Radiosurgery

Radiation therapy is the treatment of choice for most patients with brain metastases. Most patients receive whole-brain radiation because the majority of brain metastases are multifocal. Another method known as stereotactic radiosurgery provides intense focal radiation, typically using a linear accelerator or gamma knife, in patients who cannot tolerate surgery or have lesions that are surgically inaccessible (e.g., in the brain stem). 

Lederman G, Arbit E, Odaimi M, Lombardi E, Wrzolek M, Wronski M. Fractionated stereotactic radiosurgery and concurrent taxol in recurrent glioblastoma multiforme a preliminary report. Int J Radiat Oncol Biol Phys 1998 40(3) 661-666. 

Particles emitted from radioactive isotopes are generally too low in energy to provide the penetration required for conventional treatments of tumors with external radiation beams. Most external beam radiation therapies are performed with high-energy x-rays or electrons produced with compact linear accelerators with accelerating potentials between about 4 and 20 MeV. One notable exception is certain devices designed for stereotactical radiosurgery or radiation therapy of superficial tumors that use cobalt-60 y-rays. The... 

From a technical point of view, intensity-modulated radiation therapy (IMRT) optimizes several parameters selection of multiple beams and, for each beam, optimization of dose, dose rate, size and shape, etc. Tomotherapy optimizes the dose distribution by IMRT in successive sections with immediate verification gamma knife, cyberknife, and radiosurgery concentrate high radiation doses in well-defined small volumes. 

Powerful irradiation techniques are now available or under development for photons intensity-modulated radiation therapy (IMRT), tomotherapy, gamma knife, cyberknife, radiosurgery, etc. These techniques make it possible to irradiate any volume of any complex shape with minimum irradiation of critical normal structures. 

Kalapurakal JA, Silverman CL, Akhtar N, Laske DW, Braitman LE, Boyko OB, Thomas PR. Intracranial meningiomas factors that influence the development of cerebral edema after stereotactic radiosurgery and radiation therapy. Radiology 1997 204(2) 461-5. 

Results of combined stereotactic, radiosurgery and transarterial embolization for dural arteriovenous fistulas of the transverse and sigmoid sinuses. Journal of Neurosurgery 94 886-891... 

R6gis J, Bartolomei F, Kida Y et al. (2000). Radiosurgery for epilepsy associated with cavernous malformation Retrospective study in 49 patients. Neurosurgery 47 1091-1097 Schierhout G and Roberts I (2000). 

Current treatment strategies for GBM are multimodal and typically involve surgical resection followed by radiation therapy and chemotherapy. Upon tumor recurrence repeat resection or stereotactic radiosurgery followed by additional... 

Chernov M, Hayashi M, Izawa M, Ochiai T, Usukura M, Abe K, Orio Y, Muragaki Y, Kubo O, Hori T, Takakura K (2005) Differenda-dori of die radiadon-induced necrosis and tumor recurrence after gamma knife radiosurgery for brain metastases Importance of muld-voxel proton MRS. Minim Invasive Neurosurg 48 228—234. 

Gan7, J.C. Gamma Knife Radiosurgery and its Possible Relationship to malignancy a Review. J Neurosurg. 2002 Dec 97(5 Suppl) 644-52. 

Hasegawa, T., Kondziolka, D., FUckinger, J. C., and Lunsford, L. D. (2003). Stereotactic radiosurgery for brain metastases from gastrointestinal tract cancer. Surg. Neurol. 60, 506-514. 

Radiosurgery for progressively symptomatic but surgically inaccessible lesions... 

Kondziolka D, Lunsford LD, Flickinger JC, Kestle JRW (1995a) Reduction of hemorrhagic risk after stereotactic radiosurgery for cavernous malformations. J Neurosurg 83 825-831... 

To treat the AVM as a sole therapy or in association with surgery or radiosurgery... 

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