[Primary tumors of the spine. Radiotherapy and chemotherapy]

Complete surgical excision of a primary spinal tumor without contamination of the surgical wound is not always possible, and adjuvant therapy by chemotherapy and/or radiation therapy is important to improve local and survival disease free. The efficacy of radiation therapy is limited above L2 because of the risk of radionecrosis of the spinal cord if one exceeds 45 Gy over 4.5 weeks. According to drugs and radiation sensitiveness, three groups can be distinguished: i) malignant tumors with low sensitiveness: chordoma, osteo-, chondro-, and fibro-sarcoma; ii) malignant tumors with high sensitiveness: Ewing's sarcoma, plasmocytoma, and non Hodgkin lymphoma; iii) benign tumos, occasionally aggressive like giant-cells tumor. For each type of tumor, a literature review and our personal experience is presented.