Das Gehirn ist das komplexeste und zugleich vulnerabelste Organ des Menschen, rundherum geschützt von stabilstem Knochen. Von jeher besteht daher besonderer Evolutionsdruck, akkurate und minimalinvasive Techniken zu entwickeln, um sich ihm mit größter Vorsicht und vor allem vorausgeplant nähern zu können. Ein Ergebnis dieser Evolution war — vor über einem Jahrhundert — die Entwicklung und Etablierung erster stereotaktischer Operationsinstrumente und Techniken zur Durchführung höchst präziser neurochirurgischer Eingriffe in der Tiefe des Gehirns. Rund 60 Jahre später erfolgte die Einführung der zerebralen Schnittbildgebung mittels Computertomographie. Die Stereotaxie hat sich seither als Subspezialität der Neurochirurgie kontinuierlich weiterentwickelt und viele nützliche Anwendungen zur operativen und/oder strahlentherapeutischen Behandlung von Hirntumoren und anderen neurologischen Erkrankungen hervorgebracht.
Literatur
Adler JR Jr, Chang SD, Murphy MJ et al (1997) The Cyberknife: a frameless robotic system for radiosurgery. Stereotact Funct Neurosurg 69: 124–128
Combs SE, Ganswindt U, Foote RL et al (2012) State-of-the-art treatment alternatives for base of skull meningiomas: complementing and controversial indications for neurosurgery, stereotactic and robotic based radiosurgery or modern fractionated radiation techniques. Radiat Oncol 7: 226 (in process)
Collen C, Ampe B, Gevaert T et al (2011) Single fraction versus fractionated linac-based stereotactic radiotherapy for vestibular schwannoma: a singleinstitution experience. Int J Radiat Oncol Biol Phys 81: 503–509
Han J, Girvigian MR, Chen JC et al (2012) A comparative study of stereotactic radiosurgery, hypofractionated, and fractionated stereotactic radiotherapy in the treatment of skull base meningeoma. Am J Clin Oncol 13 (Epub ahead of print)
Horsley V, Clarke RH (1908) The structure and functions of the cerebellum examined by a new method. Brain 31: 45–124
Kocher M, Soffietti R, Abacioglu U et al (2011) Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952-26001 study. J Clin Oncol 29: 134–141
Kreth FW, Thon N, Siefert A, Tonn JC (2010) The place of interstitial brachytherapy and radiosurgery for low-grade gliomas. Adv Tech Stand Neurosurg 35: 183–212
Laperriere NJ, Leung PMK, McKenzie S et al (1998) Randomized study of brachytherapy in the initial management of patients with malignant astrocytoma. Int J Radiat Oncol Biol Phys 41: 1005–1011
Larson DA, Flickinger JC, Loeffler JS (1993) The radiobiology of radiosurgery. Int J Radiat Oncol Biol Phys 25: 557–561
Leksell L (1968) Cerebral radiosurgery I. Gammathalamotomy in two cases of intractable pain. Acta Chir Scand 134: 585–595
Leksell L (1951) The stereotaxic method and radiosurgery of the brain. Acta Chir Scand 102: 316–319
Milker-Zabel S, Zabel A, Schulz-Ertner D et al (2005) Fractionated stereotactic radiotherapy in patients with benign or atypical intracranial meningioma: long-term experience and prognostic factors. Int J Radiat Oncol Biol Phys 61: 809–816
Mundinger F, Noetzel H, Riechert T (1959) Experiences with localized radiation of malignant brain tumors with radioisotopes. Acta Neurochir Suppl (Wien) 6: 171–182
Ruge MI (2012) Is there still a place for stereotactic brachytherapy for brain tumors in modern neuro-oncology? Neuro-oncol 14: 87–88
Ruge MI, Simon T, Suchorska B et al (2011) Stereotactic brachytherapy with iodine-125 seeds for the treatment of inoperable low-grade gliomas in children: long-term outcome. J Clin Oncol 31: 4151–4159
Ruge MI, Kickingereder P, Grau S et al (2011) Stereotactic biopsy combined with stereotactic (125)iodine brachytherapy for diagnosis and treatment of locally recurrent single brain metastases. J Neurooncol 105: 109–118
Ruge MI, Kickingereder P, Simon T et al (2012) Stereotactic iodine-125 brachytherapy for treatment of inoperable focal brainstem gliomas of WHO grades I and II: feasibility and long-term outcome. J Neurooncol 109: 273–283
Ruge MI, Suchorska B, Maarouf M et al (2011) Stereotactic 125iodine brachytherapy for the treatment of singular brain metastases: closing a gap? Neurosurgery 68: 1209–1218
Ruge MI, Kocher M, Maarouf M et al (2011) Comparison of stereotactic brachytherapy (125 iodine seeds) with stereotactc radiosurgery (LINAC) for the treatment of singular cerebral metastases. Strahlenther Onkol 187: 7–14
Runge MJ, Maarouf M, Hunsche S et al (2012) LINAC-radiosurgery for nonsecreting pituitary adenomas. Long-term results. Strahlenther Onkol 188: 319–325
Selker RG, Shapiro WR, Burger P et al (2002) The Brain Tumor Cooperative Group NIH Trial 87-01: a randomized comparison of surgery, external radiotherapy, and carmustine versus surgery, interstitial radiotherapy boost, external radiation therapy, and carmustine. Neurosurgery 51: 343–355
Sheehan JP, Niranjan A, Sheehan JM et al (2005) Stereotactic radiosurgery for pituitary adenomas: an intermediate review of its safety, efficacy, and role in the neurosurgical treatment armamentarium. J Neurosurg 102: 678–691
Soffietti R, Kocher M, Abacioglu UM et al (2013) A European Organisation for Research and Treatment of Cancer phase III trial of adjuvant whole-brain radiotherapy versus observation in patients with one to three brain metastases from solid tumors after surgical resection or radiosurgery: quality-of-life results. J Clin Oncol 31: 65–72
Sturm V, Kober B, Höver KH et al (1987) Stereotactic percutaneous single dose irradiation of brain metastases with a linear accelerator. Int J Radiat Oncol Biol Phys 13: 279–282
Suchorska B, Ruge M, Treuer H et al (2011) Stereotactic brachytherapy of lowgrade cerebral glioma after tumor resection. Neuro Oncol 13: 1133–1142
Winston KR, Lutz W (1988) Linear accelerator as a neurosurgical tool for stereotactic radiosurgery. Neurosurgery 22: 454–464
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Ruge, M.I., Kocher, M., Treuer, H. et al. Stereotaktische Techniken zur Bestrahlung von Hirntumoren. best practice onkologie 8, 6–13 (2013). https://doi.org/10.1007/s11654-013-0071-z
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DOI: https://doi.org/10.1007/s11654-013-0071-z