Impact of Radiation Therapy on Outcomes After Spinal Instrumentation for Craniocervical Junction Malignancies
Objective Spinal reconstruction after resection of invasive craniocervical junction malignancies is fraught with technical and management considerations as well as a paucity of data in the existing literature. In this study, we describe our experience with craniocervical junction malignancies, espec...
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| Format: | Article |
| Language: | English |
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Korean Spinal Neurosurgery Society
2022-06-01
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| Series: | Neurospine |
| Subjects: | |
| Online Access: | http://e-neurospine.org/upload/pdf/ns-2244034-017.pdf |
| _version_ | 1797332487366508544 |
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| author | Matthew Muir Laurence Rhines Franco Demonte Claudio Tatsui Shaan M. Raza |
| author_facet | Matthew Muir Laurence Rhines Franco Demonte Claudio Tatsui Shaan M. Raza |
| author_sort | Matthew Muir |
| collection | DOAJ |
| description | Objective Spinal reconstruction after resection of invasive craniocervical junction malignancies is fraught with technical and management considerations as well as a paucity of data in the existing literature. In this study, we describe our experience with craniocervical junction malignancies, especially the influence of radiation on the need for revision spinal instrumentation. Methods We performed a retrospective chart review of all patients who underwent occipitocervical fixation between 2011 and 2019 at The University of Texas MD Anderson Cancer Center. Results Twenty-five patients had primary malignancies and 12 (30%) had metastatic tumors. Thirteen (33%) underwent a staged resection in multiple operations during their hospital stay. Tumor resection was performed in 19 patients (48%), while only stabilization was performed in 21 patients (52%). Nine patients (23%) underwent expanded endoscopic transclival approaches for tumor resection, 10 patients (25%) an extreme lateral approach, and 2 patients (5%) an anterior open approach. Eleven patients underwent early postoperative radiation therapy (within 3 months) and 8 underwent delayed radiation therapy (between 3 months and 1 year in 7 patients). The revision rate was 8%, with a median time to revision surgery of 42 months. The administration and timing of adjuvant radiation therapy relative to surgery had no significant effect on the need for instrumentation revision on log-rank and Cox regression analyses (p < 0.05). Conclusion Revision surgery was needed infrequently in our patients. Postoperative radiation therapy was not associated with hardware failure, indicating that the timing of radiation therapy should be dictated by the diagnosis and can be initiated postoperatively without delay. |
| first_indexed | 2024-03-08T07:49:40Z |
| format | Article |
| id | doaj.art-4067938e82d241bdafab278c5b5c622f |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T07:49:40Z |
| publishDate | 2022-06-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-4067938e82d241bdafab278c5b5c622f2024-02-02T14:59:12ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912022-06-0119243444010.14245/ns.2244034.0171270Impact of Radiation Therapy on Outcomes After Spinal Instrumentation for Craniocervical Junction MalignanciesMatthew Muir0Laurence Rhines1Franco Demonte2Claudio Tatsui3Shaan M. Raza4 Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USAObjective Spinal reconstruction after resection of invasive craniocervical junction malignancies is fraught with technical and management considerations as well as a paucity of data in the existing literature. In this study, we describe our experience with craniocervical junction malignancies, especially the influence of radiation on the need for revision spinal instrumentation. Methods We performed a retrospective chart review of all patients who underwent occipitocervical fixation between 2011 and 2019 at The University of Texas MD Anderson Cancer Center. Results Twenty-five patients had primary malignancies and 12 (30%) had metastatic tumors. Thirteen (33%) underwent a staged resection in multiple operations during their hospital stay. Tumor resection was performed in 19 patients (48%), while only stabilization was performed in 21 patients (52%). Nine patients (23%) underwent expanded endoscopic transclival approaches for tumor resection, 10 patients (25%) an extreme lateral approach, and 2 patients (5%) an anterior open approach. Eleven patients underwent early postoperative radiation therapy (within 3 months) and 8 underwent delayed radiation therapy (between 3 months and 1 year in 7 patients). The revision rate was 8%, with a median time to revision surgery of 42 months. The administration and timing of adjuvant radiation therapy relative to surgery had no significant effect on the need for instrumentation revision on log-rank and Cox regression analyses (p < 0.05). Conclusion Revision surgery was needed infrequently in our patients. Postoperative radiation therapy was not associated with hardware failure, indicating that the timing of radiation therapy should be dictated by the diagnosis and can be initiated postoperatively without delay.http://e-neurospine.org/upload/pdf/ns-2244034-017.pdfcraniocervical junctioninstrumentationcancerradiation |
| spellingShingle | Matthew Muir Laurence Rhines Franco Demonte Claudio Tatsui Shaan M. Raza Impact of Radiation Therapy on Outcomes After Spinal Instrumentation for Craniocervical Junction Malignancies Neurospine craniocervical junction instrumentation cancer radiation |
| title | Impact of Radiation Therapy on Outcomes After Spinal Instrumentation for Craniocervical Junction Malignancies |
| title_full | Impact of Radiation Therapy on Outcomes After Spinal Instrumentation for Craniocervical Junction Malignancies |
| title_fullStr | Impact of Radiation Therapy on Outcomes After Spinal Instrumentation for Craniocervical Junction Malignancies |
| title_full_unstemmed | Impact of Radiation Therapy on Outcomes After Spinal Instrumentation for Craniocervical Junction Malignancies |
| title_short | Impact of Radiation Therapy on Outcomes After Spinal Instrumentation for Craniocervical Junction Malignancies |
| title_sort | impact of radiation therapy on outcomes after spinal instrumentation for craniocervical junction malignancies |
| topic | craniocervical junction instrumentation cancer radiation |
| url | http://e-neurospine.org/upload/pdf/ns-2244034-017.pdf |
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