Intramedullary spinal cord tumors: a review of current and future treatment strategies

Abstract

Intramedullary spinal cord tumors have low incidence rates but are associated with difficult treatment options. The majority of patients with these tumors can be initially treated with an attempted resection. Unfortunately, those patients who cannot undergo gross-total resection or have subtotal resection are left with few treatment options, such as radiotherapy and chemotherapy. These adjuvant treatments, however, are associated with the potential for significant adverse side effects and still leave patients with a poor prognosis. To successfully manage these patients and improve both their quality of life and prognosis, novel treatment options must be developed to supplement subtotal resection. New research is underway investigating alternative therapeutic approaches for these patients, including directed, localized drug delivery and nanomedicine techniques. These and other future investigations will hopefully lead to promising new therapies for these devastating diseases.

Keywords: BSCB = blood-spinal cord barrier; CED = convection-enhanced delivery; EGFR = epidermal growth factor receptor; Fn14 = protein fibroblast growth factor-inducible 14; GCT = germ cell tumor; GTR = gross-total resection; IMSCT = intramedullary spinal cord tumor; STR = subtotal resection; VEGF = vascular endothelial growth factor; VHL = von Hippel-Lindau; astrocytomas; ependymoma; intramedullary spinal cord tumors; nanomedicine; resection; review.