title: Postoperative radiosurgery for malignant spinal tumors.
abstract: OBJECTIVE
  Although, as a primary therapy, radiosurgery for spinal tumors is becoming more common in clinical practice and is associated with encouraging clinical results, we wanted to evaluate outcomes after radiosurgery in a series of postoperative patients.
  
  
  METHODS
  We examined the medical records of 18 postoperative patients who received radiosurgical treatment to their residual spinal tumors: metastatic carcinoma (10), sarcoma (3), multiple myeloma/plasmacytoma (4), and giant cell tumor (1). Marginal radiosurgical doses ranged from 6 to 16 Gy (mean, 11.4 Gy) prescribed to the 90% isodose line. All regions of the spine received treatment: 2 cervical, 15 thoracic, and 1 lumbosacral. The volume of irradiated spinal elements receiving 30, 50, and 80% of the total dose ranged from 0.51 to 11.05, 0.19 to 6.34, and 0.06 to 1.73 cm, respectively. Treatment sessions (i.e., patient in to patient out of the room) varied between 20 and 40 minutes. Follow-up ranged from 4 to 36 months (median, 7 mo).
  
  
  RESULTS
  Even though significant doses of radiation were delivered to all regions of the spinal cord and nerve roots coincidentally involved in the treatments, only one patient in this series developed progressive symptoms possibly attributable to a toxic effect of the radiosurgery. Of those patients initially presenting with neurological deficits, 92% either remained neurologically stable or improved.
  
  
  CONCLUSIONS
  Our observations suggest that radiosurgery as prescribed in this series of postoperative patients with residual spinal tumor is well-tolerated and associated with little to no significant morbidity.
authors.affiliation: Department of Neurological Surgery, Hermelin Brain Tumor Center, Henry Ford Hospital, Detroit, Michigan 48202, USA. nsjar@neuro.hfh.edu
authors.forename: Jack P
authors.initials: JP
authors.lastname: Rock
authors.forename: Samuel
authors.initials: S
authors.lastname: Ryu
authors.forename: Mohammad S
authors.initials: MS
authors.lastname: Shukairy
authors.forename: Fang-Fang
authors.initials: FF
authors.lastname: Yin
authors.forename: Aktham
authors.initials: A
authors.lastname: Sharif
authors.forename: Faye
authors.initials: F
authors.lastname: Schreiber
authors.forename: Muwaffak
authors.initials: M
authors.lastname: Abdulhak
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Mark L
authors.initials: ML
authors.lastname: Rosenblum
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008875:Middle Aged; D011184:Postoperative Period; D016634:Radiosurgery / Q000379:methods; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000601:surgery*