Acta Neurochirurgica

, Volume 121, Issue 3–4, pp 140–145 | Cite as

Linear accelerator and Greitz-Bergstrom's head fixation system in radiosurgery of single cerebral metastases. A report of 86 cases

  • V. Valentino
  • M. A. Mirri
  • G. Schinaia
  • G. Dalle Ore
Clinical Articles

Summary

Between 1984 and 1991 86 patients with single cerebral metastases underwent linear accelerator radiosurgery using the atraumatic and reproducible Greitz-Bergström head-fixation device. Routine one-month follow-up documented disappearance of the tumour in 16 patients, with resolution of the oedema and ventricular shift. Shrinkage of the metastasis occurred in 51 patients. In 9 patients the tumour remained stable, in 7 there was progression of tumour size. Among the patients showing shrinkage of the tumour or unchanged tumour volume, repeated radiosurgery resulted in disappearance of the metastasis in 5 and further shrinkage in 28. In 14 patients routine stereotacitc CT follow-up study led to the detection of a new metastasis, again treated with excellent results. Local recurrence occurred in 2 patients and radiation necrosis in the target area in 5 patients. Radiosurgery thus proves to be an appropriate alternative to surgery. The versatility of our non-invasive and painless method permits CT staging (which we consider essential) without hospitalization of the patient.

Keywords

Radiosurgery linear accelerator cerebral metastases stereotaxis 

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References

  1. 1.
    Backhand EO (1979) Stereotactic radiosurgery in intracranial tumours and vascular malformations. In: Advances and technical standards in neurosurgery, Vol 6. Springer, Wien New YorkGoogle Scholar
  2. 2.
    Coffey RJ, Flickinger JC, Bissonette DJet al (1991) Radiosurgery for solitary brain metastases using the Cobalt-60 gamma unit: methods and results in 24 patients. Int J Radiat Oncol Biol Phys 20: 1287–1295PubMedGoogle Scholar
  3. 3.
    Colombo F, Benedetti A, Casentini Let al (1989) Linear accelerator radiosurgery of arteriovenous malformations. Neurosurgery 24: 833–840PubMedGoogle Scholar
  4. 4.
    Greitz T, Bergström M, Kingsley Det al (1980) Head fixation system for integration of radiodiagnostic and therapeutic procedures. Neuroradiology 19: 1–6PubMedGoogle Scholar
  5. 5.
    Kelly PJ, Kall BA, Goerss SJ (1988) Results of computed tomography-based computer-assisted stereotactic radiosurgery of metastatic intracranial tumours. Neurosurgery 22: 7–17PubMedGoogle Scholar
  6. 6.
    Kjellberg RN, Hanamura T, Davis KRet al (1983) Bragg peak proton-beam therapy for arteriovenous malformations of the brain. N Engl J Med 309: 269–274PubMedGoogle Scholar
  7. 7.
    Kooy HM, Nedzi LA, Loeffler JSet al (1991) Treatment planning for stereotactic radiosurgery of intracranial lesions. Int J Radiat Oncol Biol Phys 21: 683–693PubMedGoogle Scholar
  8. 8.
    Lindquist C (1989) Gamma knife surgery for recurrent solitary metastasis of a cerebral hypernephroma: case report. Neurosurgery 25: 802–804PubMedGoogle Scholar
  9. 9.
    Loeffler JS, Alexander III E, Siddon RLet al (1989) Stereotactic radiosurgery for intracranial arteriovenous malformations using a standard linear accelerator. Int J Radiat Oncol Biol Phys 17: 673–677PubMedGoogle Scholar
  10. 10.
    Lutz W, Winston KR, Maleki N (1988) A system for stereotactic radiosurgery with a linear accelerator. Int J Radiat Oncol Biol Phys 14: 373–381PubMedGoogle Scholar
  11. 11.
    Mirri MA, Pavin G, Schinaia G (1990) Radiochirurgia delle metastasi cerebrali. Riv Neuroradiol 3: 291–298Google Scholar
  12. 12.
    Norén G, Arndt J, Hindmarsh T (1983) Stereotactic radiosurgery in cases of acoustic neurinoma: further experiences. Neurosurgery 13: 12–22PubMedGoogle Scholar
  13. 13.
    Patchell RA, Cirrincione C, Thaler HTet al (1986) Single brain metastases: surgery plus radiation or radiation alone. Neurology 36: 447–453PubMedGoogle Scholar
  14. 14.
    Patchell RA, Tibbs PA, Walsh JWet al (1990) A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 322: 494–500PubMedGoogle Scholar
  15. 15.
    Saloman M (1990) Metastatic brain tumours. Diagnostic and therapeutic management. Contemp Neurosurg 26: 1–5Google Scholar
  16. 16.
    Sturm V, Kober B, Höver KHet al (1987) Stereotactic percutaneous single dose irradiation of brain metastases with a linear accelerator. Int J Radiat Oncol Biol Phys 13: 279–282PubMedGoogle Scholar
  17. 17.
    Valentino V (1988) Radiosurgery in cerebral tumours and AVM. Acta Neurochirur (Wien) [Suppl] 42: 193–197Google Scholar
  18. 18.
    Valentino V (1992) Radiochirurgia: work in progress. Riv Neuroradiol 5: 95–106Google Scholar
  19. 19.
    Valentino V (1991) Postoperative radiosurgery of pituitary adenomas. J Neurosurg Sci 4: 207–211Google Scholar
  20. 20.
    Valentino V (1992) Radiosurgery in medulloblastoma. A new perspective. J Neurosurg Sci 5: 507–508Google Scholar
  21. 21.
    Winston KR, Lutz W (1988) Linear accelerator as a neurosurgical tool for stereotactic radiosurgery. Neurosurgery 22: 454–463PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • V. Valentino
    • 1
  • M. A. Mirri
    • 1
  • G. Schinaia
    • 2
  • G. Dalle Ore
    • 3
  1. 1.Centro di RadiochirurgiaClinica FlaminiaRome
  2. 2.Dipartimento di BiologiaII Università degli studi di RomaRome
  3. 3.Clinica Neurochirurgica dell' Università di TorinoTurinItaly

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