-
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 -
International Journal of Radiation... Nov 2011During the past two decades, radiosurgery has arisen as a promising approach to the management of glomus jugulare. In the present study, we report on a systematic review... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
During the past two decades, radiosurgery has arisen as a promising approach to the management of glomus jugulare. In the present study, we report on a systematic review and meta-analysis of the available published data on the radiosurgical management of glomus jugulare tumors.
METHODS AND MATERIALS
To identify eligible studies, systematic searches of all glomus jugulare tumors treated with radiosurgery were conducted in major scientific publication databases. The data search yielded 19 studies, which were included in the meta-analysis. The data from 335 glomus jugulare patients were extracted. The fixed effects pooled proportions were calculated from the data when Cochrane's statistic was statistically insignificant and the inconsistency among studies was <25%. Bias was assessed using the Egger funnel plot test.
RESULTS
Across all studies, 97% of patients achieved tumor control, and 95% of patients achieved clinical control. Eight studies reported a mean or median follow-up time of >36 months. In these studies, 95% of patients achieved clinical control and 96% achieved tumor control. The gamma knife, linear accelerator, and CyberKnife technologies all exhibited high rates of tumor and clinical control.
CONCLUSIONS
The present study reports the results of a meta-analysis for the radiosurgical management of glomus jugulare. Because of its high effectiveness, we suggest considering radiosurgery for the primary management of glomus jugulare tumors.
Topics: Glomus Jugulare Tumor; Humans; Radiosurgery
PubMed: 21703782
DOI: 10.1016/j.ijrobp.2011.05.006 -
Journal of the Medical Association of... Oct 1991
-
Minerva Chirurgica Dec 2009Lung cancer is the most common cause of cancer death in both men and women in the United States. Anatomic lobectomy is the standard treatment and offers the best results... (Review)
Review
Lung cancer is the most common cause of cancer death in both men and women in the United States. Anatomic lobectomy is the standard treatment and offers the best results for curative treatment of early stage non-small cell lung cancer (NSCLC). With an aging population, a significant proportion of patients are not surgical candidates at the time of diagnosis. In medically inoperable patients, standard external beam radiation has been offered as treatment, with suboptimal results. Stereotactic radiosurgery (SRS), a term coined by Leksell describes an approach using multiple convergent beams, precise localization with a stereotactic coordinate system, and rigid immobilization. It provides precise delivery of beams from multiple collimated paths which maximizes radiation delivery to the tumor, and minimizes the exposure of normal tissue. Early results with SRS are very encouraging, and prospective trials are underway in our institution and others to evaluate its role in early stage NSCLC. In article we review the role of stereotactic radiosurgery for the treatment of lung cancer.
Topics: Humans; Lung Neoplasms; Pneumonectomy; Radiosurgery
PubMed: 20029356
DOI: No ID Found -
Journal of Neurosurgery Aug 2005
Topics: Humans; Meningeal Neoplasms; Meningioma; Neurosurgery; Physician's Role; Radiosurgery
PubMed: 16175846
DOI: 10.3171/jns.2005.103.2.0203 -
CMAJ : Canadian Medical Association... Mar 1998Radiosurgery can be defined as 3-dimensional stereotactic irradiation of small intracranial targets by various radiation techniques. The goal is to deliver, with great... (Comparative Study)
Comparative Study Review
Radiosurgery can be defined as 3-dimensional stereotactic irradiation of small intracranial targets by various radiation techniques. The goal is to deliver, with great accuracy, a large, single fraction dose to a small intracranial target, while minimizing the absorbed dose in the surrounding tissue. This article describes certain technical aspects of radiosurgery and compares the different methods of performing such treatment. The 2 most frequently used types of devices for radiosurgery are units with multiple cobalt sources (e.g., the Gamma Knife) and those based on a linear accelerator. In the former, highly collimated beams of radiation from the cobalt sources intersect at the target. In the latter, the source of a highly collimated beam of high-energy photons directed at the target turns through an arc or set of arcs. The accuracy of target localization, the steepness of fall-off of the radiation dose outside the target and the ability to irradiate an irregularly shaped target are all comparable for these 2 types of devices, despite claims to the contrary.
Topics: Humans; Radiosurgery; Treatment Outcome
PubMed: 9526480
DOI: No ID Found -
Neurosurgery Mar 2000Radiosurgery will celebrate its Golden Jubilee in the year 2001. More than 100,000 patients throughout the world have undergone radiosurgery since Lars Leksell first...
Radiosurgery will celebrate its Golden Jubilee in the year 2001. More than 100,000 patients throughout the world have undergone radiosurgery since Lars Leksell first described the technique in 1951. Rapid developments in neuroimaging and even robotic technology in the past decade have contributed to improved outcomes and wider applications for radiosurgery. A variety of different radiosurgical techniques have been developed in the past two decades. Numerous studies have examined the benefits and risks of radiosurgery performed with various devices. The long-term results of radiosurgery are now available, and these results have established radiosurgery as an effective noninvasive treatment method for intracranial vascular malformations and many tumors. Additional applications of radiosurgery for the treatment of malignant tumors and functional disorders are being assessed. Radiosurgery is an impressive combination of minimally invasive technologies administered by a multidisciplinary team of surgeons, oncologists, medical physicists, and engineers.
Topics: Diagnostic Imaging; Equipment and Supplies; Forecasting; History, 20th Century; Humans; Neurosurgery; Radiosurgery; United States
PubMed: 10719848
DOI: 10.1097/00006123-200003000-00002 -
Progress in Neurological Surgery 2007The role of stereotactic radiosurgery for the treatment of intracranial lesions is well established. Its use for the treatment of spinal lesions has been limited by the... (Review)
Review
The role of stereotactic radiosurgery for the treatment of intracranial lesions is well established. Its use for the treatment of spinal lesions has been limited by the availability of effective target immobilization and localization technologies. Conventional external beam radiotherapy lacks the precision to allow delivery of large doses of radiation near radiosensitive structures such as the spinal cord. The CyberKnife (Accuray Inc., Sunnyvale, Calif., USA) is an imageguided frameless stereotactic radiosurgery system that allows for the radiosurgical treatment of spinal lesions. The system utilizes the coupling of an orthogonal pair of X-ray cameras to a dynamically manipulated robot-mounted lightweight linear accelerator which has 6 d.f. that guides the therapy beam to the intended target without the use of frame-based fixation. Realtime imaging tracking allows for patient movement tracking with 1mm spatial accuracy. Cervical spine lesions are located and tracked relative to skull bony landmarks; lower spinal lesions are tracked relative to percutaneously placed gold fiducial bone markers. Spinal stereotactic radiosurgery using a frameless image-guided system is now both feasible and safe. The major potential benefits of radiosurgical ablation of spinal lesions are short treatment time in an outpatient setting with rapid recovery and good symptomatic response. This technique offers a successful therapeutic modality for the treatment of a variety of spinal lesions as a primary treatment or for lesions not amenable to open surgical techniques, in medically inoperable patients, lesions located in previously irradiated sites, or as an adjunct to surgery.
Topics: Humans; Particle Accelerators; Patient Care Planning; Radiosurgery; Radiotherapy Dosage; Robotics; Spinal Neoplasms
PubMed: 17318002
DOI: 10.1159/000100177 -
Progress in Neurological Surgery 2013Stereotactic radiosurgery is an accepted management option for many patients with intracranial arteriovenous malformations (AVMs). The Spetzler-Martin grading scale is... (Review)
Review
Stereotactic radiosurgery is an accepted management option for many patients with intracranial arteriovenous malformations (AVMs). The Spetzler-Martin grading scale is the most widely accepted and utilized method to predict outcomes after surgical resection of intracranial AVMs but is not sensitive to factors that correlate with successful AVM radiosurgery. The need for a system that accurately predicts patient outcomes after AVM radiosurgery led to the development of the radiosurgery-based AVM score (RBAS). The RBAS has evolved and has been modified over the years to reflect changes in AVM radiosurgical technique and has been validated by numerous centers using the Gamma Knife®, modified LINAC and the CyberKnife®. Use of the RBAS permits an accurate prediction of outcomes from radiosurgery to guide choices between observation, surgical resection or radiosurgery for individual AVM patients, and should be used in future studies on AVM radiosurgery to stratify patients for more precise comparative analyses.
Topics: Arteriovenous Malformations; Humans; Radiosurgery; Severity of Illness Index; Treatment Outcome
PubMed: 23258509
DOI: 10.1159/000341620 -
Neurosurgery Nov 2005Radiosurgery offers patients with brain metastases an effective and minimally invasive treatment modality. Radiosurgery provides local tumor control and prolongs... (Review)
Review
Radiosurgery offers patients with brain metastases an effective and minimally invasive treatment modality. Radiosurgery provides local tumor control and prolongs survival in select patients with brain metastases. This review will discuss numerous aspects of radiosurgery, including the various delivery techniques and radiobiology. Treatment recommendations will be outlined in view of the available clinical data. Although surgery or radiosurgery with whole-brain radiotherapy remains an important option for patients with a solitary brain metastasis, radiosurgery with or without whole-brain radiotherapy should be considered in patients with a limited number of small tumors and a good prognosis.
Topics: Brain Neoplasms; Clinical Trials as Topic; Evidence-Based Medicine; Humans; Neurosurgical Procedures; Practice Guidelines as Topic; Radiobiology; Radiosurgery; Randomized Controlled Trials as Topic; Retrospective Studies
PubMed: 16237288
DOI: 10.1227/01.neu.0000182741.82422.14