Preliminary results of stereotactic radiotherapy for spinal lesions using the novalis system

Aims: We report our preliminary experience of treating spinal lesions using the Novalis stereotactic radiotherapy (SRT) system. Methods: We treated 36 spinal lesions in 30 patients including 29 metastases in 23 patients, 6 primary spinal tumors, and 1 arteriovenous malformation. Most tumors were encompassed by the 90-95% isodose line. Dose was prescribed at the 100% isodose, generally giving 30-40 Gy in 10 fractions or 25-32.5 Gy in 5 fractions. Results: The median follow-up time after SRT was 3.5 months (range 3 weeks to 10 months). Eight patients died after SRT from primary cancers or systemic disease. No complications due to SRT were observed during the follow-up period. Eight patients with intractable radiating pain had partial or complete pain relief. All 4 patients with neurological deficits had partial or complete improvement during the follow-up period of 2-5 months. Of 19 metastases with imaging follow-up, 94% were controlled and 58% shrank or disappeared. Two spinal meningioma patients were stable for 2 and 6 months after SRT. Conclusions: Our observations suggest that SRT as prescribed in patients with various spinal lesions is well tolerated and with little to no significant morbidity. The authors await long-term follow-up data to determine late complications, tumor control, and nidus obliteration rates.