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New Technologies in Radiation Oncology pp 267–276Cite as

Stereotactic Radiotherapy/Radiosurgery

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Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

21.7 Conclusion

Both RS and SFS have gained eminent positions in radiation oncology and have become established modalities in the treatment of cranial lesions. Most leading radiation departments offer this technique and their numbers have grown significantly in the past decade.

The LINAC RS and gamma knife RS are equivalent techniques; however, technological and physical differences between these two methods have led to some confusion. Considering the RS, comparative clinical studies have documented that both therapeutic methodologies can be used with similar results. In comparison with gamma knife, the use of LINAC technology offers the possibility of dose fractionation, which has substantial clinical implications. The quality control of the complex LINAC is higher than of gamma knife and requires a specialized team of medical physicists and radiation oncologists. On the other hand, it is undisputed that stereotactic radiation therapy with isocentric LINAC has a high potential for further developments. Examples in this direction are the introduction of computer-guided micro-multileaf collimators which allows the delivery of a conform dose distribution with only one isocenter, using static fields or dynamic arcs and the implementation of the stereotactic intensity-modulated radiotherapy. These new technologies amplify substantially the potential of the stereotactic modality.

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References

  • Auer F, Grosu AL, Wiedenmann N et al. (2002) Stereotactic radiotherapy in patients with brain tumors: accuracy of a modified mask system. In: Kogelnik HD, Lukas P, Sedlmayer E (eds) Progress in radio-oncology, vol 7. Monduzzi Editore International Proc Division, Bologna, pp 163–168

    Google Scholar 

  • Becker G, Kortmann R, Kaulich TW et al. (1996) Gamma-Knife versus stereotaktische Linearbeschleunigerbestrahlung. Radiologe 36:345–353

    PubMed  CAS  Google Scholar 

  • Betti O, Derechinsky VE (1983) Irradiation stereotaxique multifasceaux. Neurochirurgie 29:295–298

    PubMed  CAS  Google Scholar 

  • Bortfeld TR, Boyer AL, Schlegel W et al. (1994a) Realization and verification of three-dimensional conformal radiotherapy with modulated fields. Int J Radiat Oncol Biol Phys 30:899–908

    PubMed  CAS  Google Scholar 

  • Bortfeld TR, Kahler DL, Waldron TJ et al. (1994b) X-ray field compensation with multileaf collimators. Int J Radiat Oncol Biol Phys 28:723–730

    PubMed  CAS  Google Scholar 

  • Brown RA (1979) Stereotactic headframe for use with CT body scanners. Invest Radiol 14:300–304

    PubMed  CAS  Google Scholar 

  • Couldwell WT, Apuzzo MLJ (1990) Initial experience related to the use of the Cosman-Roberts-Wells stereotactic instrument. J Neurosurg 72:145–148

    PubMed  CAS  Google Scholar 

  • Colombo F, Benedetti A, Pozza F et al. (1985) External stereotactic irradiation by linear accelerator. Neurosurgery 16:154–160

    PubMed  CAS  Google Scholar 

  • Debus J, Pirzkall A, Schlegel W et al. (1999) Stereotaktische Einzeitbestrahlung (Radiochirurgie). Strahlenther Onkol 175:47–56

    PubMed  CAS  Google Scholar 

  • DIN 6827-1, Protokollierung bei der medizinischen Anwendung ionisierender Strahlung. Teil 1: Therapie mit Elektronenbeschleuniger sowie Röntgen-und Gammabestrahlungseinrichtungen, Deutsches Institut für Industrie-Normung, 2001

    Google Scholar 

  • Engenhart R, Kimmig B, Sturm V (1989) Stereotactically guided convergent beam irradiation of solitary brain metastasis and cerebral arteriovenous malformations: In: Dyck P, Bouzaglou A (eds) Brachytherapy of brain tumors and related stereotactic treatment. Hanley and Belfus, Philadelphia, pp 119–132

    Google Scholar 

  • Engenhart R, Wowra B, Kimmig B et al. (1992) Stereotaktische Konvergenzbestrahlung: Aktuelle Perspektiven auf der Grundlage klinischer Ergebnisse. Strahlenther Onkol 168:245–259

    PubMed  CAS  Google Scholar 

  • Gademann G, Schlegel W, Debus J et al. (1993) Fractionated stereotactically guided radiotherapy of head and neck tumors: a report on clinical use of a new system in 195 cases. Radiother Oncol 29:205–213

    Article  PubMed  CAS  Google Scholar 

  • Gerszten PC, Ozhasoglu C, Burton SA et al. (2004) CyberKnife frameless stereotactic radiosurgery for spinal lesion: clinical experience in 125 cases. Neurosurgery 55:89–98

    PubMed  Google Scholar 

  • Grosu AL, Lachner R, Wiedenmann N, Stärk S, Thamm R, Kneschaurek P, Schwaiger M, Molls M, Weber WA (2003) Validation of a method for automatic fusion of CT-and C11-Methionine-PET datasets of the brain for stereotactic radiotherapy using a LINAC. First clinical experience. Int J Radiat Oncol Biol Phys 56:1450–1463

    Article  PubMed  Google Scholar 

  • Hall EJ, Brenner DJ (1993) The radiobiology of RS: rationale for different treatment regimes for AVMs and malignancies. Int J Radiat Oncol Biol Phys 25:381–385

    Article  PubMed  CAS  Google Scholar 

  • Hartmann GH (ed) (1995) Quality assurance program on stereotactic radiosurgery. Springer, Berlin Heidelberg New York

    Google Scholar 

  • Hartmann GH, Schlegel W, Sturm V et al. (1985) Cerebral radiation surgery using moving field irradiation at a linac facility. Int J Radiat Oncol Biol Phys 11:185–192

    Google Scholar 

  • Heilbrun M, Roberts T, Apuzzo M et al. (1983) Preliminary experience with Brown-Roberts-Wells (BRW) computerized tomography stereotaxic guidance system. J Neurosurg 59:217–222

    PubMed  CAS  Google Scholar 

  • Herfarth KK, Debus J, Lohr F et al. (2000) Extracranial stereotactic radiation therapy: set-up accuracy of patients treated for liver metastases. Int J Radiat Oncol Biol Phys 46:329–335

    Article  PubMed  CAS  Google Scholar 

  • ICRU Report 50 (1984) Prescribing, recording and reporting photon beam therapy. ICRU, Washington, DC

    Google Scholar 

  • Khoo V, Oldham M, Adams E et al. (1999) Comparison of intensity-modulated tomotherapy with stereotactically guided conformal radiotherapy for brain tumors. Int J Radiat Oncol Biol Phys 45:415–425

    Article  PubMed  CAS  Google Scholar 

  • Kjellberg RN, Shintani A, Frantz AG (1968) Proton beams in acromegaly. N Engl J Med 278:689–695

    Article  PubMed  CAS  Google Scholar 

  • Kortmann RD, Becker G, Perelmouter J et al. (1999) Geometric accuracy of field alignment in fractionated stereotactic conformal radiotherapy of brain tumors. Int J Radiat Oncol Biol Phys 43:921–926

    Article  PubMed  CAS  Google Scholar 

  • Larsson B, Leksell L, Rexed B et al. (1958) The high energy proton beam as a neurosurgical tool. Nature 182:1222–1223

    PubMed  CAS  Google Scholar 

  • Larsson B, Liden K, Sorby B (1974) Irradiation of small structures through intact skull. Acta Radiol Ther Phys Biol 13:513–534

    Google Scholar 

  • Lawrence JH, Tobias CA, Bom JL et al. (1962) Heavy particle irradiation in neo-plasic and neurosurgical disease. J Neurosurg 19:717–722

    PubMed  CAS  Google Scholar 

  • Leksell L (1951) The stereotactic method and radiosurgery of the brain. Acta Chir Scand 102:316–319

    PubMed  CAS  Google Scholar 

  • Leksell L, Jernberg B (1980) Stereotaxis and tomography. A technical note. Acta Neurochir 52:1–7

    Article  CAS  Google Scholar 

  • Leksell L, Leksell D, Schwebel Y (1985) Stereotaxis and nuclear magnetic resonance. J Neurol Neurosurg Psychiatry 48:14–18

    PubMed  CAS  Google Scholar 

  • Lindquist C (1995) Gamma Knife radiosurgery. Semin Radiat Oncol 5:197–202

    PubMed  Google Scholar 

  • Lyman JT, Howard J (1977) Dosimetry and instrumentation for helium and heavy ions. Int J Radiat Oncol Biol Phys 3:81–85

    PubMed  CAS  Google Scholar 

  • Mehta M, Noyes WR, Mackie TR (1995) Linear accelerator configurations for radiosurgery. Semin Radiat Oncol 5:203–212

    PubMed  Google Scholar 

  • Report of Task Group 42 (1995) Radiation Therapy Committee, AAPM Report no. 54, Schell MC (Chairman), Bova FJ, Larson DA et al., published for the American Association of Physicists in Medicine by the American Institute of Physics

    Google Scholar 

  • Riechert T, Mundinger F (1955) Beschreibung und Anwendung eines Zielgerätes für stereotaktische Hirnoperationen. Acta Neurochir 3 (Suppl):308–337

    Google Scholar 

  • Schlegel W, Pastyr O, Bortfeld T et al. (1992) Computer systems and mechanical tools for stereotactically guided conformation therapy with linear accelerators. Int J Radiat Oncol Biol Phys 24:781–787

    PubMed  CAS  Google Scholar 

  • Schlegel W, Pastyr O, Bortfeld T et al. (1993) Stereotactically guided fractionated radiotherapy: technical aspects. Radiother Oncol 29:197–204

    Article  PubMed  CAS  Google Scholar 

  • Schlegel W, Pastyr O, Kubesch R et al. (1997) A computer controlled micro-multileaf-collimator for stereotactic conformal radiotherapy. In: In: Leavitt DD (ed) Proc XIIth International Conference on the Use of Computers in Radiotherapy (ICCR). Medical Physics Publishing, Madison, Wisconsin, pp 163–165

    Google Scholar 

  • Solberg TD, Boedeker KL, DeSalles AAF (2001) Dynamic arc radiosurgery field shaping: a comparison with static field conformal and noncoplanar circular arcs. Int J Radiat Oncol Biol Phys 49:1482–1491

    Article  Google Scholar 

  • Spiegelmann R, Friedman WA (1991) Stereotactic suboccipital transcerebellar biopsy under local anesthesia using the Cosman-Roberts-Wells frame. J Neurosurg 75:486–488

    PubMed  CAS  Google Scholar 

  • Stärk S, Grosu AL, Molls M et al. (1997) Maskentechnik der Firma BrainLAB — Nicht — invasive Fixierung bei stereotaktischen Strahlentherapie von Läsionen im Gehirn. Biomed Tech 42:352–353

    Article  Google Scholar 

  • Stärk S, Grosu AL, Kneschaurek P (2004) Dynamic arc stereotactic radiotherapy. J Radiat Oncol Biol Phys

    Google Scholar 

  • Sturm V, Pastyr O, Schlegel W (1983) Stereotactic computer tomography with a modified Riechert-Mundinger device as the basis for integrated stereotactic neuroradiological investigations. Acta Neurochir 68:11–17

    Article  CAS  Google Scholar 

  • Verhey LJ, Smith V (1995) The physics of radiosurgery. Semin Radiat Oncol 5:175–191

    PubMed  Google Scholar 

  • Yu C, Main W, Taylor D, Kuduvalli G et al. (2004) An anthropomorphic phantom study of the accuracy of CyberKnife spinal radiosurgery. Neurosurgery 55:1138–1149

    Article  PubMed  Google Scholar 

  • Zimmermann FB, Geinitz H, Schill S, Grosu AL et al. (2005) Stereotactic fractionated radiation therapy for stage I non small cell lung cancer. Initial results. Lung Cancer 48:107–114

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Klinikum rechts der Isar, Technical University, Ismaningerstrasse 22, 81675, Munich, Germany

    Anca-Ligia Grosu MD & Peter Kneschaurek PhD

  2. Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69121, Heidelberg, Germany

    Wolfgang Schlegel PhD

Authors
  1. Anca-Ligia Grosu MD
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  2. Peter Kneschaurek PhD
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  3. Wolfgang Schlegel PhD
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Editor information

Editors and Affiliations

  1. Abteilung Medizinische Physik in der Strahlentherapie, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany

    Wolfgang Schlegel PhD (Professor) (Professor)

  2. Department of Radiation Oncology, Massachusetts General Hospital, 30,Fruit Street, Boston, MA, 02114, USA

    Thomas Bortfeld PhD (Professor) (Professor)

  3. Department of Radiation Oncology, Klinikum rechts der Isar Technical University Munich, Ismaningerstrasse 22, 81675, München, Germany

    Anca-Ligia Grosu MD (Privatdozent) (Privatdozent)

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© 2006 Springer-Verlag Berlin Heidelberg

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Grosu, AL., Kneschaurek, P., Schlegel, W. (2006). Stereotactic Radiotherapy/Radiosurgery. In: Schlegel, W., Bortfeld, T., Grosu, AL. (eds) New Technologies in Radiation Oncology. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-29999-8_21

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  • DOI: https://doi.org/10.1007/3-540-29999-8_21

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-00321-2

  • Online ISBN: 978-3-540-29999-8

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