Stereotactic high-dose irradiation for intramedullary metastases

Goncharov Ya.E.; Zubatkina I.S.; Ivanov P.I.

doi:https://doi.org/10.17116/neiro20248804122

Goncharov Ya.E.

Treatment and Diagnostic Center of the Sergei Berezin International Institute of Biological Systems

ORCID: 0009-0009-0066-1419

Zubatkina I.S.

Treatment and Diagnostic Center of the Sergei Berezin International Institute of Biological Systems;
Peter the Great St. Petersburg Polytechnic University

ORCID: 0000-0003-0198-231X

Ivanov P.I.

Treatment and Diagnostic Center of the Sergei Berezin International Institute of Biological Systems;
Kirov Military Medical Academy

ORCID: 0000-0003-3747-4181

Stereotactic high-dose irradiation for intramedullary metastases

Authors:

Goncharov Ya.E., Zubatkina I.S., Ivanov P.I.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2024;88(4): 22‑30

DOI: 10.17116/neiro20248804122

Read: 1377 times

To cite this article:

Goncharov YaE, Zubatkina IS, Ivanov PI. Stereotactic high-dose irradiation for intramedullary metastases. Burdenko's Journal of Neurosurgery. 2024;88(4):22‑30. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20248804122

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)

Использование инфографики авторами научных работ

Close metadata

OBJECTIVE

To study the results of stereotactic high-dose irradiation for IMM considering local control of metastases, neurological status and life expectancy.

MATERIAL AND METHODS

Nineteen patients with 29 IMMs underwent high-dose irradiation (Cyber Knife G4 and TrueBeam STx devices) between 2016 and 2022. There were 1—10 fractions, radiation dose 14.0—35.0 Gy with isodose 70—100%. Local control and new spinal cord metastases were assessed using contrast-enhanced MRI. Clinical status and neurological functions were assessed using the Karnofsky and McCormick scales.

RESULTS

Local control rates were 91% and 78% after 6 and 12 months, respectively. Overall survival after treatment was 7.3 months, 6- and 12-month overall survival — 58% and 37%, respectively. In addition, 8 patients were available for follow-up. Of these, 6 ones demonstrated improvement or stabilization of neurological function after treatment. The main cause of death was progression of the underlying disease. No significant treatment-related toxic effects were observed.

CONCLUSION

High-dose irradiation is a safe, effective and time-saving treatment for IMM. Considering unadvisable surgical methods and chemotherapy for this pathology, we can recommend high-dose irradiation for patients with spinal cord metastases.

Keywords:

intramedullary metastases

spinal cord

radiosurgery

stereotactic radiotherapy

Authors:

Goncharov Ya.E.

Treatment and Diagnostic Center of the Sergei Berezin International Institute of Biological Systems

ORCID: 0009-0009-0066-1419

Zubatkina I.S.

Treatment and Diagnostic Center of the Sergei Berezin International Institute of Biological Systems;
Peter the Great St. Petersburg Polytechnic University

ORCID: 0000-0003-0198-231X

Ivanov P.I.

Treatment and Diagnostic Center of the Sergei Berezin International Institute of Biological Systems;
Kirov Military Medical Academy

ORCID: 0000-0003-3747-4181

Received:

04.03.2024

Accepted:

31.05.2024

Close metadata

References:

Hommadi M, Belemlih M, Marnouch E, Maghous A, Zaghba N, Hamidi FZ, Bazzine A, Saghir KA, Elmarjany M, Sifat H, Hadadi K, Mansouri H. Intramedullary spinal cord metastases: Report of three cases and review of the literature. Cancer/Radiothérapie. 2021;25(2):169-174. https://doi.org/10.1016/j.canrad.2020.10.003
Ovchinnikov VA, Zuev AA. Intramedullary spinal cord metastases: current state of the problem. Russian Journal of Neurosurgery. 2022;24(4):118-123. (In Russ.). https://doi.org/10.17650/1683-3295-2022-24-4-118-123
Phillips KA, Gaughan E, Gru A, Schiff D. Regression of an intramedullary spinal cord metastasis with a checkpoint inhibitor: a case report. CNS Oncology. 2017;6(4):275-280. https://doi.org/cns-2017-0007
Kalayci M, Cagavi F, Gul S, Gul S, Yenidunya S, Acikgoz B. Intramedullary spinal cord metastases: diagnosis and treatment — an illustrated review. Acta Neurochirurgica. 2004;146(12):1347-1354. https://doi.org/10.1007/s00701-004-0386-1
Dam-Hieu P, Seizeur R, Mineo JF, Philippe JP Metges, Meriot P, Simon H. Retrospective study of 19 patients with intramedullary spinal cord metastasis. Clinical Neurology and Neurosurgery. 2009;111(1):10-17. https://doi.org/10.1016/j.clineuro.2008.06.019
Konovalov NA, Timonin SYu, Zelenkov PV, Goryainov SA, Asyutin DS, Zakirov BA, Kaprovoy SV. Visual fluorescence combined with laser spectroscopy in surgery for intramedullary spinal cord tumors. Burdenko’s Journal of Neurosurgery. 2020;84(6):5-14. (In Russ.). https://doi.org/10.17116/neiro2020840615
Payer S, Mende KC, Westphal M, Eicker SO. Intramedullary spinal cord metastases: an increasingly common diagnosis. Neurosurgical Focus. 2015;39(2):E15. https://doi.org/10.3171/2015.5.FOCUS15149
Gasser T, Sandalcioglu IE, El Hamalawi B van de Nes JA, Stolke D, Wiedemayer H. Surgical treatment of intramedullary spinal cord metastases of systemic cancer: functional outcome and prognosis. Journal of Neuro-oncology. 2005;73(2):163-168. https://doi.org/10.1007/s11060-004-4275-5
Gazzeri R, Telera S, Galarza M, Callovini GM. Surgical treatment of intramedullary spinal cord metastases: functional outcome and complications-a multicenter study. Neurosurgical Review. 2021;44(6):3267-3275. https://doi.org/10.1007/s10143-021-01491-8
Hashii H, Mizumoto M, Kanemoto A, Harada H, Asakura H, Hashimoto T, Furutani K, Katagiri H, Nakasu Y, Nishimura T. Radiotherapy for patients with symptomatic intramedullary spinal cord metastasis. Journal of Radiation Research. 2011;52(5):641-645. https://doi.org/10.1269/jrr.10187
Ehret F, Senger C, Kufeld M, Fürweger C, Kord M, Haidenberger A, Windisch P, Rueß D, Kaul D, Ruge M, Schichor C, Tonn JC, Muacevic A. Image-guided robotic radiosurgery for the Management of Intramedullary Spinal Cord Metastases-a Multicenter Experience. Cancers. 2021;13(2):297. https://doi.org/10.3390/cancers13020297
Veeravagu A, Lieberson RE, Mener A, Chen YR, Soltys SG, Gibbs IC, Adler JR, Tian AG, Chang SD. CyberKnife stereotactic radiosurgery for the treatment of intramedullary spinal cord metastases. Journal of Clinical Neuroscience. 2012;19(9):1273-1277. https://doi.org/10.1016/j.jocn.2012.02.002
Shin DA, Huh R, Chung SS Rock J, Ryu S. Stereotactic spine radiosurgery for intradural and intramedullary metastasis. Neurosurgical Focus. 2009;27(6):E10. https://doi.org/10.3171/2009.9.FOCUS09194
Tonneau M, Mouttet-Audouard R, Tinier F, Mirabel X, Pasquier D. Stereotactic body radiotherapy for intramedullary metastases: a retrospective series at the Oscar Lambret center and a systematic review. BMC Cancer. 2021;21(1):1168. https://doi.org/10.1186/s12885-021-08901-6
Golanov AV, Gorlachev GE, Antipina NA, Konovalov NA, Shevelev IN, Vetlova ER, Zolotova SV, Galkin MV, Arutiunov NV, Tissen TP, Rodionov PV. CyberKnife stereotactic radiotherapy for mass lesions of spinal cord and spine. Burdenko’s Journal of Neurosurgery. 2012;76(1):54-63. (In Russ.).
Nishimura T, Yamazaki H, Suzuki G, Watanabe S, Nagasawa S, Kawabata K, Kimoto T, Aibe N, Masui K, Yamada K. Palliative Radiation Therapy for Intramedullary Spinal Cord Metastasis. Cancer Diagnosis & Prognosis. 2022;2(6):702-706. https://doi.org/10.21873/cdp.10163