Types of Radiation Therapy Used to Treat Spine Conditions

Radiation therapy uses high doses of radiation—such as those from X-rays, gamma rays, or other particles—to stop or slow the growth of a spinal tumor. This is different from low dose radiation, which is used in radiology for imaging (X-rays, MRI, CT) broken bones or teeth.

The cancer-fighting, high-dose radiation treatments can be delivered in different ways, the most common of which is called external beam radiation therapy and is delivered from outside the patient’s body. More than half of people with cancer (about 60 percent) get radiation therapy as a treatment option.1

There has been significant progress and innovation in the field of radiation therapy. Cancer care teams can now provide individualized care with great benefits.

  • improved quality of life2
  • decrease neurological impairment2
  • decreased local tumor recurrence rates2
  • improved pain control2
  • more durable spinal stability2

If you and your doctor decide that a form of radiation therapy is the right next step for you, you may be interested in learning more about the different options available for your treatment.

External beam radiation therapy (EBRT)—radiation that is delivered from outside the body to the tumor. Typically, the total prescribed radiation dose is delivered in small doses five days a week over several weeks. Each session lasts around 15-30 minutes including set-up, dose delivery and dose verification. Actual dose delivery time is typically very short.

External beam radiation therapy can be given in a single treatment or over several appointments, called fractions, or sessions. The sessions can be once a day, five days a week and can last between two and ten weeks, depending upon the type of spine tumor and the goal of the treatment.

Your cancer care team may prescribe your radiation with different schedules, depending upon your diagnosis and overall treatment plan. You may receive your total radiation dose over a shorter number of days than traditional radiation therapy or in unique situations, you may receive small doses of radiation more than once per day.

Spinal stereotactic radiosurgery (SRS) is the focused delivery of radiation to a tumor in the spine. SRS has significantly enhanced the ability of clinicians to control spinal tumors locally and non-invasively. This tumor control extends to tumors that are deemed radioresistant by conventional radiation therapy standards.When radiation therapy is unable to reduce the volume of a tumor or the tumor recurs, it is deemed radioresistant.

Stereotactic radiosurgery (SRS)—sometimes also referred to as stereotactic body radiation therapy (SBRT) when treating areas outside of the head; also delivered from outside the body, SRS uses special equipment to position the patient with sub millimeter precision2 and deliver a large radiation dose to a tumor while avoiding surrounding healthy tissue and organs. The total radiation dose may be delivered in a single session or it may be fractionated, which means divided up into sessions.

SRS is rapidly evolving to incorporate sophisticated software, image guidance, intensity modulation, advanced radiation beam shaping. High definition treatment systems can shape the beam very precisely to the tumor and then move around the patient’s body to deliver the treatment from different angles so that the healthy tissue receives less radiation but the tumor receives a concentrated dose throughout the treatment. Stereotactic radiosurgery is becoming more common for many types of spinal tumors and is especially effective for tumors that are hard to reach and for metastases.

Intraoperative brachytherapy—typically used in conjunction with external beam radiation therapy, brachytherapy involves the insertion of radioactive substances directly into or close to the tumor. The radiation ‘fall-off’ is high so only the tumor will receive this radiation source. The EBRT is then used to complement the brachytherapy dose.

Whole brain and spinal cord radiation therapy—some tumors, like ependymomas and medulloblastomas may spread to the meninges (spinal cord covering) or the cerebrospinal fluid. If this happens, some doctors may still prescribe low dose radiation to the entire brain and spinal cord.3

Visit our Learn More section to understand spine anatomy basics and how spine tumors form.

1 National Cancer Institute ‘Radiation Therapy and You: Support for People with Cancer’
2 Fridley, J.S., Hepel, J.T., MD; Oyelese, A.A. Current Treatment of Metastatic Spine Tumors – Surgery and Stereotactic Radiosurgery. Recent Advances in Neurosurgery.
3 American Cancer Society