Primary
spinal cord tumors are rare, and treatment recommendations are therefore difficult. We reviewed a 22-year experience of postoperative
radiotherapy for
spinal cord tumors to elucidate prognostic factors and recommendations. Twenty-two patients with
spinal cord tumors were treated from 1969-1991. Ten patients had
ependymomas, of which two were high grade. Twelve had
astrocytomas, of which 4 were high grade. Karnofsky status, age, extent of resection,
tumor histology, grade, and radiation dose were evaluated, as well as degree of clinical improvement
after treatment based on change in Karnofsky status.
Ependymomas achieved 100% local control with postoperative
radiotherapy. Grade and dose were of indeterminate significance because of these excellent results. High-grade
astrocytomas all recurred and caused death. Disease recurred in 1 of 8 patients with low-grade astrocytic or mixed astrocytic
tumors. The only prognostic variables of significance were histology, grade, and change in Karnofsky status
after treatment. Radiation of primary
spinal cord tumors is rare. In nearly all cases, local fields may be used. Improvement in Karnofsky status after
radiotherapy may predict better survival. Treatment recommendations for these rare
tumors are discussed.