Radiosurgery and radiotherapy for sacral tumors

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Sacral tumors represent a small subset of spinal lesions and typically include chordomas, metastases, other primary bone tumors, and benign schwannomas. Resection is the standard treatment for many sacral tumors, but many types of sacral lesions have the potential for recurrence after excision. In these cases, adjuvant radiotherapy is often beneficial. Although conventional radiotherapy plays an important role in the management of spinal lesions, the radiation doses required for adequate local control of many sacral lesions generally exceed the tolerance doses of normal tissues, thus limiting its definitive role in the management of sacral tumors. Recent advances in the field of stereotactic radio-surgery have allowed precise targeting of the sacrum. In this report the authors review the use of these two forms of radiation treatment and their role in managing sacral tumors.

Abbreviations used in this paper:GTC = giant cell tumor; IMRT = intensity-modulated radiotherapy; LINAC = linear accelerator; SRS = stereotactic radiosurgery.

Sacral tumors represent a small subset of spinal lesions and typically include chordomas, metastases, other primary bone tumors, and benign schwannomas. Resection is the standard treatment for many sacral tumors, but many types of sacral lesions have the potential for recurrence after excision. In these cases, adjuvant radiotherapy is often beneficial. Although conventional radiotherapy plays an important role in the management of spinal lesions, the radiation doses required for adequate local control of many sacral lesions generally exceed the tolerance doses of normal tissues, thus limiting its definitive role in the management of sacral tumors. Recent advances in the field of stereotactic radio-surgery have allowed precise targeting of the sacrum. In this report the authors review the use of these two forms of radiation treatment and their role in managing sacral tumors.

Abbreviations used in this paper:GTC = giant cell tumor; IMRT = intensity-modulated radiotherapy; LINAC = linear accelerator; SRS = stereotactic radiosurgery.

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Address reprint requests to: Iris C. Gibbs, M.D., Stanford University Medical Center, Department of Radiation Oncology, Room A-095, Stanford, California 94305-5302. email: iris.gibbs@stanford.edu.
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