Stereotactic radiosurgery—an organized neurosurgery-sanctioned definition

Barnett, Gene H.; Linskey, Mark E.; Adler, John R.; Cozzens, Jeffrey W.; Friedman, William A.; Heilbrun, M. Peter; Lunsford, L. Dade; Schulder, Michael; Sloan, Andrew E.; ., .

doi:10.3171/jns.2007.106.1.1

Cited by 161 publications

(73 citation statements)

References 69 publications

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“…Hypofractionated radiosurgery is an emerging technique for delivering highly precise and accurate irradiation, dividing the total dose in up to 5 fractions. 3 Devices suitable for SRS and fSRT treatment include LINAC-based systems that use x-ray beams generated from a linear accelerator and a stereotactic frame for target localization. The Gamma Knife (Elekta) utilizes 201 individual 60 Co gamma ray sources placed within a helmet-like configuration.…”

Section: Supplementing Radiation Doses To Recurrent High-grade Gliomasmentioning

confidence: 99%

Role of stereotactic radiosurgery and fractionated stereotactic radiotherapy for the treatment of recurrent glioblastoma multiforme

Romanelli

Conti²,

Pontoriero

et al. 2009

FOC

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Glioblastoma multiforme (GBM) is a devastating malignant brain tumor characterized by resistance to available therapeutic approaches and relentless malignant progression that includes widespread intracranial invasion, destruction of normal brain tissue, progressive disability, and death. Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) are increasingly used in patients with recurrent GBM to complement traditional treatments such as resection, conventional external beam radiotherapy, and chemotherapy. Both SRS and fSRT are powerful noninvasive therapeutic modalities well suited to treat focal neoplastic lesions through the delivery of precise, highdose radiation. Although no randomized clinical trials have been performed, a variety of retrospective studies have been focused on the use of SRS and fSRT for recurrent GBMs. In addition, state-of-the-art neuroimaging techniques, such as MR spectroscopic imaging, diffusion tensor tractography, and nuclear medicine imaging, have enhanced treatment planning methods leading to potentially improved clinical outcomes. In this paper the authors reviewed the current applications and efficacy of SRS and fSRT in the treatment of GBM, highlighting the value of these therapies for recurrent focal disease.

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Section: Supplementing Radiation Doses To Recurrent High-grade Gliomasmentioning

confidence: 99%

Role of stereotactic radiosurgery and fractionated stereotactic radiotherapy for the treatment of recurrent glioblastoma multiforme

Romanelli

Conti²,

Pontoriero

et al. 2009

FOC

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“…Stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) are two examples of high-dose radiation therapy with high precision delivery ( Figure 1). SRS refers to a precisely delivered single large dose of radiation achieved by multiple noncoplanar beams converging on a radiographically defined target (14). For this type of RT delivery, there is a steep decline of radiation dose just outside the target volume, thereby limiting the dose to normal critical structures.…”

Section: Historical Perspectivementioning

confidence: 99%

Radiation Therapy for Melanoma

Shi

2017

Cutaneous Melanoma: Etiology and Therapy

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Although melanoma is a relative radioresistant tumor, radiation therapy (RT) remains a valid and effective treatment option for the management of melanoma. RT as a primary treatment is often offered in well-defined situations, such as medical inoperability, lentiginous melanoma, mucosal melanoma, and ocular melanoma. Adjuvant RT following lymphadenectomy in node-positive melanoma patients prevents local and regional recurrence; however, the role of adjuvant RT remains controversial and underutilized due to lack of overall survival benefit. On the other hand, RT is highly effective in providing symptom palliation for metastatic melanoma and is widely used. Advanced RT technologies such as stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) can achieve excellent local control with minimum toxicities. They are commonly used in the management of brain, lung, spine, and liver metastases. Most recently, it is under active investigation on combining RT with new systemic options, such as targeted therapy, or immunotherapy. The advancements in the treatment of patients with melanoma highlight the importance of multidisciplinary management in this disease. Radiation therapy will continue to be one of the key therapeutic options.

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“…The definition sanctioned by the AANS, Congress of Neurological Surgeons, and ASTRO recommends radiosurgical delivery by a team consisting of a neurosurgeon, a radiation oncologist, and a medical physicist. 3 Similarly, the American College of Radiology recommended a similar multidisciplinary approach to ensure quality of care and went so far as to detail specific responsibilities for the individual members of the multidisciplinary team during the SRS process.…”

Section: Interdisciplinary Collaborationmentioning

confidence: 99%

Inception of a national multidisciplinary registry for stereotactic radiosurgery

Sheehan

Kavanagh

Asher

et al. 2016

JNS

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Since its conception in 1951, the field of stereotactic radiosurgery (SRS) has demonstrated substantial growth, and it has altered treatment paradigms for patients with complex and diverse intracranial disorders. 12In the United States alone, there are more than 100 distinct SRS centers that treat thousands of patients each year. Patients are treated for diverse indications such as benign and malignant brain tumors, vascular malformations, and functional disorders.SRS is routinely delivered using several common radiosurgical devices. Despite the exponential growth of radiosurgery in the United States during the past 2 decades, the majority of the radiosurgical literature is composed of single-center retrospective studies.There are, of course, a small percentage of retrospective multicenter pooled analyses and even fewer prospective randomized clinical trials (RCTs). Some prospective multicenter SRS trials, such as ACOSOG-N0574 and the Stereotactic radiosurgery (SRS) represents a multidisciplinary approach to the delivery of ionizing high-dose radiation to treat a wide variety of disorders. Much of the radiosurgical literature is based upon retrospective single-center studies along with a few randomized controlled clinical trials. More timely and effective evidence is needed to enhance the consistency and quality of and clinical outcomes achieved with SRS. The authors summarize the creation and implementation of a national SRS registry. The American Association of Neurological Surgeons (AANS) through NeuroPoint Alliance, Inc., started a successful registry effort with its lumbar spine initiative. Following a similar approach, the AANS and NeuroPoint Alliance collaborated with corporate partners and the American Society for Radiation Oncology to devise a data dictionary for an SRS registry. Through administrative and financial support from professional societies and corporate partners, a framework for implementation of the registry was created. Initial plans were devised for a 3-year effort encompassing 30 high-volume SRS centers across the country. Device-specific web-based data-extraction platforms were built by the corporate partners. Data uploaders were then used to port the data to a common repository managed by Quintiles, a national and international health care trials company. Audits of the data for completeness and veracity will be undertaken by Quintiles to ensure data fidelity. Data governance and analysis are overseen by an SRS board comprising equal numbers of representatives from the AANS and NeuroPoint Alliance. Over time, quality outcome assessments and post hoc research can be performed to advance the field of SRS. Stereotactic radiosurgery offers a high-technology approach to treating complex intracranial disorders. Improvements in the consistency and quality of care delivered to patients who undergo SRS should be afforded by the national registry effort that is underway.

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Stereotactic radiosurgery—an organized neurosurgery-sanctioned definition

Cited by 161 publications

References 69 publications

Role of stereotactic radiosurgery and fractionated stereotactic radiotherapy for the treatment of recurrent glioblastoma multiforme

Role of stereotactic radiosurgery and fractionated stereotactic radiotherapy for the treatment of recurrent glioblastoma multiforme

Radiation Therapy for Melanoma

Inception of a national multidisciplinary registry for stereotactic radiosurgery

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