Three-dimensional conformal fractionated radiotherapy for spinal schwannoma with a paravertebral or an intraosseous component

Jpn J Radiol. 2015 Dec;33(12):757-63. doi: 10.1007/s11604-015-0492-4. Epub 2015 Oct 27.

Abstract

Introduction: We retrospectively evaluated the efficacy of three-dimensional conformal radiotherapy (3D-CRT) for spinal schwannoma.

Methods: Nine patients with spinal schwannoma were treated with 3D-CRT. All patients had a paravertebral or intraosseous component. Tumor sizes ranged from 0.8 to 8.7 cm, with a median of 3.5 cm. The prescribed dose was 50 Gy in 25 fractions at the isocenter, except for 1 patient who received 66 Gy in 33 fractions for a large sacral tumor. The follow-up period ranged from 20 to 137 months, with a median of 72 months.

Results: Tumor shrinkage within 3 mm occurred in 4 patients and tumor expansion within 3 mm occurred in 3. One tumor showed neither expansion nor shrinkage at the last follow-up. One patient experienced transient expansion by 8 mm in diameter at 12 months after the completion of radiotherapy (35-43 mm), and then the tumor size remained unchanged for 7 years. No severe late toxicity ≥ grade 3 was observed.

Conclusions: Only 1 of 9 tumors showed transit expansion over 3 mm after 3D-CRT, and severe late radiation toxicity was not observed. Use of 3D-CRT should be considered a treatment option for spinal schwannoma.

Keywords: Conventional fractionation; Fractionated radiotherapy; Paravertebral schwannoma; Spinal schwannoma; Three-dimensional conformal radiotherapy (3D-CRT).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Dose Fractionation, Radiation*
  • Female
  • Follow-Up Studies
  • Humans
  • Imaging, Three-Dimensional*
  • Male
  • Middle Aged
  • Neurilemmoma / diagnostic imaging
  • Neurilemmoma / radiotherapy*
  • Radiotherapy, Conformal / methods*
  • Retrospective Studies
  • Spinal Neoplasms / diagnostic imaging
  • Spinal Neoplasms / radiotherapy*
  • Spine / diagnostic imaging
  • Tomography, X-Ray Computed*
  • Treatment Outcome
  • Young Adult