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International Journal of Radiation... May 2021
Topics: Age Factors; Dose-Response Relationship, Radiation; Humans; Neoplasms; Organ Specificity; Organs at Risk; Practice Guidelines as Topic; Radiation Dose Hypofractionation; Radiosurgery; Radiotherapy Planning, Computer-Assisted; Systematic Reviews as Topic
PubMed: 33864823
DOI: 10.1016/j.ijrobp.2020.10.039 -
Progress in Neurological Surgery 2019Low-grade gliomas represent a heterogeneous group of tumors. The goals of treatment include prolonged survival and reduced morbidity. Treatment strategies vary depending... (Review)
Review
Low-grade gliomas represent a heterogeneous group of tumors. The goals of treatment include prolonged survival and reduced morbidity. Treatment strategies vary depending upon tumor histology, anatomic location, age, and the general medical condition of the patient. Safe surgical resection remains the first choice for the treatment of resectable tumors. In cases of unresectable lesions, adjuvant radiotherapy and chemotherapy are considered. Several reports in recent years have documented the safety and effectiveness of stereotactic radiosurgery (SRS) in controlling tumor growth and improving patients' survival for patients with low-grade gliomas. Patients with progressive, pilocytic, or grade 2 fibrillary astrocytomas, located in critical or deep areas of the brain, are ideal candidates for radiosurgery. The use of SRS as part of multimodal therapy for progressive, recurrent, or unresectable pilocytic or WHO grade 2 fibrillary astrocytomas is a safe and promising therapeutic modality. Gamma Knife radiosurgery has progressively gained more relevance in the management of low-grade gliomas.
Topics: Astrocytoma; Brain Neoplasms; Humans; Radiosurgery
PubMed: 31096253
DOI: 10.1159/000493063 -
Progress in Brain Research 2022The most important imaging technology for GKNS continues to be magnetic resonance. The introduction of 3 Tesla machines permits quicker studies with better signal to...
The most important imaging technology for GKNS continues to be magnetic resonance. The introduction of 3 Tesla machines permits quicker studies with better signal to noise ratio. The more powerful magnet increases the chances of heating the points of contact between patient and frame, but this has been solved with non-conducting nuts. There are several sequences for special functions. CISS studies are optimal for demonstrating cranial nerves in their passage through the subarachnoid space. FLAIR studies facilitate the distinction between CSF and edema due to inflammation. DTI permits the visualization of nerve fiber tracts. This has at least two current applications. In treatment planning of visible lesions, DTI permits a more efficient avoidance of important tracts. In functional work, tracts can be used to improve the definition of functional targets. Non stereotactic MRI can be imported into GammaPlan and co-registered to a non-distorted CT image.
Topics: Humans; Magnetic Resonance Imaging; Radiosurgery
PubMed: 35074095
DOI: 10.1016/bs.pbr.2021.10.026 -
Heart Rhythm Sep 2023Cardiac arrhythmia is a global health problem, and catheter ablation has been one of its main treatments for decades. However, catheter ablation is an invasive method... (Review)
Review
Cardiac arrhythmia is a global health problem, and catheter ablation has been one of its main treatments for decades. However, catheter ablation is an invasive method that cannot reach the deep myocardium, and it carries a considerable risk of side effects and recurrence. Therefore, it is necessary to explore a novel approach. Stereotactic body radiotherapy, which has been widely used in the field of radiation oncology, has recently expanded in the treatment of cardiac arrhythmia; when used in this context, it is known as stereotactic arrhythmia radioablation (STAR). As a noninvasive, effective, and well-tolerated treatment, STAR may be a suitable alternative method for patients with cardiac arrhythmia who are resistant or intolerant to catheter ablation. The main particles used to deliver energy in STAR are photons, protons, and carbon ions. Most studies have shown the short-term effectiveness of STAR, but problems such as a high long-term recurrence rate with a cumulative ventricular tachycardia-free survival rate from the published literature of 38.6% and related complications have also emerged. Therefore, in this article, we review the application of stereotactic body radiotherapy in cardiac arrhythmia, analyze its potential problems, and explore methods for improvement.
Topics: Humans; Arrhythmias, Cardiac; Tachycardia, Ventricular; Catheter Ablation; Radiosurgery; Myocardium
PubMed: 37150313
DOI: 10.1016/j.hrthm.2023.04.052 -
Cancer Radiotherapie : Journal de La... Apr 2020Stereotactic radiosurgery (SRS) is a non-invasive technique that enables to create brain focal lesions with a high precision and localization. Thus, functional brain... (Review)
Review
Stereotactic radiosurgery (SRS) is a non-invasive technique that enables to create brain focal lesions with a high precision and localization. Thus, functional brain disorders can be treated by SRS in case of pharmacoresistance or inoperability. To date, treatment of trigeminal neuralgia is the most described and known indication. Other indications will be developed in the future like movement disorders, refractory epilepsy, obsessive compulsive disorder and severe depression. We present here a review of actual and future indications of functional brain SRS with their level of evidence. All these SRS treatments have to be strictly conducted by trained teams with an excellent collaboration between radiation physicists, medical physicists, neurosurgeons, neurologists, psychiatrists and probably neuroradiologists.
Topics: Depressive Disorder, Major; Epilepsy; Humans; Obsessive-Compulsive Disorder; Parkinson Disease; Radiosurgery; Radiotherapy Dosage; Sclerosis; Treatment Outcome; Tremor; Trigeminal Neuralgia
PubMed: 32220562
DOI: 10.1016/j.canrad.2020.01.009 -
Handbook of Clinical Neurology 2017Cerebral arteriovenous malformations (AVMs) are rare, unstable vascular lesions which spontaneously rupture at a rate of approximately 2-4% annually. Stereotactic... (Review)
Review
Cerebral arteriovenous malformations (AVMs) are rare, unstable vascular lesions which spontaneously rupture at a rate of approximately 2-4% annually. Stereotactic radiosurgery is a minimally invasive treatment for AVMs, with a favorable risk-to-benefit profile in most patients, with respect to obliteration, hemorrhage, and seizure control. Radiosurgery is ideally suited for small to medium-sized AVMs (diameter <3cm or volume <12cm) located in deep or eloquent brain regions. Obliteration is ultimately achieved in 70-80% of cases and is directly associated with nidus volume and radiosurgical margin dose. Adverse radiation effects, which appear as T2-weighted hyperintensities on magnetic resonance imaging, develop in 30-40% of patients after AVM radiosurgery, are symptomatic in 10%, and fail to clinically resolve in 2-3%. The risk of AVM hemorrhage may be reduced by radiosurgery, but the hemorrhage risk persists during the latency period between treatment and obliteration. Delayed postradiosurgery cyst formation occurs in 2% of cases and may require surgical treatment. Radiosurgery abolishes or ameliorates seizure activity in the majority of patients with AVM-associated epilepsy and induces de novo seizures in 1-2% of those without preoperative seizures. Strategies for the treatment of large-volume AVMs include neoadjuvant embolization and either dose- or volume-staged radiosurgery.
Topics: Humans; Intracranial Arteriovenous Malformations; Radiosurgery; Seizures; Treatment Outcome
PubMed: 28552160
DOI: 10.1016/B978-0-444-63640-9.00007-2 -
Magyar Onkologia Mar 2024Stereotactic radiosurgery is today a well-established treatment modality for various intracranial pathologies. The principle of high dose focused intracranial radiation... (Review)
Review
Stereotactic radiosurgery is today a well-established treatment modality for various intracranial pathologies. The principle of high dose focused intracranial radiation guided by stereotactic technique ("Gamma Knife") was introduced by the Swedish neurosurgeon Prof. Lars Leksell in 1968. After the advent of CT and later MR imaging, stereotactic radiosurgery evolved rapidly regarding indications, and new technical solutions made it possible for linear accelerator systems to perform radiosurgery. A huge number of patients are treated yearly worldwide with this technology. In this article we overview the major indications, advantages and possible complications of stereotactic radiosurgery.
Topics: Humans; Brain Neoplasms; Radiosurgery
PubMed: 38484375
DOI: No ID Found -
Journal of Neurological Surgery. Part... Sep 2015Intramedullary spinal cord arteriovenous malformations (SCAVMs) comprise only 3 to 4% of spinal cord pathologies and are often not amenable to total resection due to... (Review)
Review
INTRODUCTION
Intramedullary spinal cord arteriovenous malformations (SCAVMs) comprise only 3 to 4% of spinal cord pathologies and are often not amenable to total resection due to extensive involvement with spinal cord parenchyma and multiple arterial feeding vessels.
METHODS
A electronic database search from 1966 to February 28, 2014, was conducted for relevant articles using the keywords and Medical Subject Headings strings spinal arteriovenous malformation, spinal radiosurgery, spinal vascular malformation, and radiosurgery for vascular lesions. Target outcomes measures were nidus obliteration, neurologic improvement, and complication rate.
RESULTS
Four retrospective articles containing a total of 30 patients were identified that described patients with SCAVMs presenting with symptomatic intramedullary or subarachnoid hemorrhage. Eighteen patients underwent treatment with CyberKnife with dosages ranging from 21 to 40 Gy (or a maximum biological equivalent dose of 58 Gy for early treatment effect) (Accuray, Inc., Sunnyvale, California, United States), 10 with a linear accelerator and real-time respiratory tracking ranging from 32 to 40 Gy, and 2 patients with external-beam radiotherapy receiving 45 Gy and 50 Gy, respectively. The mean time for clinical follow-up was 43.5 months (range: 27.9-60 months). There were no cases of spinal cord hemorrhage after radiosurgery. Nor were there any cases of neurologic worsening or signs and symptoms of neuropathic pain or myelitis. A total of 29 of the 30 patients obtained follow-up.
Topics: Arteriovenous Malformations; Humans; Radiosurgery; Spinal Cord
PubMed: 26140419
DOI: 10.1055/s-0035-1551824 -
Cancer Journal (Sudbury, Mass.)Stereotactic body radiation therapy has emerged as a safe and effective treatment modality for properly selected hepatocellular cancer (HCC) patients with normal liver... (Review)
Review
Stereotactic body radiation therapy has emerged as a safe and effective treatment modality for properly selected hepatocellular cancer (HCC) patients with normal liver function. However, many HCC patients have reduced baseline liver function due to underlying cirrhosis or prior liver-directed therapies. Therefore, because of the increased risk of hepatotoxicity, the use of stereotactic body radiation therapy for patients with reduced liver function has been approached with caution. Individualized, response-based radiotherapy incorporates models, imaging tools, and biomarkers that determine the dose-response relationship of the liver before, during, and after treatment and has been useful in reducing the likelihood of liver damage without sacrificing tumor control. This review discusses the evolution of response-based radiotherapy for HCC and highlights areas for further investigation.
Topics: Humans; Liver Neoplasms; Carcinoma, Hepatocellular; Treatment Outcome; Radiotherapy Dosage; Radiosurgery
PubMed: 37796644
DOI: 10.1097/PPO.0000000000000679 -
Hematology/oncology Clinics of North... Dec 2019Stereotactic radiation therapy (RT) involves the delivery of high dose-per-fraction treatments to small intracranial (stereotactic radiosurgery [SRS]) and extracranial... (Review)
Review
Stereotactic radiation therapy (RT) involves the delivery of high dose-per-fraction treatments to small intracranial (stereotactic radiosurgery [SRS]) and extracranial (stereotactic body radiotherapy [SBRT]) sites. SRS and SBRT share several overarching principles that differentiate stereotactic RT from conventionally fractionated radiation techniques. This review describes historical aspects of SRS/SBRT and definitions thereof, and a comparison with more modern semantics. Key principles of the stereotactic radiotherapeutic modalities are discussed, followed by an overview of the technical considerations involved. Lastly, the accepted appropriate clinical indications for stereotactic RT are outlined, and the potential role of stereotactic treatment in future oncologic management are also discussed.
Topics: Humans; Neoplasms; Radiosurgery; Radiotherapy Planning, Computer-Assisted; Radiotherapy, Intensity-Modulated
PubMed: 31668215
DOI: 10.1016/j.hoc.2019.08.007