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https://www.readbyqxmd.com/read/27911450/uveal-melanoma-relatively-rare-but-deadly-cancer
#1
REVIEW
S Kaliki, C L Shields
Although it is a relatively rare disease, primarily found in the Caucasian population, uveal melanoma is the most common primary intraocular tumor in adults with a mean age-adjusted incidence of 5.1 cases per million per year. Tumors are located either in iris (4%), ciliary body (6%), or choroid (90%). The host susceptibility factors for uveal melanoma include fair skin, light eye color, inability to tan, ocular or oculodermal melanocytosis, cutaneous or iris or choroidal nevus, and BRCA1-associated protein 1 mutation...
December 2, 2016: Eye
https://www.readbyqxmd.com/read/27911249/international-multicenter-cohort-study-of-pediatric-brain-arteriovenous-malformations-part-2-outcomes-after-stereotactic-radiosurgery
#2
Robert M Starke, Dale Ding, Hideyuki Kano, David Mathieu, Paul P Huang, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Douglas Kondziolka, Gene H Barnett, L Dade Lunsford, Jason P Sheehan
OBJECTIVE Pediatric patients (age < 18 years) harboring brain arteriovenous malformations (AVMs) are burdened with a considerably higher cumulative lifetime risk of hemorrhage than adults. Additionally, the pediatric population was excluded from recent prospective comparisons of intervention versus conservative management for unruptured AVMs. The aims of this multicenter, retrospective cohort study are to analyze the outcomes after stereotactic radiosurgery for unruptured and ruptured pediatric AVMs. METHODS We analyzed and pooled AVM radiosurgery data from 7 participating in the International Gamma Knife Research Foundation...
December 2, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27911248/international-multicenter-cohort-study-of-pediatric-brain-arteriovenous-malformations-part-1-predictors-of-hemorrhagic-presentation
#3
Dale Ding, Robert M Starke, Hideyuki Kano, David Mathieu, Paul P Huang, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Douglas Kondziolka, Gene H Barnett, L Dade Lunsford, Jason P Sheehan
OBJECTIVE Brain arteriovenous malformations (AVMs) are the most common cause of spontaneous intracranial hemorrhage in pediatric patients (age < 18 years). Since the cumulative lifetime risk of AVM hemorrhage is considerable in children, an improved understanding of the risk factors influencing hemorrhagic presentation may aid in the management of pediatric AVMs. The aims of this first of a 2-part multicenter, retrospective cohort study are to evaluate the incidence and determine the predictors of hemorrhagic presentation in pediatric AVM patients...
December 2, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27911236/patient-versus-physician-reported-facial-disability-in-vestibular-schwannoma-an-international-cross-sectional-study
#4
Øystein Vesterli Tveiten, Matthew L Carlson, Frederik Goplen, Erling Myrseth, Colin L W Driscoll, Rupavathana Mahesparan, Michael J Link, Morten Lund-Johansen
OBJECTIVE Patient-reported outcomes are increasingly used in studies of vestibular schwannoma (VS); however, few studies have examined self-evaluated facial nerve function and its relation to physician-reported outcomes. The primary objective of this study was to compare patient self-evaluations of facial disability with physician-evaluated facial nerve status and with self-evaluations of a healthy control group. The second objective was to provide insight into the controversial subject of the optimal initial management of small- and medium-sized VSs; consequently, the authors compared patient-reported facial nerve disability following treatment via observation (OBS), Gamma Knife surgery (GKS), or microsurgery (MS)...
December 2, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27911235/robustness-of-the-neurological-prognostic-score-in-brain-metastasis-patients-treated-with-gamma-knife-radiosurgery
#5
Toru Serizawa, Yoshinori Higuchi, Osamu Nagano, Shinji Matsuda, Kyoko Aoyagi, Junichi Ono, Naokatsu Saeki, Yasuo Iwadate, Tatsuo Hirai, Shinya Takemoto, Yuta Shibamoto
OBJECTIVE The neurological prognostic score (NPS) was recently proposed as a means for predicting neurological outcomes, such as the preservation of neurological function and the prevention of neurological death, in brain metastasis patients treated with Gamma Knife radiosurgery (GKRS). NPS consists of 2 groups: Group A patients were expected to have better neurological outcomes, and Group B patients were expected to have poorer outcomes. NPS robustness was tested in various situations. METHODS In total, 3040 patients with brain metastases that were treated with GKRS were analyzed...
December 2, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27909271/-epidermal-growth-factor-receptor-mutated-advanced-lung-adenocarcinoma-with-long-term-tumor-free-survival-by-chemotherapy-followed-by-tyrosine-kinase-inhibitor-treatment-after-reduction-surgery
#6
Atsushi Morio, Kazuki Nakahara, Toshirou Futagawa, Kenji Suzuki
A 67-year-old woman was detected stage III B adenocarcinoma of the left lung, with epidermal growth factor receptor(EGFR) -mutation. Since chest computed tomography showed enlarged lymph nodes in stations 7 and 1R-4R, radiochemotherapy was recommended. However, she declined radiochemotherapy and the chemotherapy after tumor reduction surgery was chosen. She underwent resection of the left lower lobe and lingular segment, and mediastinal lymph node dissection through a posterolateral thoracotomy by extended bronchoplasty(type C) due to the extranodal invasion of lymph nodes to the lingular segmental bronchus...
December 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27903198/dosimetric-characterization-of-hypofractionated-gamma-knife-radiosurgery-of-large-or-complex-brain-tumors-versus-linear-accelerator-based-treatments
#7
Peng Dong, Angélica Pérez-Andújar, Dilini Pinnaduwage, Steve Braunstein, Philip Theodosopoulos, Michael McDermott, Penny Sneed, Lijun Ma
OBJECTIVE Noninvasive Gamma Knife (GK) platforms, such as the relocatable frame and on-board imaging, have enabled hypofractionated GK radiosurgery of large or complex brain lesions. This study aimed to characterize the dosimetric quality of such treatments against linear accelerator-based delivery systems that include the CyberKnife (CK) and volumetric modulated arc therapy (VMAT). METHODS Ten patients treated with VMAT at the authors' institution for large brain tumors (> 3 cm in maximum diameter) were selected for the study...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903197/upfront-boost-gamma-knife-leading-edge-radiosurgery-to-flair-mri-defined-tumor-migration-pathways-in-174-patients-with-glioblastoma-multiforme-a-15-year-assessment-of-a-novel-therapy
#8
Christopher M Duma, Brian S Kim, Peter V Chen, Marianne E Plunkett, Ralph Mackintosh, Marlon S Mathews, Ryan M Casserly, Gustavo A Mendez, Daniel J Furman, Garrett Smith, Nathan Oh, Chad A Caraway, Ami R Sanathara, Robert O Dillman, Azzurra-Sky Riley, David Weiland, Lian Stemler, Ruslana Cannell, Daniela Alexandru Abrams, Alexa Smith, Christopher M Owen, Burton Eisenberg, Michael Brant-Zawadzki
OBJECTIVE Glioblastoma multiforme (GBM) is composed of cells that migrate through the brain along predictable white matter pathways. Targeting white matter pathways adjacent to, and leading away from, the original contrast-enhancing tumor site (termed leading-edge radiosurgery [LERS]) with single-fraction stereotactic radiosurgery as a boost to standard therapy could limit the spread of glioma cells and improve clinical outcomes. METHODS Between December 2000 and May 2016, after an initial diagnosis of GBM and prior to or during standard radiation therapy and carmustine or temozolomide chemotherapy, 174 patients treated with radiosurgery to the leading edge (LE) of tumor cell migration were reviewed...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903196/the-impact-of-cobalt-60-source-age-on-biologically-effective-dose-in-high-dose-functional-gamma-knife-radiosurgery
#9
Benjamin H Kann, James B Yu, John M Stahl, James E Bond, Christopher Loiselle, Veronica L Chiang, Ranjit S Bindra, Jason L Gerrard, David J Carlson
OBJECTIVE Functional Gamma Knife radiosurgery (GKRS) procedures have been increasingly used for treating patients with tremor, trigeminal neuralgia (TN), and refractory obsessive-compulsive disorder. Although its rates of toxicity are low, GKRS has been associated with some, if low, risks for serious sequelae, including hemiparesis and even death. Anecdotal reports have suggested that even with a standardized prescription dose, rates of functional GKRS toxicity increase after replacement of an old cobalt-60 source with a new source...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903195/dosimetric-effects-of-onyx-embolization-on-gamma-knife-arteriovenous-malformation-dose-distributions
#10
David J Schlesinger, Håkan Nordström, Anders Lundin, Zhiyuan Xu, Jason P Sheehan
OBJECTIVE Patients with arteriovenous malformations (AVMs) treated with Gamma Knife radiosurgery (GKRS) subsequent to embolization suffer from elevated local failure rates and differences in adverse radiation effects. Onyx is a common embolic material for AVMs. Onyx is formulated with tantalum, a high atomic number (Z = 73) element that has been investigated as a source of dosimetric uncertainty contributing to the less favorable clinical results. However, prior studies have not modeled the complicated anatomical and beam geometries characteristic of GKRS...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903193/three-dimensional-assessment-of-the-effects-of-high-density-embolization-material-on-the-absorbed-dose-in-the-target-for-gamma-knife-radiosurgery-of-arteriovenous-malformations
#11
Yoichi Watanabe, Divyajot Sandhu, Leighton Warmington, Sean Moen, Ramachandra Tummala
OBJECTIVE Arteriovenous malformation (AVM) is an intracranial vascular disorder. Gamma Knife radiosurgery (GKRS) is used in conjunction with intraarterial embolization to eradicate the nidus of AVMs. Clinical results indicate that patients with prior embolization tend to gain less benefit from GKRS. The authors hypothesized that this was partly caused by dosimetric deficiency. The actual dose delivered to the target may be smaller than the intended dose because of increased photon attenuation by high-density embolic materials...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903192/stereotactic-radiosurgery-for-idiopathic-glossopharyngeal-neuralgia-an-international-multicenter-study
#12
Hideyuki Kano, Dusan Urgosik, Roman Liscak, Bruce E Pollock, Or Cohen-Inbar, Jason P Sheehan, Mayur Sharma, Danilo Silva, Gene H Barnett, David Mathieu, Nathaniel D Sisterson, L Dade Lunsford
OBJECTIVE The goal of this study was to evaluate the outcomes of Gamma Knife stereotactic radiosurgery (SRS) when used for patients with intractable idiopathic glossopharyngeal neuralgia. METHODS Six participating centers of the International Gamma Knife Research Foundation identified 22 patients who underwent SRS for intractable glossopharyngeal neuralgia between 1998 and 2015. The median patient age was 60 years (range 34-83 years). The median duration of symptoms before SRS was 46 months (range 1-240 months)...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903190/prognostic-value-of-diffusion-tensor-imaging-parameters-for-gamma-knife-radiosurgery-in-meningiomas
#13
Herwin Speckter, Jose Bido, Giancarlo Hernandez, Diones Rivera Mejía, Luis Suazo, Santiago Valenzuela, Eddy Perez-Then, Peter Stoeter
OBJECTIVE Diffusion tensor imaging (DTI) parameters are able to differentiate between meningioma subtypes. The hypothesis that there is a correlation between DTI parameters and the change in tumor size after Gamma Knife radiosurgery (GKRS) was analyzed. METHODS DTI parameters were measured using MRI before GKRS in 26 patients with meningiomas. The findings were correlated with the change in tumor size after treatment as measured at the last follow-up (range 12.5-45 months). RESULTS Only those meningiomas that showed the highest fractional anisotropy (FA), the lowest spherical index of the tensor ellipsoid (Cs), and the lowest radial diffusivity (RD) either increased or remained stable in terms of volume, whereas all other meningiomas decreased in volume...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903189/grade-ii-meningiomas-and-gamma-knife-radiosurgery-analysis-of-success-and-failure-to-improve-treatment-paradigm
#14
Charles A Valery, Matthieu Faillot, Ioannis Lamproglou, Jean-Louis Golmard, Catherine Jenny, Matthieu Peyre, Karima Mokhtari, Jean-Jacques Mazeron, Philippe Cornu, Michel Kalamarides
OBJECTIVE Grade II meningiomas, which currently account for 25% of all meningiomas, are subject to multiple recurrences throughout the course of the disease and represent a challenge for the neurosurgeon. Radiosurgery is increasingly performed for the treatment of Grade II meningiomas and is quite efficient in controlling relapses locally at the site of the lesion, but it cannot prevent margin relapses. The aim of this retrospective study was to analyze the technical parameters involved in producing marginal relapses and to optimize loco-marginal control to improve therapeutic strategy...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903188/the-role-of-diffusion-tensor-imaging-tractography-for-gamma-knife-thalamotomy-planning
#15
João Gabriel Ribeiro Gomes, Alessandra Augusta Gorgulho, Amanda de Oliveira López, Crystian Wilian Chagas Saraiva, Lucas Petri Damiani, Anderson Martins Pássaro, João Victor Salvajoli, Ludmila de Oliveira Siqueira, Bernardo Peres Salvajoli, Antônio Afonso Ferreira De Salles
OBJECTIVE The role of tractography in Gamma Knife thalamotomy (GK-T) planning is still unclear. Pyramidal tractography might reduce the risk of radiation injury to the pyramidal tract and reduce motor complications. METHODS In this study, the ventralis intermedius nucleus (VIM) targets of 20 patients were bilaterally defined using Iplannet Stereotaxy Software, according to the anterior commissure-posterior commissure (AC-PC) line and considering the localization of the pyramidal tract. The 40 targets and tractography were transferred as objects to the GammaPlan Treatment Planning System (GP-TPS)...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903187/stereotactic-diffusion-tensor-imaging-tractography-for-gamma-knife-radiosurgery
#16
Cormac G Gavin, H Ian Sabin
OBJECTIVE The integration of modern neuroimaging into treatment planning has increased the therapeutic potential and safety of stereotactic radiosurgery. The authors report their method of integrating stereotactic diffusion tensor imaging (DTI) tractography into conventional treatment planning for Gamma Knife radiosurgery (GKRS). The aim of this study was to demonstrate the feasibility of this technique and to address some of the technical limitations of previously reported techniques. METHODS Twenty patients who underwent GKRS composed the study cohort...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903186/clinical-outcomes-in-patients-with-brain-metastases-from-breast-cancer-treated-with-single-session-radiosurgery-or-whole-brain-radiotherapy
#17
Michael Mix, Rania Elmarzouky, Tracey O'Connor, Robert Plunkett, Dheerendra Prasad
OBJECTIVE Gamma Knife radiosurgery (GKRS) is used to treat brain metastases from breast cancer (BMB) as the sole treatment or in conjunction with tumor resection and/or whole brain radiotherapy (WBRT). This study evaluates outcomes in BMB based on treatment techniques and tumor biological features. METHODS The authors reviewed all patients treated with BMB between 2004 and 2014. Patients were identified from a prospectively collected radiosurgery database and institutional tumor registry; 214 patients were identified...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903185/acute-clinical-adverse-radiation-effects-after-gamma-knife-surgery-for-vestibular-schwannomas
#18
Constantin Tuleasca, Mercy George, Mohamed Faouzi, Luis Schiappacasse, Henri-Arthur Leroy, Michele Zeverino, Roy Thomas Daniel, Raphael Maire, Marc Levivier
OBJECTIVE Vestibular schwannomas (VSs) represent a common indication of Gamma Knife surgery (GKS). While most studies focus on the long-term morbidity and adverse radiation effects (AREs), none describe the acute clinical AREs that might appear on a short-term basis. These types of events are investigated, and their incidence, type, and outcomes are reported in the present paper. METHODS The included patients were treated between July 2010 and March 2016, underwent at least 6 months of follow-up, and presented with a disabling symptom during the first 6 months after GKS that affected their quality of life...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903184/microinvasive-tumor-endoresection-in-combination-with-ocular-stereotactic-radiosurgery
#19
Oleg A Sinyavskiy, Roman L Troyanovsky, Pavel I Ivanov, Alexandr S Golovin, Andrey V Tibilov, Svetlana N Solonina, Anna M Astapenko, Irina S Zubatkina
OBJECTIVE The use of Gamma Knife radiosurgery (GKRS) as monotherapy in the treatment of uveal melanoma (UM) allows clinicians to achieve high local tumor control with low recurrence but does not prevent secondary enucleation due to glaucoma in cases of large tumors. The authors analyzed indications for tumor endoresection (ER), the time interval between irradiation and surgery, and the features and results of performing ER for UM after GKRS. METHODS Thirty-seven patients between 28 and 78 years of age (16 male and 11 female patients) with UM underwent GKRS with a dose of 70 to 80 Gy that was applied to the center of the tumor with complete immobilization of the eye during the procedure...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903183/stereotactic-radiosurgery-for-vestibular-schwannomas-average-10-year-follow-up-results-focusing-on-long-term-hearing-preservation
#20
Shinya Watanabe, Masaaki Yamamoto, Takuya Kawabe, Takao Koiso, Tetsuya Yamamoto, Akira Matsumura, Hidetoshi Kasuya
OBJECTIVE The aim of this study was to reappraise long-term treatment outcomes of stereotactic radiosurgery (SRS) for vestibular schwannomas (VSs). The authors used a database that included patients who underwent SRS with a unique dose-planning technique, i.e., partial tumor coverage designed to avoid excess irradiation of the facial and cochlear nerves, focusing on tumor control and hearing preservation. Clinical factors associated with post-SRS tumor control and long-term hearing preservation were also analyzed...
December 2016: Journal of Neurosurgery
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