title: Stereotactic radiotherapy for spinal intradural metastases developing within or adjacent to the previous irradiation field--report of three cases.
abstract: Results of stereotactic radiotherapy (SRT) for spinal intradural metastases developing inside or adjacent to the previous external-beam radiation therapy (EBRT) field are shown in 3 cases. One case of spinal intramedullary metastasis and two cases of intradural extramedullary metastases were treated using a Novalis shaped-beam SRT. Case 1 developed an intramedullary metastatic tumor in the C1 spinal medulla inside the previous whole brain EBRT field and another lesion adjacent to the field in the C2 spinal medulla. Case 2 developed intradural extramedullary metastasis around C6-8 inside the previous EBRT field for the primary lung adenocarcinoma. Case 3 developed multiple spinal intradural extramedullary metastatic deposits after surgical resection and following whole brain EBRT for brain metastasis. We delivered 24 to 36 Gy in 5 to 12 fractions. The treated tumors were stable or decreased in size until the patients' death from the primary cancer (10, 22, and 5 months). Neurological symptoms were stable or improved in all 3 patients. Palliative SRT using Novalis is expected to be safe and effective even if the patient develops spinal intradural metastases within or adjacent to the previous irradiation field.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Mori
authors.forename: Chisa
authors.initials: C
authors.lastname: Hashizume
authors.forename: Yuta
authors.initials: Y
authors.lastname: Shibamoto
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Hisato
authors.initials: H
authors.lastname: Nakazawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hagiwara
authors.forename: Takahiko
authors.initials: T
authors.lastname: Tsugawa
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010166:Palliative Care / Q000379:methods*; D011829:Radiation Dosage; D011874:Radiometry; D016634:Radiosurgery / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated; D013125:Spinal Neoplasms / Q000556:secondary*; D013997:Time Factors