Management of primary spinal cord tumors

The literature is scarce on surgical and/or radiotherapeutic management of primary neoplasms of the spinal cord, a rare form of tumor. We have reviewed retrospectively the records of all patients with spinal cord tumor who were treated at the University of California, San Francisco, from 1950 to 1975, a total of 34 patients. Patients were treated with megavoltage equipment to portals large enough to include the tumor with generous margins above and below the area of known disease. In 25 patients tumor histology was confirmed, while nine patients had nondiagnostic tissue diagnoses. All 12 patients who had ependymomas are alive without recurrence with a minimum follow-up of 3 years. Six patients had low grade astrocytomas and 5 of the 6 survived longer than 3 years. Five of the 9 unbiopsied patients were alive with no evidence of disease, having minimum follow-up intervals of 3 years. Detailed analysis of dose, fractionation, and field size are presented for all patients. Based upon our data, we recommend conservative surgery followed by irradiation as the optimal management for patients with spinal cord tumors