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Radiation Oncology

Stereotactic radiosurgery allows precise treatment of primary and metastatic tumors impinging on the spinal cord

07/01/2005

Physicians in UCLA’s Stereotactic Spinal Radiosurgery Program use the dedicated shaped-beam stereotactic linear accelerator to treat patients with primary and metastatic tumors in the spine (e.g., neuromas, meningiomas, metastases).

Advances in image guidance, treatment delivery, and patient immobilization now permit delivery of focused irradiation beams with the efficacy and precision typical of intracranial radiosurgery procedures. The individual beams of irradiation are precisely shaped to the contour of the tumor with an innovative micromultileaf collimator.

Spinal radiosurgery can safely be administered in a single treatment to patients who have previously received conventional radiotherapy. This therapy can be administered in an hour or less and is completely noninvasive and painless.

Four-step process

Spinal radiosurgery is a four-step process that takes one to two weeks.

Step one – physician consultations: A neurosurgeon and a radiation oncologist first evaluate the patient in separate consultations. Either the patient or the referring physician should provide copies of previous radiological studies. The consultation team assesses the patient’s emotional, medical and other special needs before recommending a treatment plan to the patient and referring physician.

Step two – computerized tomography (CT) simulation: Specific information needed to generate the treatment plan is gathered in the UCLA Radiation Oncology Department. During the two-hour appointment, a custom-shaped beanbag is fitted to the patient’s body so that the patient remains in the same position and motion-free throughout all imaging and treatment procedures. For cervical spine lesions, a thermoplastic mask is custom fitted and used to position the patient’s head in a reproducible fashion and to discourage movement throughout the treatment process. Infrared reflector spheres placed on the patient’s skin are used to position the patient and track motion during radiosurgery. The position of each sphere is marked with a tiny ink tattoo.

Finally, a CT scan performed during the simulation provides the team with specific anatomical information to differentiate the radiosurgery target from normal healthy tissue.

Step three – magnetic resonance imaging (MRI): MRI complements lesion location information gathered from the CT scan by clarifying the difference between the lesion and healthy tissue. Following the MRI, the team – consisting of a neurosurgeon, radiation oncologist and medical physicist – uses the CT simulation and MRI images to map out a treatment plan.

Step four – radiosurgery: In this painless, one-hour outpatient procedure, radiation is delivered to the tumor using a highly specialized medical linear accelerator.

Team members

Antonio A.F. DeSalles, M.D., Ph.D.
Professor of Neurosurgery
Co-Director, UCLA Stereotactic Radiosurgery Program

Michael T. Selch, M.D.
Professor of Radiation Oncology
Co-Director, UCLA Stereotactic Radiosurgery Program

Patient referral

Call (310) 794-1221 to arrange for a consultation or film evaluation.





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