SBRT in tumours of the spinal column

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Published: 15 Aug 2013
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Dr Peter Gerszten - University of Pittsburgh, USA

Dr Gerszten talks about spine radiosurgery. In particular how the recent new developments in radiosurgery has led to it being used for tumours of the spine and outside the head.

What I will be speaking about today is spine radiosurgery.

As you know, radiosurgery has been adopted around the world as a treatment for intracranial diseases such as benign tumours or malignant tumours or vascular malformations for the past fifty years.

Only recently, in the past decade, have we developed techniques to perform the same radiosurgery, or SBRT, to areas of the spine and outside of the head.

As a neurosurgeon we are interested in tumours, both benign and malignant, of the spine so we have developed radiosurgery techniques in order to treat these tumours.

The reasons that we want to perform radiosurgery instead of open surgery is that in many situations with patients with cancer it is always better to avoid open surgery and the complications of open surgery.

Oftentimes we use radiosurgery also to change the type of surgeries that we perform so that we can perform a very minimally invasive treatment of operation and then follow that with radiosurgery.

That way the patients can be treated as an outpatient, they don’t have to come in to the hospital, it avoids the morbidity and mortality of open surgeries and it improves their quality of life.

We are now doing more research with benign tumours so that many times benign tumours and primary tumours of the spine can be successfully treated with radiosurgery that is bloodless, painless and very, very safe, avoiding open surgeries.

That is what I will be speaking about today.

Can you give us a summary about your presentation in ALATRO?

Yes, what I would send across to the medical oncologists is that what we understand now, today, is that in order to treat cancer, cancer is a systemic illness, it is not a focal illness.

So we understand, as surgeons and even as radiation oncologists, that treating one metastasis will not cure a patient. The patients will be cured and their survival will be extended by systemic therapy.

So anything that we can do as surgeons to improve systemic therapy is very, very important.

What we can do with radiosurgery is that we can perform the radiosurgery to treat the metastatic disease while they are obtaining or receiving their systemic therapy.

So in the olden days when we had to operate on these patients and stop their systemic therapy for sometimes weeks or months for them to recover from surgery and therefore decreasing their chance of long-term survival, now we can continue their systemic therapy throughout their treatment by using radiosurgery.