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Assessment of image-guided CyberKnife@ radiosurgery for metastatic spine tumors

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Abstract

Spinal metastases are associated with significant symptoms. From September 2005 to September 2007, 69 consecutive patients with 127 malignant spine metastatic lesions were treated at Wanfang Hospital with CyberKnife@ (CK) radiosurgery. The radiosurgery dose ranged from 10 to 30 Gy (mean 15.5 Gy) prescribed to the 75–85% isodose line that encompassed at least 95% of the tumor volume. We used fiducials as tracking landmarks for CK treatment of the thoracic and lumbar spine. A torso anthropomorphic phantom and GafChromic MD-55 films were used to verify the accuracy of CK radiosurgery and 2D dose distribution, demonstrated high targeting accuracy with 2% average deviation of the measured dose from the estimated dose at the set-up center and less than 5% dose deviation in 2D isodose curve. Visual Analogue Scale and Oswestry Disability Index questionnaires were used to monitor functional outcome after radiosurgery. Local tumor control at 10 months was 96.8%. Mean pain scores decreased significantly from 65 to 30 after treatment (P = 0.001). Functional disability was significantly improved after treatment (P = 0.002). The most common treatment toxicities were nausea and fatigue. In conclusion, CK radiosurgery is a well-tolerated and effective treatment for spine tumors with good local tumor control and a favorable outcome on pain and functional improvement after treatment.

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Authors and Affiliations

  1. Institute of Biomedical Engineering, National Yang-Ming University, No. 155, Sec 2, Li-Nong St., Shih-Pai, Taipei, 112, Taiwan, ROC

    Jo-Ting Tsai & Woei-Chyn Chu

  2. Department of Radiation Oncology, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan, ROC

    Jo-Ting Tsai

  3. Department of Neurosurgery, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan, ROC

    Jia-Wei Lin & Wen-Ta Chiu

  4. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC

    Jia-Wei Lin

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  1. Jo-Ting Tsai
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  2. Jia-Wei Lin
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  4. Woei-Chyn Chu
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Correspondence to Woei-Chyn Chu.

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Tsai, JT., Lin, JW., Chiu, WT. et al. Assessment of image-guided CyberKnife@ radiosurgery for metastatic spine tumors. J Neurooncol 94, 119–127 (2009). https://doi.org/10.1007/s11060-009-9814-7

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  • DOI: https://doi.org/10.1007/s11060-009-9814-7

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