Skip to main content
Journal cover image

Image-guided and intensity-modulated radiosurgery for patients with spinal metastasis.

Publication ,  Journal Article
Ryu, S; Fang Yin, F; Rock, J; Zhu, J; Chu, A; Kagan, E; Rogers, L; Ajlouni, M; Rosenblum, M; Kim, JH
Published in: Cancer
April 15, 2003

BACKGROUND: Radiosurgery can deliver a single, large radiation dose to a localized tumor using a stereotactic approach and hence, requires accurate and precise delivery of radiation to the target. Of the extracranial organ targets, the spine is considered a suitable site for radiosurgery, because there is minimal or no breathing-related organ movement. The authors studied spinal radiosurgery in patients with spinal metastases to determine its accuracy and precision. METHODS: The spinal radiosurgery program was based on an image-guided and intensity-modulated, shaped-beam radiosurgical unit. It is equipped with micromultileaf collimators for beam shaping and radiation intensity modulation and with a noninvasive, frameless positioning device that uses infrared, passive marker technology together with corroborative image fusion of the digitally reconstructed image from computed tomography (CT) simulation and orthogonal X-ray imagery at the treatment position. These images were compared with the port films that were taken at the time of treatment to determine the accuracy of the isocenter position. Clinical feasibility was tested in 10 patients who had spinal metastasis with or without spinal cord compression. The patients were treated with fractionated external beam radiotherapy followed by single-dose radiosurgery as a boost (6-8 grays) to the most involved portion of the spine or to the site of spinal cord compression. RESULTS: The accuracy for the isocenter was within 1.36 mm +/- 0.11 mm, as measured by image fusion of the digitally reconstructed image from CT simulation and the port film. Clinically, the majority of patients had prompt pain relief within 2-4 weeks of treatment. Complete and partial recovery of motor function also was achieved in patients with spinal cord compression. The radiation dose to the spinal cord was minimal. The maximum dose of radiation to the anterior edge of the spinal cord within a transverse section, on average, was 50% of the prescribed dose. There was no acute radiation toxicity detected clinically during the mean follow-up of 6 months. CONCLUSIONS: Image-guided, shaped-beam spinal radiosurgery is accurate and precise. Rapid clinical improvement of pain and neurologic function also may be achieved. The results indicate the potential of spinal radiosurgery in the treatment of patients with spinal metastasis, especially those with solitary sites of spine involvement, to increase the prospects of long-term palliation.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Cancer

DOI

ISSN

0008-543X

Publication Date

April 15, 2003

Volume

97

Issue

8

Start / End Page

2013 / 2018

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Surgery, Computer-Assisted
  • Spinal Neoplasms
  • Radiosurgery
  • Oncology & Carcinogenesis
  • Magnetic Resonance Spectroscopy
  • Image Processing, Computer-Assisted
  • Humans
  • Follow-Up Studies
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Ryu, S., Fang Yin, F., Rock, J., Zhu, J., Chu, A., Kagan, E., … Kim, J. H. (2003). Image-guided and intensity-modulated radiosurgery for patients with spinal metastasis. Cancer, 97(8), 2013–2018. https://doi.org/10.1002/cncr.11296
Ryu, Samuel, Fang Fang Yin, Jack Rock, Jingeng Zhu, Archie Chu, Eduard Kagan, Lisa Rogers, Munther Ajlouni, Mark Rosenblum, and Jae Ho Kim. “Image-guided and intensity-modulated radiosurgery for patients with spinal metastasis.Cancer 97, no. 8 (April 15, 2003): 2013–18. https://doi.org/10.1002/cncr.11296.
Ryu S, Fang Yin F, Rock J, Zhu J, Chu A, Kagan E, et al. Image-guided and intensity-modulated radiosurgery for patients with spinal metastasis. Cancer. 2003 Apr 15;97(8):2013–8.
Ryu, Samuel, et al. “Image-guided and intensity-modulated radiosurgery for patients with spinal metastasis.Cancer, vol. 97, no. 8, Apr. 2003, pp. 2013–18. Pubmed, doi:10.1002/cncr.11296.
Ryu S, Fang Yin F, Rock J, Zhu J, Chu A, Kagan E, Rogers L, Ajlouni M, Rosenblum M, Kim JH. Image-guided and intensity-modulated radiosurgery for patients with spinal metastasis. Cancer. 2003 Apr 15;97(8):2013–2018.
Journal cover image

Published In

Cancer

DOI

ISSN

0008-543X

Publication Date

April 15, 2003

Volume

97

Issue

8

Start / End Page

2013 / 2018

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Surgery, Computer-Assisted
  • Spinal Neoplasms
  • Radiosurgery
  • Oncology & Carcinogenesis
  • Magnetic Resonance Spectroscopy
  • Image Processing, Computer-Assisted
  • Humans
  • Follow-Up Studies