Spinal tumors are classified into primary and secondary spinal tumors which can cause severe pain and neurological symptoms.
The primary spinal tumors are uncommon such as osteosarcoma, chondrosarcoma, hemangioma of the vertebrae. The secondary spinal tumor, or spinal metastasis, is the metastatic disease from primary tumor to the spine (vertebrae). It is common in cancer patients such as lung, breast, rectum, and many cancers, and can cause serious complications like spinal cord compression. In addition, there are diseases of the spinal cord and spinal dura itself such as glioma and meningioma but are rare.
The spine is a delicate and complex area of the body, and treating spinal tumors can be challenging. In the past, traditional radiation therapy has been used to treat spinal tumors, but this approach often has side effects and can cause damage to healthy tissues. This is because traditional radiation therapy uses high-energy x-rays that can penetrate deeply into the body and affect surrounding tissues.
Proton therapy is a form of radiation therapy that uses protons, which are positively charged particles. Unlike x-rays, protons can precisely target to the tumor, minimizing the exposure of surrounding healthy tissues. The advantages for patients with spinal tumors include:
- Precision: Proton therapy uses beams of protons that are precisely targeted to the tumor, minimizing exposure to surrounding healthy tissues.
- Reduced risk of side effects: There is a lower risk of damaging healthy tissues and long-term side effects such as nerve damage, muscle weakness, and bowel or bladder problems, compared to traditional radiation therapy.
- Improved tumor control and patient outcomes: Proton therapy can be used in combination with other treatments, such as surgery, chemotherapy, and traditional radiation therapy, to improve patient outcomes and increase the chances of a successful treatment. The combined approach can help to improve patient outcomes and increase the chances of a successful treatment.
Figure. Comparison of dose distribution between 3D-conformal radiotherapy (A), stereotactic body radiosurgery/radiotherapy (B), and proton therapy (C)
However, one of the major challenges of proton therapy is the cost, as proton therapy is still relatively new and the equipment is expensive. It is also only available at a limited number of specialized centers, which can make it difficult for patients to access the treatment. In addition, proton therapy requires a high level of expertise, and it is not suitable for all types of spinal tumors.