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Clinical Applications of Stereotactic Radiosurgery

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Advances in Radiation Therapy

Part of the book series: Cancer Treatment and Research ((CTAR,volume 93))

Abstract

Stereotactic radiosurgery was a radical departure from the general approach to clinical radiotherapy and radiobiology during the decades of the 1950s through the 1980s. The prevailing trends at the time were increasing fractionation (eventually moving to testing hyperfractionation for many tumors), treatment of larger fields (such as whole CNS axis irradiation for germinoma, ependymoma, and medulloblastoma), and avoiding treatment of benign diseases to prevent causing radiation-induced neoplasms. Radiosurgery was defined in 1951 as the single-session, closed-skull destruction of a stereotactically defined intracranial target with high-dose ionizing external beam irradiation [1]. What started out as a seemingly heretical technique on the fringes of radiation oncology and neurosurgery is now a firmly established, widely used technique, with over 14,000 patients treated per year worldwide at Gamma Knife sites alone.

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References

  1. Leksell L. 1951. The stereotaxic method and radiosurgery of the brain. Acta Chir Scand 102: 316–319.

    PubMed  CAS  Google Scholar 

  2. Lutz W, Winston KR, Maleki PV. 1988. A system for stereotactic radiosurgery with a linear accelerator. Int J Radiat Oncol Biol Phys 14:373–381.

    Article  PubMed  CAS  Google Scholar 

  3. Haas-Kogan DA, Kogan SC, Yount G, et al. 1996. The effect of fractionated radiotherapy in glioblastoma depends on p53 function. Int J Radiat Oncol Biol Phys 36:161.

    Article  Google Scholar 

  4. Loeffler JS, Alexander E, Siddon RL, et al. 1989. Stereotactic radiosurgery for intracranial arteriovenous malformations using a standard linear accelerator. Int J Radiat Oncol Biol Phys 17: 673.

    Article  PubMed  CAS  Google Scholar 

  5. Flickinger JC. 1989. The integrated logistic formula and prediction of complications from radiosurgery. Int J Radiat Oncol Biol Phys 17: 879.

    Article  PubMed  CAS  Google Scholar 

  6. Kjellberg RN, Hanamura T, Davis KR, Lyons S, Butler W, Adams R. 1983. Bragg-peak proton-beam therapy for arteriovenous malformations of the brain. N Engl J Med 309:269.

    Article  PubMed  CAS  Google Scholar 

  7. Pollock BE, Flickinger JC, Lunsford LD, Bissonette D, Kondziolka D. 1996. Factors that predict the bleeding risk of cerebral arteriovenous malformations. Stroke 27:1–6.

    Article  PubMed  CAS  Google Scholar 

  8. Lunsford LD, Kondziolka D, Flickinger J, et al. 1991. Stereotactic radiosurgery for arteriovenous malformation of the brain. J Neurosurg 75:512–524.

    Article  PubMed  CAS  Google Scholar 

  9. Friedman W, Bova F, Mendenhall W. 1995. Linear accelerator radiosurgery for arteriovenous malformations: The relationship of size to outcome. J Neurosurg 82:180–189.

    Article  PubMed  CAS  Google Scholar 

  10. Yamamoto Y, Coffey R, Nichols B, et al. 1995. Interim report on the radiosurgical treatment of cerebral arteriovenous malformations. J Neurosurg 83:832–837.

    Article  PubMed  CAS  Google Scholar 

  11. Steiner L, Lindquist C, Adler JR, et al. 1992. Clinical outcome of radiosurgery for cerebral arteriovenous malformations. J Neurosurg 77:1–8.

    Article  PubMed  CAS  Google Scholar 

  12. Kemeny A, Dias P, Forster D. 1989. Results of stereotactic radiosurgery for arteriovenous malformation: An analysis of 52 cases. J Neurol Neurosurg Psych 52:554–558.

    Article  CAS  Google Scholar 

  13. Yamamoto M, Jimbo M, Kobayashi M, et al. 1992. Long-term results of radiosurgery for arteriovenous malformation: Neurodiagnostic imaging and histological studies of angiographyically confirmed nidus obliteration. Surg Neurol 37: 219–230.

    Article  PubMed  CAS  Google Scholar 

  14. Pollock BE, Lunsford LD, Kondziolka D, et al. 1994. Patient outcomes after stereotactic radio-surgery for “operable” arteriovenous malformations. Neurosurgery 35:1–8.

    Article  PubMed  CAS  Google Scholar 

  15. Mathis J, Barr J, Horton J, et al. 1995. The efficacy of particulate embolization combined with stereotactic radiosurgery for treatment of large arteriovenous malformations of the brain. AJNR 16:299–306.

    PubMed  CAS  Google Scholar 

  16. Kondziolka D, Lunford LD, Kanal E, et al. 1994. Stereotactic magnetic resonance angiography for targeting in arteriovenous malformation radio-surgery. Neurosurgery 35:585–591.

    Article  PubMed  CAS  Google Scholar 

  17. Flickinger JC, Pollock BE, Kondziolka D, Lunsford LD. 1996. A dose-response analysis of arteriovenous malformation obliteration after radiosurgery. Int J Radiat Oncol Biol Phys 36, in press.

    Google Scholar 

  18. Flickinger JC, Kondziolka D, Pollock BE, Maitz AN, Lunsford LD. 1999. Complications from arteriovenous malformation radiosurgery: Multivariate analysis and modeling. Int J Radiat Oncol Biol Phys, in press.

    Google Scholar 

  19. Kondziolka D, Lunsford LD, Coffey R, et al. 1990. Stereotactic radiosurgery of angiographically occult vascular malformations: Indications and preliminary experience. Neurosurgery 27:892–900.

    Article  PubMed  CAS  Google Scholar 

  20. Kondziolka D, Lunsford LD, Flickinger JC, et al. 1995. Reduction of hemorrhage risk after stereotactic radiosurgery for cavernous malformations. J Neurosurg 83:825–831.

    Article  PubMed  CAS  Google Scholar 

  21. Noren G, Greitz D, Hirsch A, et al. 1993. Gamma knife surgery in acoustic tumors. Acta Neurochir 58(Suppl.):104–107.

    CAS  Google Scholar 

  22. Flickinger JC, Lunsford LD, Linskey ME, Duma CM, Kondziolka D. 1993. Gamma knife radiosurgery for acoustic tumors: Multivariate analysis of four year results. Radiother Oncol 27:91–98.

    Article  PubMed  CAS  Google Scholar 

  23. Linskey ME, Lunsford LD, Flickinger JC. 1992. Tumor control after stereotactic radiosurgery in neurofibromatosis patients with bilateral acoustic tumors. Neurosurgery 31:829–839.

    Article  PubMed  CAS  Google Scholar 

  24. Mendenhall WM, Friedman WA, Bova FJ. 1994. Linear accelerator-based stereotactic radiosurgery for acoustic schwannomas. Int J Radiat Oncol Biol Phys 284:80310.

    Google Scholar 

  25. Wallner KE, Sheline GE, Pitts LH, et al. 1987. Efficacy of irradiation for incompletely excised acoustic neurilemomas. J Neurosurg 67:858–863.

    Article  PubMed  CAS  Google Scholar 

  26. Pollock BE, Lunsford LD, Kondziolka D, et al. 1995. Outcome analysis of acoustic neuroma management: A comparison of microsurgery and stereotactic radiosurgery. Neurosurgery 36:215–229.

    Article  PubMed  CAS  Google Scholar 

  27. Flickinger JC, Kondziolka D, Pollock BE, Lunsford LD. 1996. Evolution of technique for vestibular schwannoma radiosurgery and effect on outcome. Int J Radiat Oncol Biol Phys 36: 275–280.

    Article  PubMed  CAS  Google Scholar 

  28. Flickinger JC, Kondziolka D, Lunsford LD. 1999. Dose and diameter relationships for facial, trigeminal, and acoustic neuropathies following acoustic neuroma radiosurgery. Radiother Oncol, in press.

    Google Scholar 

  29. Kondziolka D, Lunsford LD, Coffey RJ, et al. 1991. Stereotactic radiosurgery of meningiomas. J Neurosurg 74:552–559.

    Article  PubMed  CAS  Google Scholar 

  30. Duma CM, Lunsford LD, Kondziolka D, et al. 1993. Stereotactic radiosurgery of cavernous sinus meningiomas as an addition or alternative to microsurgery. Neurosurgery 32:699–705.

    Article  PubMed  CAS  Google Scholar 

  31. Tishler RB, Loeffler JS, Lunsford LD, et al. 1993. Tolerance of cranial nerves of the cavernous sinus to radiosurgery. Int J Radiat Oncol Biol Phys 27:215–221.

    Article  PubMed  CAS  Google Scholar 

  32. Kjellberg RN. 1991. Proton beam (PB) therapy of pituitary tumors (abstr). Proceedings of the International Stereotactic Radiosurgery Symposium, June 19-21, Pittsburgh, PA.

    Google Scholar 

  33. Levy RP, Fabrikant JI, Lyman JT, et al. 1992. Clinical results of stereotactic heavy charged-particle radiosurgery of the pituitary gland. In Steiner L, et al., eds. Radiosurgery: Baseline and trends. New York: Raven Press.

    Google Scholar 

  34. Backlund EO, Ganz J. 1993. Pituitary adenomas: Gamma knife. In Loeffler J, Alexander E III, Lunford LD, eds. Stereotactic Radiosurgery. New York: McGraw-Hill, pp. 167–173.

    Google Scholar 

  35. Rahn T, Thoren M, Werner S. 1991. Stereotactic surgery in pituitary adenomas. In GF et al. eds. Pituitary Adenomas: New Trends in Basic and Clinical Research. New York: Excerpta Medica, pp. 303–312.

    Google Scholar 

  36. Pollock BE, Kondziolka D, Lunsford LD, Flickinger JC. 1994. Stereotactic radiosurgery for pituitary adenomas: Imaging, visual, and endocrine results. Acta Neurochir 62(Suppl.):5–10.

    Article  Google Scholar 

  37. Pollock BE, Kondziolka D, Flickinger JC. 1993. Preservation of cranial nerve function after radiosurgery for nonacoustic schwannomas. Neurosurgery 33:597–601.

    Article  PubMed  CAS  Google Scholar 

  38. Patrice SJ, Sneed PK, Flickinger JC, et al. 1996. Radiosurgery for hemangioblastoma: Results of a multiinstitutional experience. Int J Radiat Oncol Biol Phys 35:493–499.

    Article  PubMed  CAS  Google Scholar 

  39. Alexander E, Moriarty TM, Davis RB, Wen PY, Fine HA, Black PM, Kooy HM, Loeffler JS. 1995. Stereotactic radiosurgery for the definitive, noninvasive treatment of brain metastases. J Nat 1 Cancer Instit 87:34–40.

    Article  Google Scholar 

  40. Auchter RM, Lamond JP, Alexander EA, Buatti JM, Chappell R, Friedman WA, Kinsella TJ, Levin AB, Noyes WR, Schultz CJ, Loeffler JS, Mehta MP. 1996. A multi-institutional outcome and prognostic factor analysis of radiosurgery for resectable single brain metastasis. Int J Radiat Oncol Biol Phys 35, in press.

    Google Scholar 

  41. Somaza S, Kondziolka D, Lunsford LD, Kirkwood J, Flickinger J. 1993. Stereotactic radiosurgery for cerebral metastatic melanoma. J Neurosurg 79:661–666.

    Article  PubMed  CAS  Google Scholar 

  42. Flickinger JC, Kondziolka D, Lunsford LD, et al. 1994. A multi-institutional experience with stereotactic radiosurgery for solitary brain metastasis. Int J Radiat Oncol Biol Phys 28:797–802.

    Article  PubMed  CAS  Google Scholar 

  43. Fuller BG, Kaplan ID, Adler J, et al. 1992. Stereotaxic radiosurgery for brain metastases: The importance of adjuvant whole brain irradiation. Int J Radiat Oncol Biol Phys 23:413–418.

    Article  PubMed  CAS  Google Scholar 

  44. Kihlstrom L, Karlsson B, Lindquist C. 1993. Gamma knife surgery for cerebral metastasis: Implications for survival based on 16 years experience. Stereotact Function Neurosurg 61 (Suppl. l):45–50.

    Article  Google Scholar 

  45. Loeffler JS, Shrieve DC. 1994. What is appropriate therapy for a patient with a single brain metastasis? Int J Radiat Oncol Biol Phys 29: 915–917.

    Article  PubMed  CAS  Google Scholar 

  46. Mehta MP, Rozental JM, Levin AB, et al. 1994. Defining the role of radiosurgery in the management of brain metastases. Int J Radiat Oncol Biol Phys 24:619–625.

    Article  Google Scholar 

  47. Shaw E, Farnan N, Souhami L, Dinapoli R, Kline R, Loeffler J, Fisher B. 1996. Radiosurgical treatment of previously irradiated primary brain tumors and brajn metastasis: Final report of Radiation Oncology Group (RTOG) protocol 90-05. Int J Radiat Oncol Biol Phys 34:647–654.

    Article  PubMed  CAS  Google Scholar 

  48. Borgelt B, Gelber R, Kramer S, et al. 1980. The palliation of brain metastases: The final results of the first two studies by the radiation therapy oncology group. Int J Radiat Oncol Biol Phys 6:1–9.

    Article  PubMed  CAS  Google Scholar 

  49. Noordijk EM, Vecht CJ, Haaxma-Reiche H, et al. 1994. The choice of treatment of single brain metastasis should be based on extracranial tumor activity and age. Int J Radiat Oncol Biol Phys 29:711–717.

    Article  PubMed  CAS  Google Scholar 

  50. Patchell RA, Tibbs PA, Walsh JW, et al. 1990. A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 322:494.

    Article  PubMed  CAS  Google Scholar 

  51. Mintz AH, Kestle J, Rathbone MP, et al. 1996. A randomized trial to assess the efficacy of surgery in addition to radiotherapy inpatients with a single cerebral metastasis. Cancer 78:1470–1476.

    Article  PubMed  CAS  Google Scholar 

  52. Rutigliano M, Lunsford LD, Kondziolka D, et al. 1995. The cost effectiveness of stereotactic radiosurgery versus surgical resection in the treatment of solitary metastatic brain tumors. Neurosurgery 37:445–455.

    Article  PubMed  CAS  Google Scholar 

  53. Mehta M, Masciopinto J, Rozental J, et al. 1994. Stereotactic radiosurgery for glioblastoma multiforme: A report of a prospective study evaluating prognostic factors and analyzing long-term survival advantage. Int J Radiat Oncol Biol Phys 30:541–549.

    Article  PubMed  CAS  Google Scholar 

  54. Shrieve D, Alexander E, Wen P, et al. 1995. Comparison of stereotactic radiosurgery and brachytherapy in the treatment of recurrent glioblastoma multiforme. Neurosurgery 36: 275–284.

    Article  PubMed  CAS  Google Scholar 

  55. Sarkaria JN, Mehta MP, Loeffler JS, et al. 1994. Stereotactic radiosurgery improves survival in malignant gliomas compared with the RTOG recursive partitioning analysis. Int J Radiat Oncol Biol Phys 30(Suppl. 1):164.

    Article  Google Scholar 

  56. Curran WJ Jr, Scott CB, Weinstein As, et al. 1993. Survival comparison of radiosurgery-eligible and-ineligible malignant glioma patients treated with hyperfractionated radiation therapy and carmustine: A report of Radiation Therapy Oncology Group 83-02. J Clinical Oncology 11:857–862.

    Google Scholar 

  57. Leksell L. Stereotaxic radiosurgery and trigeminal neuralgia. Acta Chir Scand 137:311–314.

    Google Scholar 

  58. Kondziolka D, Flickinger JC, Lunsford LD, et al. 1996. Stereotactic radiosurgery for trigeminal neuralgia: A multi-insitution study using the gamma unit. J Neurosurg 84:940–945.

    Article  PubMed  CAS  Google Scholar 

  59. Otsuki T, Jokura H, Takahashi K, et al. 1994. Stereotactic gamma thalamotomy with a computerized brain atlas: Technical case report. Neurosurgery 35:764–768.

    Article  PubMed  CAS  Google Scholar 

  60. Friedman J, Epstein M, Sanes J, et al. 1996. Gamma knife pallidotomy in advanced Parkinsons disease. Ann Neurol 39:535–538.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. John C. Flickinger
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  2. Douglas Kondziolka
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  3. L. Dade Lunsford
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Editor information

Editors and Affiliations

  1. Robert H. Lurie Cancer Center, Northwestern University Medical School Northwestern Memorial Hospital, Chicago, Illinois, USA

    Bharat B. Mittal M.D.

  2. Malinckrodt Institute of Radiology, Washington University Medical Center, St. Louis, Missouri, USA

    James A. Purdy Ph.D.

  3. M. D. Anderson Cancer Center, University of Texas, Houston, Texas, USA

    K. K. Ang M.D.

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© 1998 Springer Science+Business Media New York

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Flickinger, J.C., Kondziolka, D., Lunsford, L.D. (1998). Clinical Applications of Stereotactic Radiosurgery. In: Mittal, B.B., Purdy, J.A., Ang, K.K. (eds) Advances in Radiation Therapy. Cancer Treatment and Research, vol 93. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5769-2_13

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  • DOI: https://doi.org/10.1007/978-1-4615-5769-2_13

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-7644-6

  • Online ISBN: 978-1-4615-5769-2

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