Gentlemen (and Ladies), Choose your Weapons: Gamma Knife vs. Linear Accelerator Radiosurgery

Stieber, Volker W.; Bourland, J. Daniel; Mehta, Minesh P.

doi:10.1177/153303460300200202

Cited by 32 publications

(20 citation statements)

References 57 publications

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“…However, most GK models (B and C series) are designed for brain only stereotactic radiosurgery, while occasionally providing limited access to peripheral brain lesions or those located close to the foramen magnum. (11) TomoTherapy (TOMO) is also used for the delivery of stereotactic therapy. It seamlessly combines linear accelerator and megavoltage computed tomography capabilities for verifications of patient and tumor positioning.…”

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confidence: 99%

Helical TomoTherapy versus sterotactic Gamma Knife radiosurgery in the treatment of single and multiple brain tumors: a dosimetric comparison

Kumar

Rakowski

Zhao

et al. 2010

J Applied Clin Med Phys

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The objective was to compare the dosimetry of Helical TomoTherapy (TOMO) and Gamma Knife (GK) treatment plans for tumor and normal brain in the treatment of single and multiple brain tumors. An anthropomorphic Rando Head phantom was used to compare the dosimetry of TOMO and GK. Eight brain tumors of various shapes, sizes and locations were used to generate 10 plans. The radiation dose was 20 Gy prescribed to the 100% isodose line for TOMO plans and to the 50% for the GK plans. Dose Volume Histograms for tumor and brain were compared. Equivalent Uniform Dose (gEUD), Tumor Control Probability (TCP) and Normal Tissue Complication Probability (NTCP) were performed and used for plan comparisons. Average minimum, mean, median and maximum tumor doses were 19.93, 27.83, 27.38, 39.60 Gy for GK and 20.17, 20.60, 20.59, 20.90 Gy for TOMO. Average gEUD values for tumor and normal brain were 25.0 and 7.2 Gy for GK and 20.7 and 8.1 Gy for TOMO. Conformity indices (CI) were similar for both modalities. Gradient indices (GI) were greater for TOMO. A combination plan was also generated using all eight tumors. TOMO was able to target all eight tumors simultaneously resulting in mean tumor and brain doses of 20.5 and 9.35 Gy, respectively. Due to the maximum limit of 50 beams per plan, GK was unable to provide a treatment plan for all eight tumors. GK provides an advantage for all tumor sizes with respect to tumor and normal brain dose. Clinical studies are needed to correlate these dosimetric findings with patient outcomes.PACS number: 87.55‐x

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confidence: 99%

Helical TomoTherapy versus sterotactic Gamma Knife radiosurgery in the treatment of single and multiple brain tumors: a dosimetric comparison

Kumar

Rakowski

Zhao

et al. 2010

J Applied Clin Med Phys

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“…The most commonly used systems include the Leksell Gamma Knife and linear accelerator-based systems [45]. The main differences between these systems involve the method of head immobilization, types of collimators, beam properties, beam arrangements, treatment planning, patient repositioning, and machine availability [45].…”

Section: Locally Ablative Therapies: Srs and Surgerymentioning

confidence: 99%

Management of Brain Metastasis: Past Lessons, Modern Management, and Future Considerations

Koay

Sulman

2011

Curr Oncol Rep

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Brain metastasis is a major challenge for patients, physicians, and the broader health care system, with approximately 170,000 new cases per year. After a diagnosis of brain metastasis, patients have a poor prognosis, but modern management has made significant advances in the past two decades to improve palliative efficacy and patient survival through a multidisciplinary approach. A number of factors must be taken into consideration in the treatment approach, including the number of intracranial lesions, the control of extracranial disease, and the patient's overall health, while weighing the benefits of treatment against the toxicities, both acute and chronic. With quality of life as an emphasis, emerging concepts for modern management of brain metastasis have sought to minimize long-term toxicities. The economic impact of such strategies for patients and the health care system has been demonstrated in some studies, but has not been a consistent area of focus. Each of these strategies, as well as novel therapeutics, has embraced the concept of personalized treatment. This review will discuss the current knowledge of modern multidisciplinary management of brain metastasis and look forward to emerging concepts.

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“…With technologic advances in software and hardware, there is no clear advantage of one technology over the other. 13 Because the linear accelerator-based units can serve to treat nonradiosurgery patients during its downtime, these units have become more popular, especially where limited numbers of patients would be treated with SRS. 13 Radiosurgery and neurosurgical approaches are often complimentary, but there are key differences.…”

Section: Stereotactic Radiosurgery and Fractionated Stereotactic Radimentioning

confidence: 99%

“…13 Because the linear accelerator-based units can serve to treat nonradiosurgery patients during its downtime, these units have become more popular, especially where limited numbers of patients would be treated with SRS. 13 Radiosurgery and neurosurgical approaches are often complimentary, but there are key differences. Radiosurgery does not require a craniotomy, and hence general anesthesia is not required and patients are usually discharged the same day.…”

Section: Stereotactic Radiosurgery and Fractionated Stereotactic Radimentioning

confidence: 99%

Radiation Techniques in Neuro-Oncology

Khuntia

Mehta

2009

Neurotherapeutics

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Summary: Radiation therapy plays a critical role in the management of tumors of the brain. A variety of radiotherapy techniques have been used to treat these tumors. This review describes both classic and more recent and advanced techniques available to manage these tumors. Included is a discussion of standard two-and three-dimensional radiation, as well as intensity-modulated radiotherapy, image-guided radiation therapy, stereotactic radiosurgery, and heavy particles.

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Gentlemen (and Ladies), Choose your Weapons: Gamma Knife vs. Linear Accelerator Radiosurgery

Cited by 32 publications

References 57 publications

Helical TomoTherapy versus sterotactic Gamma Knife radiosurgery in the treatment of single and multiple brain tumors: a dosimetric comparison

Helical TomoTherapy versus sterotactic Gamma Knife radiosurgery in the treatment of single and multiple brain tumors: a dosimetric comparison

Management of Brain Metastasis: Past Lessons, Modern Management, and Future Considerations

Radiation Techniques in Neuro-Oncology

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