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International Journal of Surgical Oncology
Volume 2011 (2011), Article ID 979214, 9 pages
http://dx.doi.org/10.1155/2011/979214
Review Article

Stereotactic Body Radiosurgery for Spinal Metastatic Disease: An Evidence-Based Review

1Department of Radiation Oncology, Winship Cancer Institute, Emory University, 1365 Clifton Road NE, Suite CT-104, Atlanta, GA 30322, USA
2Department of Neurosurgery, Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA

Received 25 January 2011; Accepted 2 May 2011

Academic Editor: Laurence D. Rhines

Copyright © 2011 William A. Hall et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Spinal metastasis is a problem that afflicts many cancer patients. Traditionally, conventional fractionated radiation therapy and/or surgery have been the most common approaches for managing such patients. Through technical advances in radiotherapy, high dose radiation with extremely steep drop off can now be delivered to a limited target volume along the spine under image-guidance with very high precision. This procedure, known as stereotactic body radiosurgery, provides a technique to rapidly treat selected spinal metastasis patients with single- or limited-fraction treatments that have similar to superior efficacies compared with more established approaches. This review describes current treatment systems in use to deliver stereotactic body radiosurgery as well as results of some of the larger case series from a number of institutions that report outcomes of patients treated for spinal metastatic disease. These series include nearly 1400 patients and report a cumulative local control rate of 90% with myelopathy risk that is significantly less than 1%. Based on this comprehensive review of the literature, we believe that stereotactic body radiosurgery is an established treatment modality for patients with spinal metastatic disease that is both safe and highly effective.