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JPMA. the Journal of the Pakistan... May 2020The approach to treating vestibular schwannomas ranges from wait-and-scan policies to micro-and radiosurgery. However, in the past few decades, Stereotac tic... (Review)
Review
The approach to treating vestibular schwannomas ranges from wait-and-scan policies to micro-and radiosurgery. However, in the past few decades, Stereotac tic Radiosurgery (SRS) has emerged as an approved primary treatment option as well. In this review, we have assessed some of the existing literature on the role of SRS in the management of vestibular schwannomas, and to estimate its efficacy in tumour control and conservation of cranial nerve function.
Topics: Humans; Neuroma, Acoustic; Radiosurgery; Treatment Outcome
PubMed: 32400760
DOI: No ID Found -
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 -
Movement Disorders : Official Journal... Jan 2017Functional radiosurgery has advanced steadily during the past half century since the development of the gamma knife technique for treating intractable cancer pain.... (Review)
Review
Functional radiosurgery has advanced steadily during the past half century since the development of the gamma knife technique for treating intractable cancer pain. Applications of radiosurgery for intracranial diseases have increased with a focus on understanding radiobiology. Currently, the use of gamma knife radiosurgery to ablate deep brain structures is not widespread because visualization of the functional targets remains difficult despite the increased availability of advanced neuroimaging technology. Moreover, most existing reports have a small sample size or are retrospective. However, increased experience with intraoperative neurophysiological evaluations in radiofrequency thalamotomy and deep brain stimulation supports anatomical and neurophysiological approaches to the ventralis intermedius nucleus. Two recent prospective studies have promoted the clinical application of functional radiosurgery for movement disorders. For example, unilateral gamma knife thalamotomy is a potential alternative to radiofrequency thalamotomy and deep brain stimulation techniques for intractable tremor patients with contraindications for surgery. Despite the promising efficacy of gamma knife thalamotomy, however, these studies did not include sufficient follow-up to confirm long-term effects. Herein, we review the radiobiology literature, various techniques, and the treatment efficacy of gamma knife radiosurgery for patients with movement disorders. Future research should focus on randomized controlled studies and long-term effects. © 2016 International Parkinson and Movement Disorder Society.
Topics: Deep Brain Stimulation; Humans; Movement Disorders; Radiosurgery; Thalamus
PubMed: 27029223
DOI: 10.1002/mds.26625 -
Deutsches Arzteblatt International Feb 2009Radiosurgery is a special treatment method that employs highly focused radiation to destroy tumors with high precision in a single session. A broad base of scientific... (Review)
Review
BACKGROUND
Radiosurgery is a special treatment method that employs highly focused radiation to destroy tumors with high precision in a single session. A broad base of scientific evidence already exists for the radiosurgical treatment of brain metastases. Recent advances in medical technology now allow radiosurgery to be extended to the spine as well.
METHODS
Selective literature review based on a PubMed search using the search terms stereotaxis, radiosurgery, stereotactic radiotherapy, accuracy, quality assurance, spine, spine metastasis, pain, Novalis, CyberKnife, Synergy, and robotics. We also present and analyze our own data as an illustration of the application of spinal radiosurgery.
RESULTS
The literature search identified 20 scientific original publications and one recent review. The data indicate that, within the specific constraints of the method, radiosurgery can arrest the growth of up to 96% of spinal metastases. Durable pain relief can be achieved in patients with tumor-associated pain syndromes. The morbidity of spinal radiosurgery is low, with a less than 1% risk of myelopathy.
CONCLUSIONS
Spinal radiosurgery is an independent, essentially noninvasive method of treatment. Different types of radiosurgical treatment apparatus are available. For properly selected patients, radiosurgery offers a good chance of therapeutic success with relatively rare complications.
Topics: Humans; Neoplasms; Radiosurgery; Surgery, Computer-Assisted
PubMed: 19562022
DOI: 10.3238/arztebl.2009.0106 -
Progress in Neurological Surgery 2012Classic radiosurgery is a neurosurgical treatment concept for single-fraction irradiation of cerebral lesions not amenable to open surgery. Until recently it has been... (Review)
Review
Classic radiosurgery is a neurosurgical treatment concept for single-fraction irradiation of cerebral lesions not amenable to open surgery. Until recently it has been realized mainly by frame-based technologies (Gamma Knife; stereotactic linear accelerators). The CyberKnife described in 1997 is an image-guided frameless robotic technology for whole-body radiosurgery. It can be used for classic single-fraction radiosurgery and for hypofractionated treatments. The CyberKnife treatment procedure is completely non-invasive and can be repeated throughout the body if necessary. Brain metastases are an important and frequently treated indication of modern radiosurgery. Data concerning radiosurgical treatment of brain metastases with the CyberKnife are reviewed. Scientific evidence shows that the full-body applicability of the CyberKnife is not at the expense of an inferior intracranial treatment quality when compared to standard frame-based technology. The clinical results of CyberKnife single-fraction radiosurgery are in line with the published literature. The attractive therapeutic profile of CyberKnife radiosurgery is reflected by a high tumor control and a low toxicity and the repeatability of the treatments for recurrent metastases. Although hypofractionated treatments (in 3-5 fractions) of brain metastases have been performed with the CyberKnife to treat large metastases, the clinical significance of this new radiosurgical concept is unclear and requires further study. A new approach is to treat the resection cavity with radiosurgery after surgical removal of brain metastases. In this concept radiosurgery replaces fractionated radiation therapy as an adjunct to surgery. The initial results are very promising. The CyberKnife has been established as a modern non-invasive technology for intra- and extracranial radiosurgery. It adds to the oncological armamentarium and confers upon radiosurgery a greater emphasis as an oncological treatment concept.
Topics: Brain Neoplasms; Humans; Radiosurgery
PubMed: 22236681
DOI: 10.1159/000331193 -
Nature Medicine Jun 1996
Review
Topics: Brain Neoplasms; Forecasting; Humans; Radiosurgery
PubMed: 8640567
DOI: 10.1038/nm0696-712 -
Neurology India 2023Skull base paragangliomas, also known as glomus tumors, are grouped as glomus jugulare or glomus tympanicum. Paragangliomas are rare tumors, with an estimated incidence... (Review)
Review
Skull base paragangliomas, also known as glomus tumors, are grouped as glomus jugulare or glomus tympanicum. Paragangliomas are rare tumors, with an estimated incidence of 1 case per million persons. They occur more commonly in females and are more common in the fifth or sixth decade of life. Management of these tumors traditionally involved surgical excision. However, surgical excision can result in high complication rates, particularly cranial nerve palsies. Stereotactic radiosurgery has been shown to yield tumor control rates of more than 90%. A recent meta-analysis reported improvement in neurological status in 48.7% of cases, while it stabilized in 39.3% of patients. Transient deficits such as headache, nausea, vomiting, and hemifacial spasm developed following SRS in 5.8% of patients, while 2.1% of patients developed permanent deficits. There is no difference in the rate of tumor control between different radiosurgery techniques. Dose-fractionated SRS can be used for large tumors to decrease the risk of radiation-induced complications.
Topics: Female; Humans; Radiosurgery; Treatment Outcome; Paraganglioma; Cranial Nerve Diseases; Skull Base
PubMed: 37026347
DOI: 10.4103/0028-3886.373640 -
Progress in Neurological Surgery 2012We discuss the current literature on the role of stereotactic radiosurgery in the multidisciplinary management of brain metastases and focus on the level of evidence... (Comparative Study)
Comparative Study Review
We discuss the current literature on the role of stereotactic radiosurgery in the multidisciplinary management of brain metastases and focus on the level of evidence that addresses key management questions. We reviewed the literature on the different roles of radiosurgery, radiotherapy, and resection, and in particular the 2009 Guidelines project of the Joint Section on Tumors of the AANS/CNS. Retrospective case series, matched cohort studies, and randomized trials show specific survival and local tumor control benefits after radiosurgery. Radiosurgery is an effective and safe minimally invasive option for patients with brain metastases. Randomized trials include tumors of different histologies which can detract from their relevance to specific tumor types.
Topics: Brain Neoplasms; Combined Modality Therapy; Cranial Irradiation; Humans; Radiosurgery; Randomized Controlled Trials as Topic
PubMed: 22236673
DOI: 10.1159/000331184 -
Future Oncology (London, England) May 2022The CyberKnife system combines real-time image guidance and a dynamic tracking system to implement frameless radiotherapy. This umbrella review is aimed to evaluate the... (Review)
Review
The CyberKnife system combines real-time image guidance and a dynamic tracking system to implement frameless radiotherapy. This umbrella review is aimed to evaluate the effectiveness and safety of CyberKnife. A comprehensive search of health technology assessments and systematic reviews was performed among the Embase, PubMed and other grey databases until July 2020. Treatment outcomes were extracted, and the quality of included studies were assessed using AMSTAR-2. Nineteen studies were eligible. CyberKnife not only had a wide range of applications, long overall survival and great local control, but also had a limited toxicity and good cost-effectiveness compared with other radiotherapy equipment. Despite the relatively low quality of the evidence, our findings can still provide a decision reference for policymakers.
Topics: Humans; Radiosurgery; Treatment Outcome
PubMed: 35137603
DOI: 10.2217/fon-2021-0844 -
Neurosurgery Clinics of North America Oct 2013Stereotactic radiosurgery was conceptualized to treat functional diseases of the brain. The need for devices capable of molding the radiation dose to the nuances of... (Review)
Review
Stereotactic radiosurgery was conceptualized to treat functional diseases of the brain. The need for devices capable of molding the radiation dose to the nuances of intracranial lesions and yet preserve brain function became a challenge. Several devices capable of performing radiosurgery of high quality became commercially available, each with advantages and disadvantages. Speed of radiosurgery delivery for cost effectiveness and comfort for the patient are currently the main developments in the field. Nuances of these devices, procedural steps of radiosurgery, and the team approach of radiosurgery are discussed in this article.
Topics: Brain; History, 20th Century; History, 21st Century; Humans; Radiosurgery; Spine
PubMed: 24093567
DOI: 10.1016/j.nec.2013.07.001