The role of the gamma knife in the treatment of malignant primary and metastatic brain tumors

Young, Ronald F.

doi:10.3322/canjclin.48.3.177

Cited by 20 publications

(10 citation statements)

References 52 publications

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“…In our unselected series of 193 consecutive patients with brain metastases, we found an overall survival of 7.5 months, which is comparable to other unselected series [12,14,[16][17][18][19]. The longer survival times noted in the studies of Auchter et al [13] and Flickinger et al [11], 11 and 13 months respectively, may be due to selection criteria.…”

Section: Discussionsupporting

confidence: 79%

Gamma Knife Radiosurgery for the Treatment of Brain Metastases

Sansur

Chin²,

Ames³

et al. 2000

Stereotact Funct Neurosurg

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One hundred and ninety-three patients with brain metastases from various primary sites received Gamma Knife radiosurgery (GKR) from July 1992 to August 1997 and were reviewed to evaluate their clinical outcome. Survival follow-up was available on 173 patients. Whole-brain radiation therapy was also administered to 148 of these patients. The median survival was 13.1 months from initial detection of brain metastases, and 7.5 months from GKR. Univariate and multivariate analyses were performed to determine prognostic factors that influenced survival following GKR. Enhanced survival is observed in patients with radiosensitive tumor types, supratentorial tumor, history of brain tumor resection, controlled primary site, and absent extracranial metastases. Local lesion control was obtained in 82% of the patients according to their last follow-up MRI scan. GKR is an effective means of treating patients with brain metastases.

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Section: Discussionsupporting

confidence: 79%

Gamma Knife Radiosurgery for the Treatment of Brain Metastases

Sansur

Chin²,

Ames³

et al. 2000

Stereotact Funct Neurosurg

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“…The applicability of stereotactic radiotherapy (SBRT) has expanded to include primary liver cancer . Given the inherent radiosensitivity of the liver, SBRT may be a means to deliver precise therapeutic doses of radiation to the tumor while sparing the normal liver to avoid subsequent liver dysfunction .…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary approaches to intrahepatic cholangiocarcinoma

Maithel

Gamblin

Kamel

et al. 2013

Cancer

120

100

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After hepatocellular carcinoma, intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy. The etiology of ICC in most patients is not known, but its incidence is on the rise worldwide. There are 3 morphologic subtypes of ICC that can be characterized on cross-sectional imaging, mass forming, periductal infiltrating, and intraductal growth; and the radiographic characteristics of ICC may vary based on the subtype. Complete surgical resection remains the only potentially curative option for patients with ICC. Routine lymphadenectomy at the time of surgical resection should be strongly considered, because lymph node status provides important prognostic information. After surgery, the 5-year survival rate for ICC remains poor at only 25% to 35% in most series. Although numerous clinical trials have been conducted using a variety of chemotherapy regimens to treat ICC, systemic options for ICC remain limited. Doublet gemcitabine and cisplatin therapy is currently considered the standard-of-care first-line therapy for patients with advanced disease. Because ICC is typically confined to the liver and systemic chemotherapy traditionally has had only limited efficacy, there has been increasing interest in locoregional therapy. Although locoregional therapy may include intra-arterial therapies, stereotactic radiotherapy, hepatic artery pump therapy, or ablation, most data are limited. The purpose of this article was to provide a multidisciplinary appraisal of the current therapeutic approaches to ICC. Cancer 2013;119:3929-42.

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“…This technique allows radiation to be delivered with sub-millimeter precision and with a rapid radiation fall-off from the target field thus sparing normal tissue from high dose of radiation. Initially developed for intracranial lesions, SRS resulted in local control rates above 80–90% for the treatment of brain metastases (4). When SRS is used in extracranial tumors, it is also called stereotactic body radiation therapy (SBRT).…”

Section: Introductionmentioning

confidence: 99%

Stereotactic Body Radiation Therapy for Nonresectable Tumors of the Pancreas

Goyal

Einstein

Ibarra

et al. 2012

Journal of Surgical Research

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Purpose Stereotactic body radiation therapy (SBRT) has emerged as a potential treatment option for local tumor control of primary malignancies of the pancreas. We report on our experience with SBRT in patients with pancreatic adenocarcinoma whom were found not to be candidates for surgical resection. Methods The prospective database of the first 20 consecutive patients receiving SBRT for unresectable pancreatic adenocarcinomas and a neuroendocrine tumor under an IRB approved protocol was reviewed. Prior to SBRT, cylindrical solid gold fiducial markers were placed within or around the tumor endoscopically (n=13), surgically (n=4), or percutaneously under CT-guidance (n=3) to allow for tracking of tumor during therapy. Mean radiation dose was 25 Gray (range 22–30Gy) delivered over 1–3 fractions. Chemotherapy was given to 68% of patients in various schedules/timing. Results Patients had a mean gross tumor volume of 57.2 cm3 (range 10.1–118 cm3) before SBRT. The mean total gross tumor volume reduction at 3 and 6 months after SBRT were 21 and 38%, respectively (P<0.05). Median follow-up was 14.57 months (range 5–23 months). The overall rate of freedom from local progression at 6 and 12 months were 88 and 65%. The probability of overall survival at 6 and 12 months were 89 and 56%. No patient had a complication related to fiducial markers placement regardless of modality. The rate of radiation induced adverse events was: grade 1–2 (11%) and grade 3 (16%). There were no grade 4/5 adverse events seen. Conclusion Our preliminary results showed SBRT as a safe and likely effective local treatment modality for pancreatic primary malignancy with acceptable rate of adverse events.

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The role of the gamma knife in the treatment of malignant primary and metastatic brain tumors

Cited by 20 publications

References 52 publications

Gamma Knife Radiosurgery for the Treatment of Brain Metastases

Gamma Knife Radiosurgery for the Treatment of Brain Metastases

Multidisciplinary approaches to intrahepatic cholangiocarcinoma

Stereotactic Body Radiation Therapy for Nonresectable Tumors of the Pancreas

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