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Photon Radiosurgery: A Clinical Review

Published online by Cambridge University Press:  18 September 2015

Michael R. McKenzie
Affiliation:
Department of Oncology (Division of Radiation Oncology), McGill University, Montreal
Luis Souhami*
Affiliation:
Department of Oncology (Division of Radiation Oncology), McGill University, Montreal
Ervin B. Podgorsak
Affiliation:
Department of Oncology (Division of Radiation Oncology), McGill University, Montreal
André Olivier
Affiliation:
Department of Neurosurgery, McGill University, Montreal
Jean-Louis Caron
Affiliation:
Department of Neurosurgery, McGill University, Montreal
Jean-Guy Villemure
Affiliation:
Department of Neurosurgery, McGill University, Montreal
*
Department of Radiation Oncology, Montreal General Hospital, 1650 Avenue Cedar, Montreal, Quebec, Canada H3G 1A4
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Abstract:

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The term radiosurgery has been used to describe a variety of radiotherapy techniques which deliver high doses of radiation to small, stereotactically defined intracranial targets in such a way that the dose fall-off outside the targeted volume is very sharp. Proton, charged particle, gamma unit, and linear accelerator-based techniques appear to be equivalent from the standpoint of accuracy, dose distributions, and clinical results. However, capital and operating costs associated with the use of linear accelerators in general clinical use are much lower. Radiosurgery has an established role in the treatment of arteriovenous malformations and acoustic neurinomas. Interest in these techniques is increasing in neurosurgical and radiation oncological communities, as radiosurgery is rapidly assuming a place in the management of several other conditions, including craniopharyngiomas, meningiomas, and selected malignant lesions.

Type
Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1992

References

1.Spiegel, EA.History of human stereotaxy (stereoencephalotomy). In: Schaltenbrand, G, Walker, AE, eds. Stereotaxy of the Human Brain (ed 2). Stuttgart/New York: George Thieme Verlag, 1982; 310.Google Scholar
2.Zemoff, DN.L’encephalometre. Rev Gen Clin Ther 1890; 4: 302305.Google Scholar
3.Kandel, El, Schavinsky, YV.Stereotaxic apparatus and operations in Russia in the 19th century. J Neurosurg 1972; 37: 407411.Google Scholar
4.Picard, C, Olivier, A, Bertrand, G.The first human stereotaxic apparatus: the contribution of Aubrey Mussen to the field of stereotaxis. J Neurosurg 1983; 59: 673676.CrossRefGoogle Scholar
5.Larson, DA, Gutin, PH, Leibel, SA, et al. Stereotaxic irradiation of brain tumors. Cancer 1990; 65 (Suppl): 792799.3.0.CO;2-P>CrossRefGoogle ScholarPubMed
6.Leksell, L.A stereotaxic apparatus for intracerebral surgery. Acta Chir Scand 1949; 99: 229233.Google Scholar
7.Leksell, L.The stereotaxic method and radiosurgery of the brain. Acta Chir Scand 1951; 102:316319.Google ScholarPubMed
8.Leksell, L, Larsson, B, Andersson, B, et al. Lesions in the depth of the brain produced by a beam of high energy protons. Acta Radiol 1960; 54:251264.CrossRefGoogle ScholarPubMed
9.Leksell, L.Cerebral radiosurgery: I Gammathalamotomy in two cases of intractable pain. Acta Chir Scand 1968; 134: 585595.Google Scholar
10.Leksell, L.Stereotactic radiosurgery. J Neurol Neurosurg Psychiatry 1983; 46: 797803.CrossRefGoogle ScholarPubMed
11.Leksell, L, Herner, T, Leksell, D, et al. Visualization of stereotactic radiolesions by nuclear magnetic resonance. J Neurol Neurosurg Psychiatry 1985; 48: 1920.CrossRefGoogle ScholarPubMed
12.Backlund, EO.Studies on craniopharyngiomas – III Stereotaxic treatment with intracystic Yttrium-90. Acta Chir Scand 1973; 139:237247.Google Scholar
13.Backlund, EO, Rahn, T, Sarby, B.Treatment of pinealomas by stereotaxic radiation surgery. Acta Radiol Ther (Stockholm) 1974; 13:368376.Google ScholarPubMed
14.Backlund, EO, Bergstrand, G, Herton-Laurell, U, et al. Tumor changes after single dose irradiation by stereotactic radiosurgery in ‘non-active’ pituitary adenomas and prolactinomas. In: Szikla, G, ed. Stereotactic Cerebral Irradiation: INSERM Symposium No. 12. Amsterdam: Elsevier/North Holland Biomedical Press, 1979; 199296.Google Scholar
15.Noren, G, Arndt, J, Hindmarsh, T.Stereotactic radiosurgery in cases of acoustic neuroma: further experiences. Neurosurgery 1983; 13: 1222.Google Scholar
16.Noren, G, Arndt, J, Hindmarsh, T, et al. Stereotactic radiosurgical treatment of acoustic neurinomas. In: Lunsford, LD, ed. Modern stereotactic neurosurgery. Boston: Martinus Nijhoff, 1988; 481489.CrossRefGoogle Scholar
17.Steiner, L, Greitz, T, Backlund, EO, et al. Radiosurgery in arteriovenous malformations of the brain: undue effects. In: Szikla, G, ed. Stereotactic Cerebral Irradiation: INSERM Symposium No. 12. Amsterdam: Elsevier/North Holland Biomedical Press, 1979; 257269.Google Scholar
18.Steiner, L.Radiosurgery in cerebral arteriovenous malformations. In: Flamm, E, Fein, J, eds. Textbook of Cerebrovascular Surgery. New York, Springer Verlag, 1986; 11611215.Google Scholar
19.Steiner, L.Stereotactic radiosurgery with the Cobalt-60 gamma unit in the surgical treatment of intracranial tumors and arteriovenous malformations. In: Schmidek, HH, Sweet, WH, eds. Operative Neurosurgical Techniques – Indications, Methods, and Results. Philadelphia: WB Saunders, 1988; 515529.Google Scholar
20.Steiner, L, Lindquist, L.Radiosurgery in cerebral arteriovenous malformations. Neurosurg State of the Art Reviews 1987; 2: 329336.Google Scholar
21.Leksell, DG.Stereotactic radiosurgery: present status and future trends. Neurol Res 1987; 9: 6068.CrossRefGoogle ScholarPubMed
22.Kjellberg, RN, Preston, WM.The use of the Bragg peak of a proton beam for intracerebral lesions. Excerpta Medica 1961; 36: E103.Google Scholar
23.Tobias, CA, Lawrence, JH, Born, JL, et al. Pituitary irradiation with high-energy proton beams: a preliminary report. Cancer Res 1958; 18: 121134.Google Scholar
24.Marks, M, Delapaz, RL, Fabrikant, JI, et al. Intracranial vascular malformations; imaging of charged-particle radiosurgery; Part I – Results of therapy. Radiology 1988; 168(2): 447455.CrossRefGoogle ScholarPubMed
25.Lunsford, LD, Flickinger, J, Coffey, RJ.Stereotactic gamma knife radiosurgery – initial North American experience in 207 patients. Arch Neurol 1990; 47: 169175.CrossRefGoogle ScholarPubMed
26.Walton, L, Bomford, CK, Ramsden, D.The Sheffield Stereotactic Radiosurgery Unit: physical characteristics and principles of operation. Br J Radiol 1987; 60: 897906.CrossRefGoogle ScholarPubMed
27.Barcia-Salorio, JL, Hernandez, G, Broseta, J, et al. Radiosurgical treatment of carotid-cavernous fistula. Appl Neurophysiol 1982; 45: 520522.Google ScholarPubMed
28.Betti, OO, Munari, C, Rosier, R.Stereotactic radiosurgery with the linear accelerator: treatment of arteriovenous malformations. Neurosurgery 1989; 24: 311321.CrossRefGoogle ScholarPubMed
29.Colombo, F, Benedetti, A, Pozza, F, et al. External stereotactic irradiation by linear accelerator. Neurosurgery 1985; 16: 154159.CrossRefGoogle ScholarPubMed
30.Friedman, A.Linac radiosurgery. Neurosurg Clin N Am 1990; 1: 9911008.CrossRefGoogle ScholarPubMed
31.Hartmann, GH, Schlegel, W, Sturm, V, et al. Cerebral radiation surgery using moving field irradiation at a linear accelerator facility. Int J Radiat Oncol Biol Phys 1985; 11: 11851192.CrossRefGoogle Scholar
32.Hitchcock, E, Kitchen, G, Dalton, E, et al. Stereotactic linac radiosurgery. Br J Neurosurg 1989; 3: 305312.CrossRefGoogle ScholarPubMed
33.Loeffler, JS, Alexander, E, Siddon, RL, et al. Stereotactic radiosurgery for intracranial arteriovenous malformations using a standard linear accelerator. Int J Radiat Oncol Biol Phys 1989; 17; 673677.CrossRefGoogle ScholarPubMed
34.Podgorsak, EB, Olivier, A, Pla, M, et al. Dynamic stereotactic radiosurgery. Int J Radiat Oncol Biol Phys 1988; 14: 115126.CrossRefGoogle ScholarPubMed
35.Griffin, BR, Warcola, SH, Mayberg, MR, et al. Stereotactic neutron radiosurgery for arteriovenous malformations of the brain. Med Dosim 1988; 13: 179182.CrossRefGoogle ScholarPubMed
36.Gutin, PH, Wilson, CB.Editorial – Radiosurgery for malignant brain tumors. J Clin One 1990; 8: 571573.CrossRefGoogle ScholarPubMed
37.Larson, DA, Gutin, PH.Introduction to radiosurgery. Neurosurg Clin NAm 1990; 1:897908.CrossRefGoogle ScholarPubMed
38.Podgorsak, EB, Pike, GB, Olivier, A, et al. Radiosurgery with high energy photon beams: a comparison among techniques. Int J Radiat Oncol Biol Phys 1989; 16: 857865.CrossRefGoogle Scholar
39.Peters, TM, Clark, JA, Olivier, A, et al. Integrated stereotaxic imaging with CT, MR imaging and digital subtraction angiography. Radiology 1986; 161: 821826.Google ScholarPubMed
40.Schad, LR, Boesecke, R, Schlegel, W, et al. Three dimensional image correlation of CT, MR, and PET studies in radiotherapy treatment planning of brain tumors. J Comp Assist Tomogr 1987; 11: 948954.CrossRefGoogle ScholarPubMed
41.Phillips, MH, Frankel, KA, Lyman, JT, et al. Heavy charged-particle stereotactic radiosurgery: cerebral angiography and CT in the treatment of intracranial malformations. Int J Radiat Oncol Biol Phys 1989; 17:419426.CrossRefGoogle Scholar
42.Podgorsak, EB.Physics for radiosurgery with linear accelerators. Neurosurg Clin N Am 1992; 3: 924.CrossRefGoogle ScholarPubMed
43.International Commission on Radiation Units and Measurements (ICRU), Report 24: Determination of absorbed dose in a patient irradiated by beams of X or gamma rays in radiotherapy procedures. Washington, ICRU, 1976.Google Scholar
44.Houdek, PV, Fayos, JV, van Buren, JM, et al. Stereotaxic radiotherapy technique for small intracranial lesions. Med Phys 1985; 12: 469472.CrossRefGoogle ScholarPubMed
45.McGinley, PH, Butker, EK, Crocker, IR, et al. A patient rotator for stereotactic radiosurgery. Phys Med Biol 1990; 35: 649657.CrossRefGoogle ScholarPubMed
46.Phillips, MH, Frankel, KA, Lyman, JT, et al. Comparison of different radiation types and irradiation geometries in stereotactic radiosurgery. Int J Radiat Oncol Biol Phys 1990; 18: 211220.Google ScholarPubMed
47.Flickinger, JC, Lunsford, LD, Wu, A, et al. Treatment planning for gamma knife radiosurgery with multiple isocenters. Int J Radiat Oncol Biol Phys 1990; 18: 14951501.CrossRefGoogle ScholarPubMed
48.Flickinger, JC, Maitz, A, Kalend, AM, et al. Treatment volume shaping with selective beam blocking using the Leksell Gamma Unit. Int J Radiat Oncol Biol Phys 1990; 19: 783789.CrossRefGoogle ScholarPubMed
49.Podgorsak, EB, Pike, GB, Pla M et al. Radiosurgery with photon beams: physical aspects and adequacy of linear accelerators. Radiother Oncol 1990; 17:349358.CrossRefGoogle ScholarPubMed
50.Austin-Seymour, M, Munzenrider, J, Lingood, R, et al. Fractionated proton radiation therapy of cranial and intracranial tumors. Am J Clin Oncol 1990; 13:327330.Google ScholarPubMed
51.Pozza, F, Colombo, F, Chierego, G, et al. Low grade astrocytomas: treatment with unconventionally fractionated external beam stereotactic radiation therapy. Radiology 1989; 171: 565569.CrossRefGoogle ScholarPubMed
52.Schwade, JG, Houdek, PV, Landy, HJ, et al. Small field stereotactic external beam radiation therapy of intracranial lesions: fractionated treatment with a fixed-halo immobilization. Radiology 1990; 176:563565.CrossRefGoogle ScholarPubMed
53.Souhami, L, Olivier, A, Podgorsak, EB, et al. Fractionated dynamic stereotactic radiotherapy for intracranial tumors. Cancer 1991; 68:21012108.3.0.CO;2-C>CrossRefGoogle ScholarPubMed
54.Hudgins, WR. (letter) What is radiosurgery? Neurosurgery 1988; 23: 272.CrossRefGoogle ScholarPubMed
55.Jane, JA, Kassell, NF, Tomer, JC, et al. The natural history of aneurysms and arteriovenous malformations. J Neurosurg 1985; 62:321323.CrossRefGoogle ScholarPubMed
56.Graf, CJ, Perret, GE, Tomer, JC.Bleeding from arteriovenous malformations as part of their natural history. J Neurosurg 1983; 58: 331337.CrossRefGoogle ScholarPubMed
57.Poulsen, MG.Arteriovenous malformations – a summary of 6 cases treated with radiation therapy. Int J Radiat Oncol Biol Phys 1987; 13: 15531557.CrossRefGoogle ScholarPubMed
58.Kjellberg, RN, Hanamura, T, Davis, KR, et al. Bragg peak proton beam therapy for arteriovenous malformations of the brain. N Engl J Med 1983; 309: 269274.CrossRefGoogle ScholarPubMed
59.Colombo, F, Benedetti, A, Pozza, F, et al. Linear accelerator radiosurgery of cerebral arteriovenous malformations. Neurosurgery 1989; 24: 833840.CrossRefGoogle ScholarPubMed
60.Souhami, L, Olivier, A.Podgorsak, EB, et al. Dynamic stereotactic radiosurgery in arteriovenous malformations. Preliminary treatment results. Cancer 1990; 66: 1520.3.0.CO;2-8>CrossRefGoogle ScholarPubMed
61.McCormick, WF.Pathology of vascular malformations of the brain. In: Stein, BM, ed. Intracranial Arteriovenous Malformations. Baltimore, Williams and Wilkins, 1984; 4464.Google Scholar
62.Kjellberg, RN.Proton beam radiotherapy for arteriovenous malformations of the brain. In: Schmidek, HH, Sweet, WH, eds. Operative Neurosurgical Techniques: Indications, Methods, and Results. Philadelphia: WB Saunders, 1988; 911915.Google Scholar
63.Marks, M, Delapaz, RL, Fabrikant, JI, et al. Intracranial vascular malformations: imaging of charged-particle radiosurgery; Part II – Complications. Radiology 1988; 168; 457462.CrossRefGoogle ScholarPubMed
64.Souhami, L, Olivier, A, Podgorsak, EB, et al. Radiosurgery of cerebral arteriovenous malformations with the dynamic stereotactic irradiation. Int J Radiat Oncol Biol Phys 1990; 19: 775782.CrossRefGoogle ScholarPubMed
65.Levy, RP, Fabrikant, JI, Frankel, KA, et al. Stereotactic heavycharged-particle Bragg peak radiosurgery for the treatment of intracranial arteriovenous malformations in childhood and adolescence. Neurosurgery 1989; 24: 841852.CrossRefGoogle ScholarPubMed
66.Kemeny, AA, Dias, PA, Forster, DM.Results of stereotactic radiosurgery of arteriovenous malformations: an analysis of 52 cases. J Neurol Neurosurg Psychiatry 1989; 52: 554558.Google ScholarPubMed
67.Lindquist, C, Steiner, L.Stereotactic radiosurgical treatment of arteriovenous malformations. In: Lunsford, LD, ed. Modern Stereotactic Radiosurgery. Boston: Martinus Nijhoff, 1988; 491505.CrossRefGoogle Scholar
68.Levy, RP, Fabrikant, JI, Frankel, KA, et al. Charged particle radiosurgery of the brain. Neurosurg Clin N Am 1990; 1: 955990.CrossRefGoogle ScholarPubMed
69.Weil, S, Tew, JM, Steiner, L.Comparison of radiosurgery and microsurgery for treatment of cavernous malformations of the brainstem (Abstract). J Neurosurg 1990; 72: 336A.Google Scholar
70.Kondziolka, D, Lunsford, LD, Coffey, RJ, et al. Stereotactic radiosurgery of angiographically occult vascular malformations: indications and preliminary experience. Neurosurgery 1990; 27: 892900.CrossRefGoogle ScholarPubMed
71.Wallner, KE, Sheline, GE, Pitts, LH, et al. Efficacy of irradiation for incompletely excised acoustic neunlemmomas. J Neurosurg 1987; 67: 858863.CrossRefGoogle Scholar
72.Gantz, BJ, Parnes, LS, Harker, LA, et al. Middle cranial fossa acoustic neuroma excision: results and complications. Ann Otol Rhinol Laryngol 1986; 95: 454459.CrossRefGoogle ScholarPubMed
73.Flickinger, JC, Lunsford, LD, Coffey, RJ, et al. Radiosurgery of acoustic neurinomas. Cancer 1991; 67: 345353.Google ScholarPubMed
74.Taylor, B, Marcus, R, Friedman, W, et al. The meningioma controversy: post-operative radiation therapy. Int J Radiat Oncol Biol Phys 1988; 15:299304.CrossRefGoogle Scholar
75.King, D, Chang, C, Pool, J.Radiotherapy in the management of meningiomas. Acta Radiol Ther Phys Biol 1966; 5: 2633.CrossRefGoogle ScholarPubMed
76.Coffey, RJ, Lunsford, LD.Stereotactic radiosurgery using the 201 Colbalt-60 source gamma knife. Neurosurg Clin N Am 1990; 1: 933953.CrossRefGoogle Scholar
77.Engenhart, R, Kimmig, BN, Hover, KH, et al. Stereotactic single high dose radiation therapy of benign intracranial meningiomas. Int J Radiat Oncol Biol Phys 1990; 19: 10211026.CrossRefGoogle ScholarPubMed
78.Kondziolka, D, Lunsford, LD, Coffey, RJ, et al. Stereotactic radiosurgery of meningiomas. J Neurosurg 1991; 74: 552559.Google ScholarPubMed
79.Baskin, DS, Wilson, CB.Surgical management of craniopharyngiomas. J Neurosurg 1986; 65: 2225.CrossRefGoogle ScholarPubMed
80.Kjellberg, RN, Shintani, A, Frantz, AG, et al. Proton beam therapy in acromegaly. New Engl J Med 1968; 278: 689695.Google ScholarPubMed
81.Sturm, V, Kober, B, Hover, KH, et al. Stereotactic percutaneous single dose irradiation of brain metastases with a linear accelerator. Int J Radiat Oncol Biol Phys 1987; 13: 279282.CrossRefGoogle ScholarPubMed
82.Marin-Grenz, M, Kimmig, B, Engenhart, R, et al. High dose percutaneous stereotactic irradiation of solitary brain metastases using a 15 MeV linear accelerator (Abstract). Int J Radiat Oncol Biol Phys 1988; 15 (Suppl 1): 231.Google Scholar
83.Loeffler, JS, Kooy, HM, Wen, PY, et al. The treatment of recurrent brain metastases with stereotactic radiosurgery. J Clin Oncol 1990; 8:576582.CrossRefGoogle ScholarPubMed
84.Caron, JL, Souhami, L, Podgorsak, EB.Dynamic stereotactic radiosurgery in the palliative treatment of isolated cerebral metastatic tumors. J Neurooncol 1992; 12: 173179.CrossRefGoogle Scholar
85.Gragoudas, ES, Goitein, M, Verhey, I, et al. Proton beam irradiation of uveal melanoma: results of a 5’/2 year study. Arch Ophthalmol 1982; 100:928934.Google Scholar
86.Rand, RW, Khonsary, A, Brown, J, et al. Leksell stereotactic radiosurgery in the treatment of eye melanoma. Neurol Res 1987; 9: 142146.CrossRefGoogle ScholarPubMed
87.Sheline, GE, Wara, WM, Smith, V.Therapeutic irradiation and brain injury. Int J Radiat Oncol Biol Phys 1980; 6: 12151228.CrossRefGoogle ScholarPubMed
88.Kjellberg, RN, Davis, KR, Lyons, S, et al. Bragg peak proton beam therapy for arteriovenous malformation of the brain. Clin Neurosurg 1983; 31: 248290.CrossRefGoogle ScholarPubMed
89.Loeffler, JS, Siddon, RL, Wen, PY, et al. Stereotactic radiosurgery of the brain using a standard linear accelerator: a study of early and late effects. Radiother Oncol 1990; 17: 311321.CrossRefGoogle ScholarPubMed
90.Alexander, E, Siddon, RL, Loeffler, JS.The acute onset of nausea and vomitting following stereotactic radiosurgery: correlation with the total dose to area postrema. Surg Neurol 1989; 32: 4044.Google ScholarPubMed
91.Wennerstrand, J, Ungerstedt, U.Cerebral radiosurgery II: an anatomical study of gamma radiolesions. Acta Chir Scand 1970; 136: 133137.Google Scholar
92.Arndt, J, Backlund, EO, Larsson, B, et al. Stereotactic irradiation of intracranial structures: physical and biological considerations. In: Szikla, G, ed. Stereotactic Cerebral Irradiation: INSERM Symposium No. 12. Amsterdam: Elsevier/North Holland Biomedical Press, 1979; 8192.Google Scholar
93.Kjellberg, RN.Isoeffective dose parameters for brain necrosis in relation to proton radiosurgical dosimetry. In: Szikla, G, ed. Stereotactic Cerebral Irradiation: INSERM Symposium No. 12. Amsterdam: Elsevier/North Holland Biomedical Press, 1979; 157166.Google Scholar
94.Flickinger, JC.An integrated logistic formula for prediction of complications from radiosurgery. Int J Radiat Oncol Biol Phys 1989; 17:879885.CrossRefGoogle ScholarPubMed
95.Flickinger, JC, Schell, MC, Larson, DA.Estimation of complications for linear accelerator radiosurgery with the integrated logistic formula. Int J Radiat Oncol Biol Phys 1990; 19: 143148.CrossRefGoogle ScholarPubMed
96.Flickinger, JC, Steiner, L.Radiosurgery and the double logistic product formula. Radiother Oncol 1990; 17: 229237.CrossRefGoogle ScholarPubMed