[Radiotherapy of primary spinal cord tumors in adults]

Between 1980 and 1985 we treated 21 patients with primary spinal cord tumors. There were two diffuse and ten localized ependymoma, six low grade astrocytoma and three malignant glioma. Surgery consisted of total resection in six patients, subtotal resection in three and biopsy in twelve patients. Radiation doses ranged 45-55 Gy. Median age was 55 years (34-70 years), and median follow-up after therapy was 5 years (1-9 years). For patients with localized ependymoma, overall survival and 5-year recurrence-free survival are 80%. Of two patients with diffuse ependymoma, one is alive with no evidence of disease 6 years after the initial diagnosis, while the other is dead. Overall survival and 5 years recurrence-free survival for patients with low grade astrocytoma are 83% and 67%, respectively. All three patients with malignant glioma died of local recurrence (one had diffuse craniospinal metastases, too) one year after the initial diagnosis. Radiotherapy is therapy of choice after surgery in primary spinal cord tumors in adults, although local recurrences remain the major problem.