title: Intradural extramedullary benign spinal lesions radiosurgery. Medium- to long-term results from a single institution experience.
abstract: BACKGROUND
  Surgery represents the first-choice treatment for spinal intradural tumours. On the other hand, whether it is most appropriate in the setting of recurrences, residual or multiple lesions remains an open question. Moreover, some patients are less than ideal candidates for surgery. In this study we report about our own radiosurgery experience in the treatment of benign intradural extramedullary tumours of the spine.
  
  
  METHODS
  In our study we analyzed the outcomes for 18 patients (21 lesions) treated for benign intradural extramedullary lesions, with a minimum follow-up period of 32 months. The lesions included 11 meningiomas, 9 schwannomas and 1 neurofibroma.
  
  
  RESULTS
  The mean follow-up was 43 months (32-73 months). The median tumour volume was 2 cc (0.2-17.7 cc). Eleven lesions underwent single-fraction treatment (mean prescribed dose ranging from 10 to 13 Gy). The others received a multisession radiosurgery treatment (4-6 fractions) with a mean prescription dose ranging from 18.5 to 25 Gy. The maximum dose to the spinal cord ranged from 9.2 to 26 Gy. During the follow-up period, none of the lesions showed radiological evidence of progression. Neurological status was preserved or improved and no permanent sequelae were observed. Significant and durable pain relief was observed.
  
  
  CONCLUSIONS
  Although surgical excision remains the primary treatment option for most intradural tumours, radiosurgery offers a real alternative therapeutic modality, especially in case of recurrent and residual lesions or when surgery is contraindicated.
authors.affiliation: Department of Neurosurgery, Radiotherapy Unit, Fondazione IRCCS Istituto Neurologico C Besta, Via Celoria 11, 20133, Milan, Italy. marchettimarcello@gmail.com
authors.forename: Marcello
authors.initials: M
authors.lastname: Marchetti
authors.forename: Elena
authors.initials: E
authors.lastname: De Martin
authors.forename: Ida
authors.initials: I
authors.lastname: Milanesi
authors.forename: Laura
authors.initials: L
authors.lastname: Fariselli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009442:Neurilemmoma / Q000473:pathology / Q000601:surgery*; D009455:Neurofibroma / Q000473:pathology / Q000601:surgery*; D016634:Radiosurgery / Q000379:methods*; D013120:Spinal Cord Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome