Radiotherapy Advances for Cervical Spine Tumors

STUDY DESIGN: Narrative review. OBJECTIVES: To evaluate the current data related to radiation treatment for cervical spine tumors and how this impacts surgical strategies, emerging technologies, and the effect of advancements in systemic therapies. SUMMARY OF BACKGROUND DATA: Cervical spine tumors are most commonly metastatic in origin, with primary malignancies and benign pathologies also possible. Unique treatment challenges for these tumors exist, and a multidisciplinary approach is often required. METHODS: A review was performed synthesizing the existing literature regarding radiation therapies in the management of cervical spine tumors. RESULTS: Both spine stereotactic body radiotherapy (SBRT) and conventional external beam radiotherapy (cEBRT) remain frequently utilized for the treatment of spinal metastases, with randomized data supporting higher rates of complete pain relief and improved local control with SBRT. Particle therapies have demonstrated promise in scenarios requiring dose escalation, but access and costs remain barriers to widespread adoption. Targeted systemic therapies provide significant survival benefits, but their efficacy and safety for spinal metastases remain an active area of investigation. CONCLUSIONS: Advances in radiation delivery technologies, minimally invasive hybrid approaches, and the rapid growth of systemic treatment options are transforming the management of cervical spine tumors while allowing for continued development of personalized treatment approaches.