Stereotactic radiosurgery for XXXX to the craniovertebral junction preserves spine stability and offers symptomatic relief.

@entity1 @entity137 @entity0 @entity174 @entity5 @entity1149 @entity4048 @entity1745 @entity3 @entity158
UNASSIGNED: OBJECT Metastatic disease to the craniovertebral junction (CVJ) is rare but presents unique management challenges. To date, studies on using stereotactic radiosurgery (SRS) for CVJ @entity3 have been limited to case reports and small case series. The aim of this analysis was to evaluate the utility of SRS in the management of these secondary lesions. METHODS Clinical and radiological information from the charts of 25 @entity1 with metastatic disease of the CVJ who were treated with SRS between 2005 and 2013 at the Stanford CyberKnife Center were retrospectively reviewed. RESULTS Seven male and 18 female @entity1 with a median age of 58 years (range 34-94 years) were identified. The most common @entity5 were @entity0 (n = 5) and @entity1149 (n = 5), and the most frequent symptom was @entity4048 (n = 17). The average @entity5 volume treated was 15.9 cm(3) (range 0.16-54.1 cm(3)), with a mean marginal radiation dose of 20.3 Gy (range 15-25.5 Gy). The median follow-up was 18 months (range 1-81 months), though 1 @entity1 was lost to follow-up. SRS provided @entity5 stability in over 80% of @entity1 , offered @entity158 alleviation in nearly two-thirds of @entity1 , and produced no serious complications. Moreover, SRS preserved spinal stability in all but 1 @entity1 , in whom pre-SRS stability was established. There was no evidence of radiation @entity137 in the @entity1 population. Median survival was 28 months (range 2-81 months), with survival of 13.3% at 5 years. CONCLUSIONS In the absence of unstable pathological @entity174 and @entity1745 , @entity3 of the CVJ can be safely and effectively treated with SRS. This treatment option offers palliative @entity158 relief and can halt @entity5 progression with only a low risk of complications or spinal instability.
