Spinal Tumor Treatment: Radiation Therapy and Radiosurgery

Radiation therapy and radiosurgery are types of localized, or site-specific, non-invasive therapies that deliver highly focused beams of energy to the tumor site, while minimizing damage to healthy tissue surrounding the tumor.

Radiation therapy and radiosurgery

Radiation therapy is commonly used when the cancer has metastasized to the bones.  Its high-energy X-rays penetrate and damage targeted cancer cells inside the bone.

However, there are limitations. Some tumors are resistant to radiation therapy or are too close to the spinal cord or nerves to receive radiation therapy. Additionally, cancer patients previously treated with radiation therapy may no longer be candidates for this therapy as adjacent vital tissues, such as the spinal cord, may have already reached their radiation exposure limit. Although infrequent, damage to the spinal cord and surrounding nerves or increased brittleness in vertebrae are also possible complications.

How does radiation therapy treat metastatic spinal tumors?

The radiation targets only the metastatic spinal tumor on the affected vertebra, thereby minimizing radiation exposure to the surrounding healthy tissue. This targeted performance has historically made radiation a common treatment for many metastatic spinal tumors.

Within radiation therapy, two principle treatment methods exist: external beam radiotherapy, commonly administered in daily doses (called fractions) over a series of weeks, and stereotactic radiosurgery, which can have a shorter treatment timeline. 

Knowing this, patients and physicians must decide how to use radiation therapy to treat a metastatic spinal tumor while balancing other needs the patient may have, such as a desire to limit hospital visits or a need to continue chemotherapy and other prescribed primary cancer treatment regimen. Such primary treatments must often be delayed for an extended period to avoid the risks associated with simultaneous treatments, known as cumulative toxicity.

With either stereotactic radiosurgery or external beam radiotherapy, meaningful pain relief may take weeks or months to be achieved.