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Stereotactic radiosurgery

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https://www.readbyqxmd.com/read/29332081/radiosurgical-subthalamic-nucleotomy
#1
Jean Régis, Romain Carron, Tatiana Witjas
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is the reference technique in Parkinson's disease (PD) at different stages of complications. Some patients cannot afford DBS due to anticoagulation or comorbidities or due to pecuniary reasons. Radiosurgery is a minimally invasive stereotactic technique, with no craniotomy and subsequently no risk of bleeding or infection. Its good safety efficacy profile has been established in the treatment of tremor, and the postoperative care issues are simple with a much shorter hospital stay (mean 48 h)...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332069/the-history-of-movement-disorder-brain-surgery
#2
L Dade Lunsford, Ajay Niranjan
The first surgical procedures for abnormal movement disorders began in the 1930s, when surgeons first proposed ablative techniques of the caudate nucleus or transection of motor (pyramidal) pathways to reduce involuntary movements in patients with Parkinson's related tremor. During the 50-year interval between 1945 and 1995, the development of precise intracranial guiding devices, brain maps, and advanced imaging led to the refinement of appropriate deep brain targets affecting extrapyramidal pathways. Lesional surgery and subsequent neuroaugmentation using deep brain stimulation extended the role of deep brain surgery for a wider group of patients with tremor, rigidity, dyskinesia, and other involuntary movement disorders...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29331746/canadian-neurosurgery-educators-views-on-stereotactic-radiosurgery-in-residency-training
#3
Nardin Samuel, Justine Philteos, Naif M Alotaibi, Christopher Ahuja, Alireza Mansouri, Abhaya V Kulkarni
OBJECTIVE: Despite the increasing prominence of stereotactic radiosurgery (SRS) in treating intracranial and spinal pathologies, there is currently a dearth of exposure to this modality in neurosurgical residency. To address this gap, the aim of this study is to assess neurosurgery educators' views regarding the current state of SRS exposure, and to identify potential approaches to improve residency education in this domain. METHODS: Qualitative thematic analysis and constructivist grounded theory methodology were employed...
January 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29327171/efficacy-of-adjuvant-radiotherapy-in-the-intracranial-hemangiopericytoma
#4
Seung Hyuck Jeon, Sung-Hye Park, Jin Wook Kim, Chul-Kee Park, Sun Ha Paek, Il Han Kim
We retrospectively evaluated an efficacy of adjuvant radiotherapy (RT) in the intracranial hemangiopericytoma (HPC) and analyzed prognostic factors influencing treatment outcomes. Among 49 patients diagnosed as localized intracranial HPC between 1995 and 2016, 31 patients received adjuvant RT after surgery; 26 with fractionated RT and 5 with stereotactic radiosurgery using Gamma Knife. After gross total resection (GTR) (n = 32) and subtotal resection (STR) (n = 17), histopathological grade was confirmed to be grade II (n = 9) or grade III (n = 40)...
January 11, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29326012/stereotactic-body-radiotherapy-sbrt-for-patients-with-locally-advanced-pancreatic-cancer-a-single-center-experience
#5
Raphaël Jumeau, Guila Delouya, David Roberge, David Donath, Dominic Béliveau-Nadeau, Marie-Pierre Campeau
INTRODUCTION: Despite advances in treatment, notably in systemic therapy, the prognosis of pancreatic adenocarcinoma (PADC) remains dismal. Stereotactic body radiotherapy (SBRT) is an emerging tool in the complex management of PADC. We review outcomes of SBRT for PADC at our institution. METHODS: We reviewed patients treated with SBRT for either unresectable PADC or locally recurrent PADC after surgery. Treatment was delivered using a robotic radiosurgery system with respiratory tracking...
December 21, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29325944/hemorrhagic-cavernous-sinus-hemangioma-with-sudden-onset-abducens-palsy-case-report
#6
Fumihiko Nishimura, Park Young-Su, Ichiro Nakagawa, Shuichi Yamada, Hiroyuki Nakase, Yasushi Nagatomo
BACKGROUND: We report a rare case of hemorrhagic cavernous sinus hemangioma with sudden onset of abducens palsy. CASE DESCRIPTIONS: Sudden onset of diplopia occurred in a 49-year-old female. Head computed tomography (CT) findings revealed a high density mass in the right cavernous sinus with protrusion to the sphenoid sinus. Endoscopic endonasal surgery was performed, though early recurrence was noted. A gamma knife surgical procedure was then performed to prevent early recurrence after histopathological confirmation of cavernous sinus hemangioma...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29315459/pretherapeutic-functional-neuroimaging-predicts-tremor-arrest-after-thalamotomy
#7
C Tuleasca, E Najdenovska, J Régis, T Witjas, N Girard, J Champoudry, M Faouzi, J-P Thiran, M Bach Cuadra, M Levivier, D Van De Ville
OBJECTIVE: Essential tremor (ET) represents the most common movement disorder. Drug-resistant ET can benefit from standard stereotactic procedures (deep brain stimulation or radiofrequency thalamotomy) or alternatively minimally invasive high-focused ultrasound or radiosurgery. All aim at same target, thalamic ventro-intermediate nucleus (Vim). METHODS: The study included a cohort of 17 consecutive patients, with ET, treated only with left unilateral stereotactic radiosurgical thalamotomy (SRS-T) between September 2014 and August 2015...
January 7, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29315190/audiological-outcomes-in-growing-vestibular-schwannomas-managed-either-conservatively-or-with-stereotactic-radiosurgery
#8
Thomas Daniel Milner, Richard R Locke, Georgios Kontorinis, John A Crowther
OBJECTIVE: Recent studies have suggested good hearing preservation following stereotactic radiosurgery (STRS) in patients with vestibular schwannomas (VS). This study aims to assess audiological outcomes in patients with growing VS treated either with STRS, or managed conservatively. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary referral center. PATIENTS: Out of 540 patients with VS, 69 patients with growing VS fulfilled the inclusion criteria; 24 treated conservatively and 45 with STRS...
February 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29309683/congress-of-neurological-surgeons-systematic-review-and-evidence-based-guidelines-on-hearing-preservation-outcomes-in-patients-with-sporadic-vestibular-schwannomas
#9
Matthew L Carlson, Esther X Vivas, D Jay McCracken, Alex D Sweeney, Brian A Neff, Neil T Shepard, Jeffrey J Olson
Question 1: What is the overall probability of maintaining serviceable hearing following stereotactic radiosurgery utilizing modern dose planning, at 2, 5, and 10 yr following treatment? Recommendation: Level 3: Individuals who meet these criteria and are considering stereotactic radiosurgery should be counseled that there is moderately high probability (>50%-75%) of hearing preservation at 2 yr, moderately high probability (>50%-75%) of hearing preservation at 5 yr, and moderately low probability (>25%-50%) of hearing preservation at 10 yr...
December 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29309637/congress-of-neurological-surgeons-systematic-review-and-evidence-based-guidelines-on-the-role-of-radiosurgery-and-radiation-therapy-in-the-management-of-patients-with-vestibular-schwannomas
#10
Isabelle M Germano, Jason Sheehan, Johnathan Parish, Tyler Atkins, Anthony Asher, Constantinos G Hadjipanayis, Stuart H Burri, Sheryl Green, Jeffrey J Olson
Question: What are the indications for stereotactic radiosurgery (SRS) treatment vs observation for patients with intracanalicular vestibular schwannomas without evidence of radiographic progression? Recommendation: Level 3: If tinnitus is not observed at presentation, it is recommended that intracanalicular vestibular schwannomas and small tumors (<2 cm) without tinnitus be observed as observation does not have a negative impact on tumor growth or hearing preservation compared to treatment...
December 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29309635/letter-radiation-induced-changes-after-stereotactic-radiosurgery-for-brain-arteriovenous-malformations
#11
Zengpanpan Ye, Xiaolin Ai, Chao You
No abstract text is available yet for this article.
December 22, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29309632/congress-of-neurological-surgeons-systematic-review-and-evidence-based-guidelines-on-surgical-resection-for-the-treatment-of-patients-with-vestibular-schwannomas
#12
Constantinos G Hadjipanayis, Matthew L Carlson, Michael J Link, Tarek A Rayan, John Parish, Tyler Atkins, Anthony L Asher, Ian F Dunn, C Eduardo Corrales, Jamie J Van Gompel, Michael Sughrue, Jeffrey J Olson
QUESTION 1: What surgical approaches for vestibular schwannomas (VS) are best for complete resection and facial nerve (FN) preservation when serviceable hearing is present? RECOMMENDATION: There is insufficient evidence to support the superiority of either the middle fossa (MF) or the retrosigmoid (RS) approach for complete VS resection and FN preservation when serviceable hearing is present. QUESTION 2: Which surgical approach (RS or translabyrinthine [TL]) for VS is best for complete resection and FN preservation when serviceable hearing is not present? RECOMMENDATION: There is insufficient evidence to support the superiority of either the RS or the TL approach for complete VS resection and FN preservation when serviceable hearing is not present...
December 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29307350/brain-metastases-radiosurgery
#13
Amparo Wolf, Douglas Kondziolka
Stereotactic radiosurgery has revolutionized the management of brain metastases. It delivers focused, highly conformal, ionizing radiation to a tumor delineated using high-resolution imaging, with low toxicity to adjacent brain structures. Randomized controlled and prospective trials have demonstrated a survival advantage and high local control rates after stereotactic radiosurgery for metastatic disease to the central nervous system, including for up to 10 brain metastases. Its minimal-access nature makes it an attractive alternative to surgical resection...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29307349/brain-metastases-fractionated-whole-brain-radiotherapy
#14
Tony J C Wang, Paul D Brown
Brain metastases are the most common malignant adult intracranial tumors, occurring in approximately 10-30% of cancer patients, and generally lead to a poor prognosis. The incidence has been steadily rising, likely due to longer survival from newer systemic therapies and increased utilization of magnetic resonance imaging. Historically, whole-brain radiotherapy has been a standard of care for the management of patients with brain metastases. However, better understanding of both the acute and long-term toxicities associated with whole-brain radiotherapy has led to a more selective use of whole-brain radiotherapy...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29307348/the-role-of-surgery-for-brain-metastases-from-solid-tumors
#15
Niklas Thon, Friedrich-Wilhelm Kreth, Joerg-Christian Tonn
Surgery, stereotactic radiosurgery, radiotherapy, and chemotherapy including novel targeted therapy strategies and any combination thereof as well as supportive care are the key elements for treatment of brain metastases. Goals of microsurgery are to obtain tissue samples for histologic diagnosis (particularly in case of uncertainty about the unknown primary tumor but also in the context of future targeted therapies), to relieve burden from space-occupying effects, to improve local tumor control, and to prolong overall survival...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29306379/variation-assessment-of-deformable-registration-in-stereotactic-radiosurgery
#16
C-S Chang, R Shih, J-M Hwang, K-S Chuang
INTRODUCTION: The regular functions of CT-MRI registration include delineation of targets and organs-at-risk (OARs) in radiosurgery planning. The question of whether deformable image registration (DIR) could be applied to stereotactic radiosurgery (SRS) in its place remains a subject of debate. METHODS: This study collected data regarding 16 patients who had undergone single-fraction SRS treatment. All lesions were located close to the brainstem. CT and MRI two image sets were registered by both rigid image registration (RIR) and DIR algorithms...
February 2018: Radiography
https://www.readbyqxmd.com/read/29303453/stereotactic-radiosurgery-for-who-grade-i-posterior-fossa-meningiomas-long-term-outcomes-with-volumetric-evaluation
#17
Mohana Rao Patibandla, Cheng-Chia Lee, Athreya Tata, Gokul Chowdary Addagada, Jason P Sheehan
OBJECTIVE Research over the past 2 decades has been characterizing the role of stereotactic radiosurgery (SRS) in the treatment of benign intracranial tumors, including meningiomas. However, few studies have examined the long-term outcomes of SRS treatment for posterior fossa meningiomas (PFMs). Furthermore, previous studies have typically used single diameter measurements when reporting outcomes, which can yield misleading results. The authors describe the use of SRS in the treatment of benign WHO grade I PFMs and correlate volumetric analysis with long-term outcomes...
January 5, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29303446/combination-ipilimumab-and-radiosurgery-for-brain-metastases-tumor-edema-and-adverse-radiation-effects
#18
Kevin Diao, Shelly X Bian, David M Routman, Cheng Yu, Paul E Kim, Naveed A Wagle, Michael K Wong, Gabriel Zada, Eric L Chang
OBJECTIVE Tumor and edema volume changes of brain metastases after stereotactic radiosurgery (SRS) and ipilimumab are not well described, and there is concern regarding the safety of combination treatment. The authors evaluated tumor, edema, and adverse radiation-induced changes after SRS with and without ipilimumab and identified associated risk factors. METHODS This single-institution retrospective study included 72 patients with melanoma brain metastases treated consecutively with upfront SRS from 2006 to 2015...
January 5, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29300187/a-treatment-planning-comparison-between-a-novel-rotating-gamma-system-and-robotic-linear-accelerator-based-intracranial-stereotactic-radiosurgery-radiotherapy
#19
Muhammad Mohsin Fareed, Ahmed A Eldib, Stephanie E Weiss, Shelly B Hayes, Jinsheng Li, Chang-Ming Charlie Ma
Purpose: To compare the dosimetric parameters of a novel Rotating Gamma Ray System (RGS) with well-established CyberKnife system (CK) for treating malignant brain lesions. Materials and Methods: RGS has a treatment head of 16 cobalt-60 sources focused to the isocenter, which can rotate 360° on the ring gantry and swing 35° in the superior direction. We compared several dosimetric parameters in 10 patients undergoing brain stereotactic radiosurgery including plan normalization, the number of beams and nodes for CK and shots for RGS, collimators used, estimated treatment time, D 2 cm and conformity index (CI) among two modalities...
January 4, 2018: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29299738/recursive-partitioning-analysis-is-predictive-of-overall-survival-for-patients-undergoing-spine-stereotactic-radiosurgery
#20
Ehsan H Balagamwala, Jacob A Miller, Chandana A Reddy, Lilyana Angelov, John H Suh, Muhammad B Tariq, Erin S Murphy, Kailin Yang, Toufik Djemil, Anthony Magnelli, Alireza M Mohammadi, Sherry Soeder, Samuel T Chao
Spine stereotactic radiosurgery (SRS) offers excellent radiographic and pain control for patients with spine metastases. We created a prognostic index using recursive partitioning analysis (RPA) to allow better patient selection for spine SRS. Patients who underwent single-fraction spine SRS for spine metastases were included. Primary histologies were divided into favorable (breast/prostate), radioresistant (renal cell/sarcoma/melanoma) and other. Cox proportional hazards regression was done to identify factors associated with overall survival (OS)...
January 3, 2018: Journal of Neuro-oncology
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