Radiosurgery Eases Pain of Spinal Tumors

NEW YORK MAR 19, 2008 (Reuters Health)- Radiosurgery can provide long-lasting pain relief to cancer patients who have developed cancer in the spine, a study in 49 patients shows.

"All patients have tolerated the procedure well and, given the single outpatient hospital visit required, the procedure has proven to be very convenient," Dr. Samuel Ryu and colleagues from Henry Ford Health System in Detroit write in the March issue of the Journal of Pain and Symptom Management.

In radiosurgery, a narrow beam of powerful radiation is used like a surgical knife, making it unnecessary to cut open the body as in conventional surgery.

Spinal tumors are most often metastases from cancers in other parts of the body, Ryu and his team note. They are almost always painful, and can compress the spinal cord, producing weakness in the arms and legs, incontinence and other problems. These tumors are typically treated with painkillers and steroids, radiation, and surgery.

Given their location, the researchers say, targeting these tumors precisely is crucial. Furthermore, now that patients with spinal metastases are living longer, it is important to provide treatments that will control tumor growth and ease pain while also maintaining or restoring neurological function over the long term.

In the current study, Ryu and his colleagues report on 49 patients with a total of 61 spinal metastases among them who were treated with single-dose radiosurgery guided by a CT scan and computerized targeting, to minimize radiation damage to the spinal cord.

Patients experienced pain relief in 14 days, on average, although one reported pain relief 24 hours after the surgery. Eight weeks after the procedure, 46% had complete pain relief, 18.9% had partial pain relief, and pain had stabilized in 16.2%.

Half of patients had pain relief lasting for at least 13.3 months, while 84% had pain control lasting a year, the researchers report.

While the study was designed to look at pain, not nerve function, some patients did show neurological improvement, Ryu and his colleagues note. One patient experienced "near-complete disappearance" of the tumor that had surrounded his spine, along with "complete neurologic improvement and pain relief."

They conclude: "This experience demonstrates that spinal radiosurgery can achieve rapid and durable pain relief. Single dose radiosurgery has a potential to be a viable treatment option for single spinal metastasis."

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