title: Stereotactic radiosurgery yields long-term control for benign intradural, extramedullary spinal tumors.
abstract: BACKGROUND
  The role of stereotactic radiosurgery in the treatment of benign intracranial lesions is well established. Although a growing body of evidence supports its role in the treatment of malignant spinal lesions, a much less extensive dataset exists for treatment of benign spinal tumors.
  
  
  OBJECTIVE
  To examine the safety and efficacy of stereotactic radiosurgery for treatment of benign, intradural extramedullary spinal tumors.
  
  
  METHODS
  From 1999 to 2008, 87 patients with 103 benign intradural extramedullary spinal tumors (32 meningiomas, 24 neurofibromas, and 47 schwannomas) were treated with stereotactic radiosurgery at Stanford University Medical Center. Forty-three males and 44 females had a median age of 53 years (range, 12-86). Twenty-five patients had neurofibromatosis. Treatment was delivered in 1 to 5 sessions (median, 2) with a mean prescription dose of 19.4 Gy (range, 14-30 Gy) to an average tumor volume of 5.24 cm (range, 0.049-54.52 cm).
  
  
  RESULTS
  After a mean radiographic follow-up period of 33 months (range, 6-87), including 21 lesions followed for ≥ 48 months, 59% were stable, 40% decreased in size, and a single tumor (1%) increased in size. Clinically, 91%, 67%, and 86% of meningiomas, neurofibromas, and schwannomas, respectively, were symptomatically stable to improved at last follow-up. One patient with a meningioma developed a new, transient myelopathy at 9 months, although the tumor was smaller at last follow-up.
  
  
  CONCLUSIONS
  As a viable alternative to microsurgical resection, stereotactic radiosurgery provides safe and efficacious long-term control of benign intradural, extramedullary spinal tumors with a low rate of complication.
authors.affiliation: Department of Radiation Oncology, Stanford University Cancer Center, Stanford, California, USA.
authors.forename: Sean
authors.initials: S
authors.lastname: Sachdev
authors.forename: Robert L
authors.initials: RL
authors.lastname: Dodd
authors.forename: Steven D
authors.initials: SD
authors.lastname: Chang
authors.forename: Scott G
authors.initials: SG
authors.lastname: Soltys
authors.forename: John R
authors.initials: JR
authors.lastname: Adler
authors.forename: Gary
authors.initials: G
authors.lastname: Luxton
authors.forename: Clara Y H
authors.initials: CY
authors.lastname: Choi
authors.forename: Laurie
authors.initials: L
authors.lastname: Tupper
authors.forename: Iris C
authors.initials: IC
authors.lastname: Gibbs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008579:Meningioma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009442:Neurilemmoma / Q000473:pathology / Q000601:surgery*; D009455:Neurofibroma / Q000473:pathology / Q000601:surgery*; D017253:Neurofibromatoses / Q000473:pathology / Q000601:surgery; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D013116:Spinal Cord / Q000473:pathology / Q000601:surgery; D013120:Spinal Cord Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult