Radiation and intensity-modulated radiotherapy for metastatic spine tumors

Although promising, many questions remain regarding spinal IMRT. The challenge of patient immobilization must be surmounted before a radiation facility can safely offer spinal IMRT. At many institutions, the increased expense and time requirements from physicists, therapists, and physicians preclude the routine use of IMRT for spinal lesions. Finally, there are no randomized data comparing the safety or efficacy of IMRTwith more conventional means of spinal radiation. Nonetheless, IMRT is one of the most important recent technologic advancements in radiation therapy. For complex treatment problems, such as spinal tumors, in which the surrounding organs at risk traditionally place significant constraints on the prescription dose, IMRT has great potential to provide the ideal solution.