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Gamma knife radiation

Giuseppe Minniti, Mattia Falchetto Osti, Maximillian Niyazi
Stereotactic radiosurgery (SRS) delivered as either single-fraction or multi-fraction SRS (2-5 fractions) is frequently employed in patients with residual or recurrent pituitary adenoma. The most common delivery systems used for SRS include the cobalt-60 system Gamma Knife, the CyberKnife (CK) robotic radiosurgery system, or a modified conventional radiotherapy machine (linear accelerator, LINAC). Tumor control and normalization of hormone hypersecretion have been reported in 75-100 % and 25-80 % of patients, respectively...
October 11, 2016: Radiation Oncology
Giorgio Spatola, Laura Frosio, Marco Losa, Antonella Del Vecchio, Martina Piloni, Pietro Mortini
BACKGROUND: Gamma knife radiosurgery is an effective and safe treatment modality in the management of pituitary adenomas. Internal carotid occlusion is a rare but possible complication of Gamma Knife Radiosurgery for lesions within the cavernous sinus. AIM: To stress the importance of considering the Internal carotid artery as an organ at risk in cavernous sinus invading adenomas and reduce the dose delivered to this structure whenever possible. CASE DESCRIPTION: We report two cases of asymptomatic occlusion of the intracavernous segment of the internal carotid artery seven years after treatment in acromegalic patients...
November 2016: Reports of Practical Oncology and Radiotherapy
Young-Bem Se, Dong Gyu Kim, Sung Kwon Kim, Jin Wook Kim, Yong Hwy Kim, Chul-Kee Park, Hyun-Tai Chung, Sun-Ha Paek
BACKGROUND: Supratentorial primitive neuroectodermal tumors (PNETs) are highly malignant and rare tumors of the central nervous system. OBJECTIVES: The aim of this study was to determine the role of Gamma Knife surgery (GKS) as a salvage treatment option for patients with recurrent or residual supratentorial PNETs. METHODS: Between 1998 and 2014, 11 patients with supratentorial PNETs were retrospectively analyzed. This series consisted of 7 male and 4 female patients...
October 8, 2016: Stereotactic and Functional Neurosurgery
Joshua Chiu, Marlon Pierce, Steve E Braunstein, Philip V Theodosopoulos, Michael W McDermott, Penny K Sneed, Lijun Ma
Sharp dose fall-off is the hallmark of brain radiosurgery for the purpose of delivering high dose radiation to the target while minimizing peripheral dose to regional normal brain tissue. In this study, a technique was developed to enhance the peripheral dose gradient by magnifying the total number of beams focused toward each isocenter through pre-programmed patient head tilting. This technique was tested in clinical settings on a dedicated brain radiosurgical system (GKPFX, Gamma Knife Perfexion, Elekta Oncology) by comparing dosimetry as well as delivery efficiency for 20 radiosurgical cases previously treated with the system...
October 3, 2016: Physics in Medicine and Biology
Or Cohen-Inbar, Robert M Starke, Gabriella Paisan, Hideyuki Kano, Paul P Huang, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S Grills, David Mathieu, Danilo Silva, Mahmoud Abbassy, Symeon Missios, John Y K Lee, Gene H Barnett, Douglas Kondziolka, L Dade Lunsford, Jason P Sheehan
OBJECTIVE The goal of stereotactic radiosurgery (SRS) for arteriovenous malformation (AVM) is complete nidus obliteration, thereby eliminating the risk of future hemorrhage. This outcome can be observed within the first 18 months, although documentation of AVM obliteration can extend to as much as 5 years after SRS is performed. A shorter time to obliteration may impact the frequency and effect of post-SRS complications and latency hemorrhage. The authors' goal in the present study was to determine predictors of early obliteration (18 months or less) following SRS for cerebral AVM...
September 23, 2016: Journal of Neurosurgery
Joo Whan Kim, Hye Ran Park, Jae Meen Lee, Jin Wook Kim, Hyun-Tai Chung, Dong Gyu Kim, Hee-Won Jung, Sun Ha Paek
PURPOSE: Stereotactic radiosurgery (SRS) is widely used for brain metastases but has been relatively contraindicated for large lesions (>3 cm). In the present study, we analyzed the efficacy and toxicity of hypofractionated Gamma Knife radiosurgery to treat metastatic brain tumors for which surgical resection were not considered as the primary treatment option. METHODS AND MATERIALS: Thirty-six patients, forty cases were treated with Gamma Knife-based fractionated SRS for three to four consecutive days with the same Leksell frame on their heads...
2016: PloS One
Fei Dong, Qian Li, JianJun Wu, MinMing Zhang, GuangQiang Zhang, Bin Li, Kai Jin, Jie Min, WeiRen Liang, Ming Chao
INTRODUCTION: Carotid blowout syndrome (CBS) secondary to radiation therapy is life-threatening and requires emergency treatment. More recently, endovascular treatment has provided an effective way to control CBS-related bleeding. CASE DESCRIPTION: We present a case of CBS with a rupture of the internal carotid artery (ICA) pseudo-aneurysm after Gamma Knife radiation therapy for nasopharyngeal carcinoma (NPC). The patient was a 55-year-old man who was transferred to our hospital with severe repetitive epistaxis...
2016: SpringerPlus
A Sean Alemi, Chase M Heaton, William R Ryan, Ivan El-Sayed, Steven J Wang
OBJECTIVE: Cervical schwannomas are benign tumors that commonly present as asymptomatic masses and are managed with observation, radiation, or surgery. To our knowledge, the rate of volumetric change seen on serial imaging is not currently used to determine surgical candidacy. We assess average growth rates and determine whether growth rate of cervical schwannoma predicts having undergone surgery. STUDY DESIGN: Case series with chart review. SETTING: Quaternary academic medical center...
September 13, 2016: Otolaryngology—Head and Neck Surgery
Moon-Soo Han, Yeong-Jin Kim, Kyung-Sub Moon, Kyung-Hwa Lee, Jung-In Yang, Woo Dae Kang, Sa-Hoe Lim, Woo-Youl Jang, Tae-Young Jung, In-Young Kim, Shin Jung
Intracranial meningiomas involving the major venous sinus (MVS) pose several complication risks upon performing radical resection. Some surgeons consider MVS invasion a contraindication for a complete resection of meningioma, and others suggest total resection followed by venous reconstruction. The aim of the study was to analyze our surgical results and discuss management strategy for intracranial meningiomas involving the MVS. Between 1993 and 2011, 107 patients with intracranial meningiomas involving MVS underwent surgery in our institution...
August 2016: Medicine (Baltimore)
Seong-Cheol Park, Do Hee Lee, Jung Kyo Lee
OBJECTIVE: To investigate gamma knife radiosurgery (GKS) for benign tumor-associated secondary trigeminal neuralgia. METHODS: From 2006 to 2015, 21 patients with secondary trigeminal neuralgia from meningioma were treated using GKS. Their mean age was 56.5 ± 12.2 years. The 50% isodose was 12.5±1.1 Gy for the first GKS for the meningioma. Retrogasserian targeting of the trigeminal nerve at 90 Gy with a 4-mm collimator was used for the second GKS. RESULTS: The pain duration until GKS was 1...
August 27, 2016: World Neurosurgery
Zi-Feng Dai, Qi-Lin Huang, Hai-Peng Liu, Wei Zhang
OBJECTIVES: A retrospective study was undertaken to compare the efficacy of stereotactic gamma knife surgery (GKS) and microvascular decompression (MVD) in the treatment of primary trigeminal neuralgia (TN) at a single center. The study included the evaluation of clinical outcomes of pain relief and pain recurrence and complications associated with GKS and MVD. METHODS: The study included 202 patients with primary TN and was conducted between January 2013 and December 2014; about 115 patients were treated with GKS and 87 patients were treated with MVD...
2016: Journal of Pain Research
Nataniel H Lester-Coll, Arie P Dosoretz, James A Hayman, James B Yu
PURPOSE:  Estimating the cost-effectiveness of whole-brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS), including Gamma Knife radiosurgery (GKRS), requires the quantitative measurement of patients' health states after treatment. We sought to quantify individuals' preferences for the relevant health states after WBRT or GKRS for brain metastases on a 0 to 1 scale, where 1 is perfect health and 0 is death. METHODS:  We prospectively measured utilities in patients with brain metastases evaluated at Yale for consideration of WBRT and/or GKRS, as well as oncology nurses who had cared for patients with brain metastases before and after WBRT or GKRS, using the Standard Gamble (SG) technique...
2016: Curēus
Winnie Li, Young-Bin Cho, Steve Ansell, Normand Laperriere, Cynthia Ménard, Barbara-Ann Millar, Gelareh Zadeh, Paul Kongkham, Mark Bernstein, David A Jaffray, Caroline Chung
PURPOSE: The present study used cone beam computed tomography (CBCT) to measure the inter- and intrafraction uncertainties for intracranial stereotactic radiosurgery (SRS) using the Leksell Gamma Knife (GK). METHODS AND MATERIALS: Using a novel CBCT system adapted to the GK radiosurgery treatment unit, CBCT images were acquired immediately before and after treatment for each treatment session within the context of a research ethics board-approved prospective clinical trial...
September 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Marlee M Vandewouw, Dionne M Aleman, David A Jaffray
PURPOSE: Continuous dose delivery in radiation therapy treatments has been shown to decrease total treatment time while improving the dose conformity and distribution homogeneity over the conventional step-and-shoot approach. The authors develop an inverse treatment planning method for Gamma Knife® Perfexion™ that continuously delivers dose along a path in the target. METHODS: The authors' method is comprised of two steps: find a path within the target, then solve a mixed integer optimization model to find the optimal collimator configurations and durations along the selected path...
August 2016: Medical Physics
Toshiki Endo, Ayumi Narisawa, Hosam Shata Mohamed Ali, Kensuke Murakami, Takashi Watanabe, Mika Watanabe, Hidefumi Jokura, Hidenori Endo, Miki Fujimura, Yukihiko Sonoda, Teiji Tominaga
BACKGROUND: Atypical meningioma differs from Grade I meningioma in terms of high recurrence rate and short life expectancy. We evaluated the clinical course of atypical meningioma and investigated prognostic factors affecting its outcomes. METHOD: We reviewed 45 patients with atypical meningioma who underwent surgical intervention between January 2000 and December 2013. The mean age of the patients and mean follow-up period was 58.7 years and 81.0 months, respectively...
September 2016: Acta Neurochirurgica
Takashi Shuto, Shigeo Matsunaga
Cyst formation is the most common long-term complication after gamma knife surgery (GKS) for cerebral arteriovenous malformations; however, this rarely occurs after GKS for vestibular schwannoma (VS). We describe two patients that developed aggressive, symptomatic large cysts at more than 4 and 12years after GKS for VS, although the tumor control for these patients had been acceptable at 3 and 11years, respectively. During the surgery, a reddish lesion, which was distinct from the surrounding tumor, was observed...
November 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Musaddiq J Awan, Jennifer Dorth, Arvind Mani, Haksoo Kim, Yiran Zheng, Mazen Mislmani, Scott Welford, Jiankui Yuan, Barry W Wessels, Simon S Lo, John Letterio, Mitchell Machtay, Andrew Sloan, Jason W Sohn
The purpose of this research is to establish a process of irradiating mice using the Gamma Knife as a versatile system for small animal irradiation and to validate accurate intracranial and extracranial dose delivery using this system. A stereotactic immobilization device was developed for small animals for the Gamma Knife head frame allowing for isocentric dose delivery. Intercranial positional reproducibility of a reference point from a primary reference animal was verified on an additional mouse. Extracranial positional reproducibility of the mouse aorta was verified using 3 mice...
July 21, 2016: Technology in Cancer Research & Treatment
Junjeong Choi, Sung-Hye Park, Shin Kwang Khang, Yeon-Lim Suh, Sang Pyo Kim, Youn Soo Lee, Hyun Seok Kwon, Seok-Gu Kang, Se Hoon Kim
BACKGROUND: Hemangiopericytoma (HPC) in the central nervous system (CNS) is a rare disease with distinctive biological/clinical characteristics compared with meningioma. METHODS: Cases of HPCs of the CNS were collected, and clinicopathological records were retrospectively reviewed and analyzed. Immunohistochemistry (IHC) for proliferative markers (Ki-67, PHH3) and STAT6 were performed. RESULTS: A total of 140 cases were collected, with mean follow-up of 77 months (median 58...
July 21, 2016: Annals of Surgical Oncology
Manmohan Singh, Deepak Aggarwal, Shashank Sharad Kale
INTRODUCTION: Large brain arteriovenous malformations (AVMs) pose management challenge in neurosurgical practice. Management remains conservative unless these AVMs bleed or present with neurological deficits. For patients who require treatment, options are limited with very high treatment-related morbidity. Gamma knife radiosurgery remains an excellent noninvasive option for such AVMs. METHODS: This is a retrospective study of 74 patients with large AVMs who were treated with gamma knife radiosurgery over 16 years...
August 2016: Neurosurgery
Dale Ding, Zhiyuan Xu, Robert M Starke, Chun-Po Yen, Han-Hsun Shih, Thomas Buell, Jason P Sheehan
INTRODUCTION: Approximately 10% to 30% of intracranial arteriovenous malformations (AVMs) harbor AVM-associated arterial aneurysms (AAAs). The presence of an AAA has been found to significantly increase an untreated AVM's hemorrhage risk. Previous studies have also shown AVMs with patent AAAs to have higher hemorrhage rates after treatment with stereotactic radiosurgery (SRS). However, the effect of AAAs on AVM SRS outcomes remains incompletely understood. Therefore, the aim of this retrospective, matched cohort study is to determine the effect of AAAs on outcomes after SRS for AVMs...
August 2016: Neurosurgery
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