Stereotactic Body Radiotherapy for Spine Tumors

Eligibility Criteria:

• Patient age >= 18 years
• performance status of 0-3
• Vertebral and/or paraspinal metastases, with or without prior surgery and/or fractionated radiotherapy
• Benign extradural spine tumors such as chordomas, meningiomas, schwannomas, neurofibromas, paragangliomas, and arteriovenous malformations (AVMs).
• Established histologic diagnosis of a benign or malignant tumor of the spine.
• Arteriovenous malformation of the spine identified radiographically (no biopsy)
• Well-defined lesion involving no more than 2 adjacent vertebral levels or spinal segment
• Minimal spinal canal compromise that is not rapidly progressive. Ideally, the tumor should not be within 5 mm of the spinal cord.
• If chemotherapy is planned, ideally it should not have been given within 30 days of starting radiation and should not resume until at least 2 weeks after completing radiation. In addition, it is not recommended to perform SBRT when targeted anti-angiogenesis therapy is planned within 2 months of the procedure.
• Signed study-specific consent form

Exclusion Criteria

• Lesion involving > 3 adjacent vertebral levels
• Overt spinal instability
• Neurologic deficit due to bony fragments/bony compression of neural structures
• Prior radiotherapy at the involved level(s) within 3 months of radiosurgery, more than one prior course of radiotherapy at the involved level(s), or more than 45 Gy previous radiation exposure at the involved level(s)
• Rapidly progressive spinal cord compromise or neurological deficit
• Paralysis, or otherwise compromised motor function due to radiographically confirmed cord compression
• Patient unable to undergo an MRI
• Pregnant or lactating women, due to potential exposure of the fetus to RT and unknown effects of RT on lactating females
• Patients with psychiatric or addictive disorder that would preclude obtaining informed consent