter
Thariat, J., Soltys, S.G. (2012). Treatment of Spinal Tumors with Cyberknife Stereotactic Radiotherapy. In: Hayat, M. (eds) Tumors of the Central Nervous System, Volume 6. Tumors of the Central Nervous System, vol 6. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2866-0_20
Download citation
DOI: https://doi.org/10.1007/978-94-007-2866-0_20
Published:
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-007-2865-3
Online ISBN: 978-94-007-2866-0
eBook Packages: MedicineMedicine (R0)