Both RS and SFS have gained eminent positions in radiation oncology and have become established modalities in the treatment of cranial lesions. Most leading radiation departments offer this technique and their numbers have grown significantly in the past decade.
The LINAC RS and gamma knife RS are equivalent techniques; however, technological and physical differences between these two methods have led to some confusion. Considering the RS, comparative clinical studies have documented that both therapeutic methodologies can be used with similar results. In comparison with gamma knife, the use of LINAC technology offers the possibility of dose fractionation, which has substantial clinical implications. The quality control of the complex LINAC is higher than of gamma knife and requires a specialized team of medical physicists and radiation oncologists. On the other hand, it is undisputed that stereotactic radiation therapy with isocentric LINAC has a high potential for further developments. Examples in this direction are the introduction of computer-guided micro-multileaf collimators which allows the delivery of a conform dose distribution with only one isocenter, using static fields or dynamic arcs and the implementation of the stereotactic intensity-modulated radiotherapy. These new technologies amplify substantially the potential of the stereotactic modality.
KeywordsTarget Volume Planning Target Volume Dose Distribution Radiat Oncol Biol Phys Target Point
Unable to display preview. Download preview PDF.
- Auer F, Grosu AL, Wiedenmann N et al. (2002) Stereotactic radiotherapy in patients with brain tumors: accuracy of a modified mask system. In: Kogelnik HD, Lukas P, Sedlmayer E (eds) Progress in radio-oncology, vol 7. Monduzzi Editore International Proc Division, Bologna, pp 163–168Google Scholar
- DIN 6827-1, Protokollierung bei der medizinischen Anwendung ionisierender Strahlung. Teil 1: Therapie mit Elektronenbeschleuniger sowie Röntgen-und Gammabestrahlungseinrichtungen, Deutsches Institut für Industrie-Normung, 2001Google Scholar
- Engenhart R, Kimmig B, Sturm V (1989) Stereotactically guided convergent beam irradiation of solitary brain metastasis and cerebral arteriovenous malformations: In: Dyck P, Bouzaglou A (eds) Brachytherapy of brain tumors and related stereotactic treatment. Hanley and Belfus, Philadelphia, pp 119–132Google Scholar
- Grosu AL, Lachner R, Wiedenmann N, Stärk S, Thamm R, Kneschaurek P, Schwaiger M, Molls M, Weber WA (2003) Validation of a method for automatic fusion of CT-and C11-Methionine-PET datasets of the brain for stereotactic radiotherapy using a LINAC. First clinical experience. Int J Radiat Oncol Biol Phys 56:1450–1463PubMedCrossRefGoogle Scholar
- Hartmann GH (ed) (1995) Quality assurance program on stereotactic radiosurgery. Springer, Berlin Heidelberg New YorkGoogle Scholar
- Hartmann GH, Schlegel W, Sturm V et al. (1985) Cerebral radiation surgery using moving field irradiation at a linac facility. Int J Radiat Oncol Biol Phys 11:185–192Google Scholar
- ICRU Report 50 (1984) Prescribing, recording and reporting photon beam therapy. ICRU, Washington, DCGoogle Scholar
- Larsson B, Liden K, Sorby B (1974) Irradiation of small structures through intact skull. Acta Radiol Ther Phys Biol 13:513–534Google Scholar
- Report of Task Group 42 (1995) Radiation Therapy Committee, AAPM Report no. 54, Schell MC (Chairman), Bova FJ, Larson DA et al., published for the American Association of Physicists in Medicine by the American Institute of PhysicsGoogle Scholar
- Riechert T, Mundinger F (1955) Beschreibung und Anwendung eines Zielgerätes für stereotaktische Hirnoperationen. Acta Neurochir 3 (Suppl):308–337Google Scholar
- Schlegel W, Pastyr O, Kubesch R et al. (1997) A computer controlled micro-multileaf-collimator for stereotactic conformal radiotherapy. In: In: Leavitt DD (ed) Proc XIIth International Conference on the Use of Computers in Radiotherapy (ICCR). Medical Physics Publishing, Madison, Wisconsin, pp 163–165Google Scholar
- Stärk S, Grosu AL, Kneschaurek P (2004) Dynamic arc stereotactic radiotherapy. J Radiat Oncol Biol PhysGoogle Scholar