Proton Radiation Therapy for Spinal Tumors

Proton therapy may provide the benefits of local control or palliation, while reducing the
risk associated with photon radiation, by delivering therapeutic doses to a well-defined
target area with significant reduction in the integral dose. A dosimetry comparison of
protons and photons at the University of Florida Proton Therapy Institute confirmed the
feasibility of proton irradiation of these tumors with less exposure of normal tissue to
radiation than expected with photon techniques. This reduced radiation exposure to
uninvolved normal tissues is expected to decrease the risk of radiation-induced second
malignancies and neoplasms.

Inclusion Criteria:

- MPNSTs that are biopsy-positive and resected, subtotally resected or unresectable.

- Symptomatic (pain, numbness, or weakness) NF1 neurofibromas that are biopsy-positive
and unresectable or subtotally resected.

- Symptomatic NF1 neurofibromas that are unbiopsied and PET-negative, if the patient
refuses biopsy/surgery or is medically inoperable.

- Asymptomatic NF1 neurofibromas with radiologic progression after surgery.

- PET-positive, unbiopsied lesions in NF1 patients who refuse biopsy/surgery or are
medically inoperable.

Exclusion Criteria:

- Spinal instability.

- Metal stabilization hardware within the target area.

- Previously irradiated at this disease site.

- Spinal cord compression with complete loss of function.