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• W1993735418 abstract "To retrospectively review the safety and efficacy of image-guided linear accelerator-based radiosurgery for the treatment of patients with benign nerve sheath tumors. Between March 2003 and July 2007, 20 patients with 25 nerve sheath tumors were treated with spinal radiosurgery. Patient age varied from 17 to 78 years (median 61). Five patients had neurofibromatosis type-1 and 4 had neurofibromatosis type-2. Seven patients underwent subtotal tumor removal 2 to 36 months prior to radiosurgery. There were 8 neurofibromas, 8 schwannomas, and 9 lesions diagnosed on clinicoradiographic features. Eleven tumors were located in the cervical spine, 10 in the lumbar spine, and 4 in the thoracic spine. The largest tumor dimension varied from 0.9 to 4.1 cm (median 2.1). Tumor volume varied from 0.5 to 13.7 cc (median 2.6). Thirteen lesions caused sensory disturbance, 12 caused pain, and 9 motor weakness. Radiosurgery was performed in the outpatient setting with a 6 MV linear accelerator equipped with a micro-multileaf collimator (Novalis, BrainLAB, Feldkirchen, Germany). Forward dose planning was used for 20 lesions and inverse planning for 5 tumors. Forward planned targets were treated with 3 or 4 arc fields. Inverse planned targets were treated with 6 static beams. Median peripheral tumor dose and prescription isodose were 12 Gy and 90%, respectively. Image-guidance was performed using a combination of optical tracking with infrared reflectors, fusion of oblique amorphous silicon radiographs with a dynamically reconstructed digital radiograph and automatic patient positioning capable of 4 degrees of movement. Follow-up varied from 6 to 48 months (median 12). There have been no local failures detected on follow-up magnetic resonance imaging. Twenty-three tumors have remained stable and 2 lesions demonstrated at least 50% reduction in the greatest tumor dimension. Reduction in pain occurred in one site, reduction in numbness in two sites and an improvement in motor weakness in one site. There has been no clinical or imaging evidence of spinal cord injury following radiosurgery. One patient had a transient increase in pain and 1 a transient increase in numbness, both occurring 6 months after radiosurgery. The results of this limited experience indicate that linear-accelerator-based spinal radiosurgery is safe and effective for patients with benign nerve sheath tumors. Further follow-up with a larger group of patients is required but these results imply that spinal radiosurgery may represent a therapeutic alternative for patients with spinal nerve sheath tumors." @default.
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• W1993735418 date "2008-09-01" @default.
• W1993735418 modified "2023-09-25" @default.
• W1993735418 title "Image Guided Linac Spinal Radiosurgery for Benign Nerve Sheath Tumors" @default.
• W1993735418 doi "https://doi.org/10.1016/j.ijrobp.2008.06.1544" @default.
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