We have previously reported good clinical results
|
|
- Maud Walsh
- 6 years ago
- Views:
Transcription
1 J Neurosurg 113:48 52, 2010 Gamma Knife surgery as sole treatment for multiple brain metastases: 2-center retrospective review of 1508 cases meeting the inclusion criteria of the JLGK0901 multi-institutional prospective study Clinical article To r u Se r i z a w a, M.D., Ph.D., 1 Ma s a a k i Ya m a m o t o, M.D., Ph.D., 2 Ya s u n o r i Sa t o, Ph.D., 3,4 Yo s h i n o r i Hi g u c h i, M.D., Ph.D., 5 Os a m u Na g a n o, M.D., Ph.D., 6 Ta k u ya Ka w a b e, M.D., 2 Sh i n j i Ma t s u d a, M.D., Ph.D., 6 Ju n i c h i On o, M.D., Ph.D., 5 Na o k a t s u Sa e k i, M.D., Ph.D., 3,4 Man a b u Ha t a n o, M.D., Ph.D., 1 a n d Ta t s u o Hi r a i, M.D. Ph.D. 1 1 Tokyo Gamma Unit Center, Tsukiji Neurological Clinic, Tokyo; 2 Mito Gamma House, Katsuta Hospital, Hitachinaka; 3 Clinical Research Center, Chiba University Hospital; 4 Department of Neurological Surgery, 5 Graduate School of Medicine, Chiba University, Chiba; and 6 Gamma Knife House, Chiba Cardiovascular Center, Ichihara, Japan Object. The authors retrospectively reviewed the results of Gamma Knife surgery (GKS) used as the sole treatment for brain metastases in patients who met the eligibility criteria for the ongoing JLGK0901 multi-institutional prospective trial. They also discuss the anticipated results of the JLGK0901 study. Methods. Data from 1508 consecutive cases were analyzed. All of the patients were treated at the Gamma Knife House of Chiba Cardiovascular Center or the Mito Gamma House of Katsuta Hospital between 1998 and 2007 and met the following JLGK0901 inclusion criteria: 1) newly diagnosed brain metastases, 2) 1 10 brain lesions, 3) less than 10 cm 3 volume of the largest tumor, 4) no more than 15 cm 3 total tumor volume, 5) no findings of CSF dissemination, and 6) no impairment of activities of daily living (Karnofsky Performance Scale score < 70) due to extracranial disease. At the initial treatment, all visible lesions were irradiated with GKS without upfront whole-brain radiation therapy. Thereafter, gadolinium-enhanced MR imaging was performed every 2 3 months, and new distant lesions were appropriately retreated with GKS. Patients were divided into groups according to numbers of tumors: Group A, single lesions (565 cases); Group B, 2 4 tumors (577 cases); and Group C, 5 10 tumors (366 cases). The differences in overall survival (OS) were compared between groups. Results. The median age of the patients was 66 years (range years). There were 963 men and 545 women. The primary tumors were in the lung in 1114 patients, gastrointestinal tract in 179, breast in 105, urinary tract in 66, and other sites in 44. The overall mean survival time was 0.78 years (0.99 years for Group A, 0.68 years for Group B, and 0.62 years for Group C). The differences between Groups A and B (p < ) and between Groups B and C (p = ) were statistically significant. Multivariate analysis revealed significant prognostic factors for OS to be sex (poor prognostic factor: male, p < ), recursive partitioning analysis class (Class I vs Class II and Class II vs III, both p < ), primary site (lung vs breast, p = ), and number of tumors (Group A vs Group B, p < ). However, no statistically difference was detected between Groups B and C (p = , hazard ratio 1.124, 95% CI ). Conclusions. The results of this retrospective analysis revealed an upper CI of for the hazard ratio, which was lower than the 1.3 initially set by the JLGK0901 study. The JLGK0901 study is anticipated to show noninferiority of GKS as sole treatment for patients with 5 10 brain metastases compared with those with 2 4 in terms of OS. (DOI: / GKS10838) Ke y Wo r d s metastatic brain tumor stereotactic radiosurgery Gamma Knife surgery whole-brain radiation therapy Abbreviations used in this paper: GK = Gamma Knife; GKS = GK surgery; HR = hazard ratio; JLGK = Japan Leksell Gamma Knife; JROSG = Japanese Radiation Oncology Study Group; KPS = Karnofsky Performance Scale; RPA = recursive partitioning analysis; RTOG = Radiation Therapy Oncology Group; SRS = stereotactic radiosurgery; UMIN = University Hospital Medical Information Network; WBRT = whole-brain radiation therapy. We have previously reported good clinical results of SRS alone using GKS for patients with multiple (even 5 or more) brain metastases According to the Japanese Radiation Oncology Study Group (JROSG) Study 99-1, reported by Aoyama et al. 1 in 2006, the efficacy of SRS alone for 1 4 brain metastases has been confirmed. However, we GK sur- 48 J Neurosurg / Volume 113 / December 2010
2 GKS alone for 1 10 brain metastases in JLGK0901-eligible cases geons have some doubts about this upper number limit of only 4 lesions. Therefore, the Japan Leksell Gamma Knife (JLGK) Society has planned a prospective multiinstitutional study (UMIN ID , umin.ac.jp/) for selected patients to establish evidence of the efficacy of GKS as the sole treatment for brain metastases in patients with 5 10 brain lesions, as previously reported in a single GK center. 6 In this paper, we discuss the anticipated results based on a retrospective review of more than 1500 patients in 2 GK centers, focusing on statistical analysis of overall survival, which is the primary end point of the JLGK0901 study. Methods Of 3716 patients with metastatic brain tumors treated with GKS between 1998 and 2008 at the Chiba Cardiovascular Center and Katsuta Hospital by 2 of the authors (T.S. and M.Y.) as the chief surgeons, 1508 patients satisfied the following JLGK0901 inclusion criteria: 1) newly diagnosed brain metastases, 2) 1 10 brain lesions, 3) less than 10 cm 3 volume of the largest tumor, 4) less than 15 cm 3 total tumor volume, 5) no MR imaging findings of CSF dissemination, and 6) no impaired activities of daily living (< 70 of KPS score) due to extracranial disease. Data pertaining to these 1508 cases were retrospectively analyzed for the present study. At initial treatment, all lesions were irradiated with GKS without upfront WBRT. Gadolinium-enhanced MR imaging was performed every 2 3 months until disease progression. The dates of death were documented by the patients primary physicians. The standard peripheral doses were 22 Gy if the tumor volume was < 4.0 cm 3 and 20 Gy if it was 4.0 but < 10.0 cm 3. We changed the dose depending on tumor pathology, physical status, tumor location, extracranial disease status, and so on. The dose was also reduced if the tumor was located adjacent to SRS-risk organs (such as the brainstem, optic apparatus, cochlear, and facial nerves). The interval from the date of GKS treatment until the date of death (OS) was calculated by the Kaplan-Meier method. We divided patients into 3 groups according to number of tumors: Group A, single tumor (565 cases); Group B, 2 4 tumors (577 cases); and Group C, 5 10 tumors (366 cases). Differences between groups were assessed using the log-rank test. Covariates that emerged as significant on univariate analyses were included in the multivariate model and then verified by stepwise methods in the final model. We calculated the HR of the following covariates: GK center (Chiba, Mito), patient age ( 65 years, < 65 years), patient sex (male, female), primary tumor site (lung, breast, and others), extracranial disease status (controlled, active), pretreatment KPS score (< 70, 70), number of brain lesions (Group A, 1; Group B, 2 4; and Group C, 5 10), initial neurological symptoms (yes, no), total tumor volume ( 4 cm 3, > 4 cm 3 ), and RPA classification (Classes I, II, and III). Using multivariate analyses, we calculated the adjusted HR of Group C to Group B. All computations were planned, and the tests were 2-sided. A p value < 0.05 was considered to be statistically significant. All statistical analyses were performed using SAS 9.2 (SAS Institute Inc.). J Neurosurg / Volume 113 / December 2010 Results Patient characteristics are summarized in Table 1. The overall mean survival time was 0.78 years (0.99 years in Group A, 0.68 years in Group B, and 0.62 years in Group C), as shown in Fig. 1. The mean survival times for each subgroup of covariates are presented in Table 2. The association between prognostic factors and OS was evaluated by univariate analysis in Table 3. Multivariate analysis revealed 4 statistically significant poor prognostic factors: multiple brain metastases, male sex, lung cancer origin, and low RPA class. The strongest significant prognostic factor was the RTOG-RPA classification, as shown in Fig. 2. Table 4 lists the final results of multivariate analysis, which revealed no statistically significant differences between Groups B and C (p = , HR 1.124, 95% CI ). Among 1299 patients who died, 452 (34.8%) required salvage GKS for new distant lesions. For numerous new distant lesions and/or CSF dissemination, salvage WBRT was performed in 36 cases (2.8%). Discussion Background of the JLGK 0901 Study The JROSG 99-1 study reported by Aoyama et al. 1 found no significant differences in OS, neurological death, or functional preservation between SRS alone and SRS with upfront WBRT, although new lesions and tumor progression were observed significantly more frequently in patients treated with SRS alone. These results confirmed the efficacy of SRS alone for patients with 1 4 brain metastases. However, no evidence supporting SRS alone for multiple brain tumors (that is, more than 3 4) has yet been obtained. Indeed, SRS using the GK has been widely applied to multiple brain metastases, as reported especially by Japanese groups In previous papers, the first author of the present paper (T.S.) and colleagues 4,5,9 have insisted that factors limiting the application of GKS as sole treatment include not only the number but also the size of lesions, as well as the presence of CSF dissemination and total tumor volume. As the first step to bridging the gap between broad clinical application and limited evidence of efficacy for multiple brain tumors, we, the JLGK Society, undertook a prospective multiinstitutional study of GKS without upfront WBRT to establish evidence that such a treatment strategy is feasible for 5 10 brain metastases. Validity of Selected Cases in the JLGK0901 Study Based on the considerable experience and vast literature on SRS alone using the GK in treating multiple brain metastases in Japan, the following intracranial conditions are not considered to be good indications for GKS alone: ) volume of the largest tumor of 10 cm 3 or more, 2) total tumor volume greater than 15 cm 3, 3) presence of CSF dissemination, 4) numerous (> 10) brain metastases, and 5) impaired activities of daily living (KPS score < 70) due to extracranial disease. Thus, the JLGK0901 study committee set the above 49
3 T. Serizawa et al. TABLE 1: Characteristics of 1508 cases* Characteristic Value GK center (no. of pts) Chiba 579 Mito 929 age (yrs) median 66 mean 64.7 range sex (no. of pts) M 963 F 545 extracranial disease (no. of pts) controlled 256 active 1252 pretreatment KPS score median 100 range primary tumor site (no. of pts) lung 1114 GI tract 179 breast 105 kidney 66 other 44 no. of brain lesions median 2 mean 3.2 range 1 10 total tumor volume (cm 3 ) median 2.7 mean 3.9 range RTOG-RPA classification Class I 113 Class II 1365 Class III 30 * GI = gastrointestinal; pts = patients. as exclusion criteria. Patients with sarcoma, lymphoma, and unknown primary cancers were also excluded. The protocol stipulates follow-up, including enhanced MR imaging and neurological examinations, every 3 months at a minimum. Statistical Analysis of the JLGK0901 Study This prospective study is designed to prove the noninferiority of OS in patients with several (5 10) metastases (Group C) compared with OS in those with 2 4 lesions (Group B). With 80% statistical power to achieve a significant level of for a 1-sided test with 2 years of recruitment and an additional 1-year follow-up, a planned total sample size of 1200 has been determined for this prospective trial. Noninferiority will be confirmed if the Fig. 1. Overall survival curves according to tumor number group. Mean survival time (MST) was 0.78 years (0.99 years in Group A, 0.68 years in Group B, and 0.62 years in Group C). There were significant differences between all 3 pairs of groups (p < for A vs B, p = for B vs C, and p < for A vs C). TABLE 2: Mean survival times by subgroup* Covariate Group MST (yrs) GK center Chiba Mito age (yrs) 65 < sex M F primary tumor site lung GI tract breast urinary tract other extracranial disease controlled active pretreatment KPS score 70 < no. of brain lesions Group A (1) Group B (2 4) Group C (5 10) initial neurol Sx yes no total tumor vol 4 cm 3 >4 cm RTOG-RPA classification Class I Class II Class III * MST = Mean Survival Time; neurol = neurological. 50 J Neurosurg / Volume 113 / December 2010
4 GKS alone for 1 10 brain metastases in JLGK0901-eligible cases TABLE 3: Results of univariate analysis Covariate Comparison p Value HR 95% CI GK center Chiba vs Mito age (yrs) 65 vs < sex M vs F < primary organ GI vs lung < extracranial disease active vs controlled < pretreatment KPS score <70 vs 70 < no. of brain lesions 1 vs 2 4 < vs initial neurol Sx yes vs no < total tumor vol (cm 3 ) >4 vs 4 < RTOG-RPA classification Class II vs I < Class III vs II < upper limit of the CI for the HR does not exceed 1.3, which is in accordance with the noninferiority margin. This trial has been registered by the Japanese ethics committee (UMIN). Expected Results of the JLGK 0901 Study Results of our final multivariate analysis model showed the HR for OS in Group C versus Group B in our sample of 1508 previously treated patients to be less than 1.3, allowing us to conclude that the 5 10 brain metastases group will not have results inferior to those of the 2 4 lesions group with a noninferiority margin of 7.5%. 2 Secondary end points of the JLGK 0901 study include neurological death, functional independence, emergence of new lesions, and higher function. These results will bring more useful information about GKS as sole treatment for up to 10 brain metastases. Fig. 2. Overall survival curves according RTOG-RPA classification. Mean survival time was 0.78 years (2.22 years in Class I, 0.72 years in Class II, and 0.25 years in Class III). There were significant differences between all pairs of groups (p < ). TABLE 4: Final results of multivariate analysis Covariate Comparison p Value HR 95% CI no. of tumors 1 vs 2 4 < vs sex M vs F < primary site breast vs lung other vs lung RTOG-RPA Class II vs I < classification Class III vs II < J Neurosurg / Volume 113 / December 2010 Conclusions The OS for patients with 5 10 brain metastases was almost the same as that of patients with 2 4 brain lesions in our retrospective study. We anticipate that these results will be confirmed by the JLGK 0901 study, which is a well-designed prospective multi-institutional controlled trial. If this study proves noninferiority between 2 4 and 5 10 brain metastases, Level 2 evidence of the efficacy of GKS alone for 5 10 brain metastases will be established. Disclosure The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper. Author contributions to the study and manuscript preparation include the following. Conception and design: Serizawa, Yamamoto, Sato, Higuchi. Acquisition of data: Serizawa, Yamamoto, Higuchi, Nagano, Kawabe, Matsuda, Ono, Saeki, Hatano, Hirai. Analysis and interpretation of data: Sato, Higuchi. Drafting the article: Serizawa. Critically revising the article: Serizawa. Reviewed final version of the manuscript and approved it for submission: all authors. Statistical analysis: Serizawa, Sato. Study supervision: Serizawa. 51
5 T. Serizawa et al. References 1. Aoyama H, Shirato H, Tago M, Nakagawa K, Toyoda T, Hatano K, et al: Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA 295: , Schoenfeld DA, Richter JR: Nomograms for calculating the number of patients needed for a clinical trial with survival as an endpoint. Biometrics 38: , Serizawa T: Metastatic brain tumors: lung cancer, in Yamamoto M (ed): Japanese Experience with Gamma Knife Radiosurgery. Basel: Karger, 2008, pp Serizawa T, Higuchi Y, Ono J, Matsuda S, Iuchi T, Nagano O, et al: Gamma Knife surgery for metastatic brain tumors from lung cancer without prophylactic whole brain radiation therapy, in Kondziolka D (ed): Radiosurgery, Vol 6. Basel: Karger, 2006, pp Serizawa T, Higuchi Y, Ono J, Matsuda S, Nagano O, Iwadate Y, et al: Gamma Knife surgery for metastatic brain tumors without prophylactic whole-brain radiotherapy: results in 1000 consecutive cases. J Neurosurg 105 (Suppl):86 90, Serizawa T, Hirai T, Nagano O, Higuchi Y, Matsuda S, Ono J, et al: Gamma knife surgery for 1 10 brain metastases without prophylactic whole-brain radiation therapy: analysis of cases meeting the Japanese prospective multi-institute study (JLGK0901) inclusion criteria. J Neurooncol 98: , Serizawa T, Iuchi T, Ono J, Saeki N, Osato K, Odaki M, et al: Gamma knife treatment for multiple metastatic brain tumors compared with whole-brain radiation therapy. J Neurosurg 93 (3 Suppl):32 36, Serizawa T, Ono J, Iichi T, Matsuda S, Sato M, Odaki M, et al: Gamma knife radiosurgery for metastatic brain tumors from lung cancer: a comparison between small cell and non small cell carcinoma. J Neurosurg 97 (5 Suppl): , Serizawa T, Saeki N, Higuchi Y, Ono J, Iuchi T, Nagano O, et al: Gamma knife surgery for brain metastases: indications for and limitations of a local treatment protocol. Acta Neurochir (Wien) 147: , Serizawa T, Yamamoto M, Nagano O, Higuchi Y, Matsuda S, Ono J, et al: Gamma Knife surgery for metastatic brain tumors. A 2-institute study in Japan. J Neurosurg 109 (Suppl): , Yamamoto M, Ide M, Nishio S, Urakawa Y: Gamma Knife radiosurgery for numerous brain metastases: is this a safe treatment? Int J Radiat Oncol Biol Phys 53: , 2002 Manuscript submitted May 29, Accepted August 24, Address correspondence to: Toru Serizawa, M.D., Ph.D., Tokyo Gamma Unit Center, Tsukiji Neurological Clinic, Tsukiji, Chuo-ku, Tokyo , Japan. gamma-knife.serizawa@ nifty.com. 52 J Neurosurg / Volume 113 / December 2010
Survival and Intracranial Control of Patients With 5 or More Brain Metastases Treated With Gamma Knife Stereotactic Radiosurgery
ORIGINAL ARTICLE Survival and Intracranial Control of Patients With 5 or More Brain Metastases Treated With Gamma Knife Stereotactic Radiosurgery Ann C. Raldow, BS,* Veronica L. Chiang, MD,w Jonathan P.
More informationSince Sturm et al. reported successful treatment of
J Neurosurg (Suppl 2) 121:16 25, 2014 AANS, 2014 Stereotactic radiosurgery for patients with multiple brain metastases: a case-matched study comparing treatment results for patients with 2 9 versus 10
More informationClinical significance of conformity index and gradient index in patients undergoing stereotactic radiosurgery for a single metastatic tumor
CLINICAL ARTICLE J Neurosurg (Suppl) 129:103 110, 2018 Clinical significance of conformity index and gradient index in patients undergoing stereotactic radiosurgery for a single metastatic tumor Hitoshi
More informationCerebral metastases occur in 20% 40% of cancer
See the corresponding editorial, DOI: 10.3171/2012.1.JNS12103. DOI: 10.3171/2012.4.JNS11870 Stereotactic radiosurgery using the Leksell Gamma Knife Perfexion unit in the management of patients with 10
More informationA Population-Based Study on the Uptake and Utilization of Stereotactic Radiosurgery (SRS) for Brain Metastasis in Nova Scotia
A Population-Based Study on the Uptake and Utilization of Stereotactic Radiosurgery (SRS) for Brain Metastasis in Nova Scotia Gaurav Bahl, Karl Tennessen, Ashraf Mahmoud-Ahmed, Dorianne Rheaume, Ian Fleetwood,
More informationBrain metastases are common brain malignant neoplasms
J Neurosurg (Suppl) 117:49 56, 2012 Hypofractionated stereotactic radiotherapy with or without whole-brain radiotherapy for patients with newly diagnosed brain metastases from non small cell lung cancer
More informationStereotactic Radiosurgery for Brain Metastasis: Changing Treatment Paradigms. Overall Clinical Significance 8/3/13
Stereotactic Radiosurgery for Brain Metastasis: Changing Treatment Paradigms Jason Sheehan, MD, PhD Departments of Neurosurgery and Radiation Oncology University of Virginia, Charlottesville, VA USA Overall
More informationJAMA. 2006;295:
ORIGINAL CONTRIBUTION Stereotactic Radiosurgery Plus Whole-Brain Radiation Therapy vs Stereotactic Radiosurgery Alone for Treatment of Brain Metastases A Randomized Controlled Trial Hidefumi Aoyama, MD,
More informationOptimal Management of Isolated HER2+ve Brain Metastases
Optimal Management of Isolated HER2+ve Brain Metastases Eliot Sims November 2013 Background Her2+ve patients 15% of all breast cancer Even with adjuvant trastuzumab 10-15% relapse Trastuzumab does not
More informationBr a i n metastases occur in 20 40% of all patients. The results of resection after stereotactic radiosurgery for brain metastases.
J Neurosurg 111:825 831, 2009 The results of resection after stereotactic radiosurgery for brain metastases Clinical article Hi d e y u k i Ka n o, M.D., Ph.D., 1,3 Do u g l a s Ko n d z i o l k a, M.D.,
More informationMehmet Ufuk ABACIOĞLU Neolife Medical Center, İstanbul, Turkey
Updated Oncology 2015: State of the Art News & Challenging Topics CURRENT STATUS OF STEREOTACTIC RADIOSURGERY IN BRAIN METASTASES Mehmet Ufuk ABACIOĞLU Neolife Medical Center, İstanbul, Turkey Bucharest,
More informationAdditional radiation boost to whole brain radiation therapy may improve the survival of patients with brain metastases in small cell lung cancer
Sun et al. Radiation Oncology (2018) 13:250 https://doi.org/10.1186/s13014-018-1198-4 RESEARCH Open Access Additional radiation boost to whole brain radiation therapy may improve the survival of patients
More informationSergio Bracarda MD. Head, Medical Oncology Department of Oncology AUSL-8 Istituto Toscano Tumori (ITT) San Donato Hospital Arezzo, Italy
Sergio Bracarda MD Head, Medical Oncology Department of Oncology AUSL-8 Istituto Toscano Tumori (ITT) San Donato Hospital Arezzo, Italy Ninth European International Kidney Cancer Symposium Dublin 25-26
More informationEvidence Based Medicine for Gamma Knife Radiosurgery. Metastatic Disease GAMMA KNIFE SURGERY
GAMMA KNIFE SURGERY Metastatic Disease Evidence Based Medicine for Gamma Knife Radiosurgery Photos courtesy of Jean Régis, Timone University Hospital, Marseille, France Brain Metastases The first report
More informationThe Role of Radiation Therapy in the Treatment of Brain Metastases. Matthew Cavey, M.D.
The Role of Radiation Therapy in the Treatment of Brain Metastases Matthew Cavey, M.D. Objectives Provide information about the prospective trials that are driving the treatment of patients with brain
More informationKEY WORDS gamma knife surgery metastatic brain tumor radiation injury tumor recurrence thallium-201 single-photon emission computerized tomography
J Neurosurg (Suppl) 102:266 271, 2005 Diagnostic value of thallium-201 chloride single-photon emission computerized tomography in differentiating tumor recurrence from radiation injury after gamma knife
More informationLiang-Hua Ma, Guang Li *, Hong-Wei Zhang, Zhi-Yu Wang, Jun Dang, Shuo Zhang and Lei Yao
Ma et al. Radiation Oncology (2016) 11:92 DOI 10.1186/s13014-016-0667-x RESEARCH Open Access The effect of non-small cell lung cancer histology on survival as measured by the graded prognostic assessment
More informationORIGINAL ARTICLE. Annals of Oncology 28: , 2017 doi: /annonc/mdx332 Published online 27 June 2017
Annals of Oncology 28: 2588 2594, 217 doi:1.193/annonc/mdx332 Published online 27 June 217 ORIGINAL ARTICLE Whole brain radiotherapy after stereotactic radiosurgery or surgical resection among patients
More informationSTEREOTACTIC RADIOSURGERY FOR LIMITED BRAIN METASTASES IN IRANIAN BREAST CANCER PATIENTS
STEREOTACTIC RADIOSURGERY FOR LIMITED BRAIN METASTASES IN IRANIAN BREAST CANCER PATIENTS Yousefi Kashi A. SH, Mofid B. 1 Department of Radiation Oncology,Shohada Tajrish Hospital,Shahid Beheshti University
More informationPrognostic Factors for Survival in Patients Treated With Stereotactic Radiosurgery for Recurrent Brain Metastases After Prior Whole Brain Radiotherapy
International Journal of Radiation Oncology biology physics www.redjournal.org Clinical Investigation: Metastases Prognostic Factors for Survival in Patients Treated With Stereotactic Radiosurgery for
More informationLaboratory data from the 1970s first showed that malignant melanoma
2265 Survival by Radiation Therapy Oncology Group Recursive Partitioning Analysis Class and Treatment Modality in Patients with Brain Metastases from Malignant Melanoma A Retrospective Study Jeffrey C.
More informationLocal control of brain metastases by stereotactic radiosurgery in relation to dose to the tumor margin
J Neurosurg 104:907 912, 2006 Local control of brain metastases by stereotactic radiosurgery in relation to dose to the tumor margin MICHAEL A. VOGELBAUM, M.D., PH.D., LILYANA ANGELOV, M.D., SHIH-YUAN
More informationARROCase Brain Metastases
ARROCase Brain Metastases Colin Hill*, Daniel M. Trifiletti*, Timothy N. Showalter*, Jason P. Sheehan Radiation Oncology* and Neurosurgery University of Virginia Charlottesville, VA Case: HPI 64 year old
More informationSUCCESSFUL TREATMENT OF METASTATIC BRAIN TUMOR BY CYBERKNIFE: A CASE REPORT
SUCCESSFUL TREATMENT OF METASTATIC BRAIN TUMOR BY CYBERKNIFE: A CASE REPORT Cheng-Ta Hsieh, 1 Cheng-Fu Chang, 1 Ming-Ying Liu, 1 Li-Ping Chang, 2 Dueng-Yuan Hueng, 3 Steven D. Chang, 4 and Da-Tong Ju 1
More informationPotential role for LINAC-based stereotactic radiosurgery for the treatment of 5 or more radioresistant melanoma brain metastases
clinical article J Neurosurg 123:1261 1267, 2015 Potential role for LINAC-based stereotactic radiosurgery for the treatment of 5 or more radioresistant melanoma brain metastases *Jessica M. Frakes, MD,
More informationSelecting the Optimal Treatment for Brain Metastases
Selecting the Optimal Treatment for Brain Metastases Clinical Practice Today CME Co-provided by Learning Objectives Upon completion, participants should be able to: Understand the benefits, limitations,
More informationPrognostic indices in stereotactic radiotherapy of brain metastases of non-small cell lung cancer
Kaul et al. Radiation Oncology (2015) 10:244 DOI 10.1186/s13014-015-0550-1 RESEARCH Open Access Prognostic indices in stereotactic radiotherapy of brain metastases of non-small cell lung cancer David Kaul
More informationSee the corresponding editorial in this issue, pp J Neurosurg 114: , 2011
See the corresponding editorial in this issue, pp 790 791. J Neurosurg 114:792 800, 2011 Stereotactic radiosurgery as primary and salvage treatment for brain metastases from breast cancer Clinical article
More informationRESEARCH HUMAN CLINICAL STUDIES
TOPIC RESEARCH HUMAN CLINICAL STUDIES RESEARCH HUMAN CLINICAL STUDIES Radiosurgery to the Surgical Cavity as Adjuvant Therapy for Resected Brain Metastasis Jared R. Robbins, MD* Samuel Ryu, MD* Steven
More informationNeurological Change after Gamma Knife Radiosurgery for Brain Metastases Involving the Motor Cortex
ORIGINAL ARTICLE Brain Tumor Res Treat 2016;4(2):111-115 / pissn 2288-2405 / eissn 2288-2413 http://dx.doi.org/10.14791/btrt.2016.4.2.111 Neurological Change after Gamma Knife Radiosurgery for Brain Metastases
More informationTr a d i t i o n a l ly, WBRT has been the standard approach
Neurosurg Focus 27 (6):E7, 2009 Stereotactic radiosurgery boost to the resection bed for oligometastatic brain disease: challenging the tradition of adjuvant whole-brain radiotherapy Br i a n J. Ka r l
More informationBrain metastases: changing visions
Brain metastases: changing visions Roberto Spiegelmann, MD Baiona, 2014 Head, Stereotactic Radiosurgery Unit Dept of Neurosurgery, Chaim Sheba Medical Center Tel Hashomer, Israel The best current estimate
More informationIntroduction. Akifumi Miyakawa 1 Yuta Shibamoto 1 Shinya Takemoto 2 Toru Serizawa 3 Shinya Otsuka 4 Tatsuo Hirai 5
DOI 10.1007/s10147-016-1058-x ORIGINAL ARTICLE Fractionated stereotactic radiotherapy for metastatic brain tumors that recurred after gamma knife radiosurgery results in acceptable toxicity and favorable
More informationMinesh Mehta, Northwestern University. Chicago, IL
* Minesh Mehta, Northwestern University Chicago, IL Consultant: Adnexus, Bayer, Merck, Tomotherapy Stock Options: Colby, Pharmacyclics, Procertus, Stemina, Tomotherapy Board of Directors: Pharmacyclics
More informationCollection of Recorded Radiotherapy Seminars
IAEA Human Health Campus Collection of Recorded Radiotherapy Seminars http://humanhealth.iaea.org The Role of Radiosurgery in the Treatment of Gliomas Luis Souhami, MD Professor Department of Radiation
More informationTreatment of Recurrent Brain Metastases
Treatment of Recurrent Brain Metastases Penny K. Sneed, M.D. Dept. of Radiation Oncology University of California San Francisco Background Brain metastases occur in 8.5-15% of cancer pts in population-
More informationPrescription dose and fractionation predict improved survival after stereotactic radiotherapy for brainstem metastases
Leeman et al. Radiation Oncology 2012, 7:107 RESEARCH Open Access Prescription dose and fractionation predict improved survival after stereotactic radiotherapy for brainstem metastases Jonathan E Leeman
More informationLocoregional treatment Session Oral Abstract Presentation Saulo Brito Silva
Locoregional treatment Session Oral Abstract Presentation Saulo Brito Silva Background Post-operative radiotherapy (PORT) improves disease free and overall suvivallin selected patients with breast cancer
More informationA prospective pilot study of two-session Gamma Knife surgery for large metastatic brain tumors
J Neurooncol (2012) 109:159 165 DOI 10.1007/s11060-012-0882-8 CLINICAL STUDY A prospective pilot study of two-session Gamma Knife surgery for large metastatic brain tumors Shoji Yomo Motohiro Hayashi Claire
More informationStereotactic radiosurgery for the treatment of melanoma and renal cell carcinoma brain metastases
ONCOLOGY REPORTS 29: 407-412, 2013 Stereotactic radiosurgery for the treatment of melanoma and renal cell carcinoma brain metastases SHELLY LWU 1, PABLO GOETZ 1, ERIC MONSALVES 1, MANDANA ARYAEE 1, JULIUS
More informationJefferson Digital Commons. Thomas Jefferson University. Maria Werner-Wasik Thomas Jefferson University,
Thomas Jefferson University Jefferson Digital Commons Department of Radiation Oncology Faculty Papers Department of Radiation Oncology May 2008 Increasing tumor volume is predictive of poor overall and
More informationShoji Yomo 1,2* and Motohiro Hayashi 2
Yomo and Hayashi BMC Cancer (2015) 15:95 DOI 10.1186/s12885-015-1103-6 RESEARCH ARTICLE Open Access Is stereotactic radiosurgery a rational treatment option for brain metastases from small cell lung cancer?
More informationOutcomes in patients with brain metastasis from esophageal carcinoma
Original Article Outcomes in patients with brain metastasis from esophageal carcinoma Nishi Kothari 1, Eric Mellon 2, Sarah E. Hoffe 2, Jessica Frakes 2, Ravi Shridhar 3, Jose Pimiento 1, Ken Meredith
More informationGamma Knife Treatment of Brainstem Metastases
Int. J. Mol. Sci. 2014, 15, 9748-9761; doi:10.3390/ijms15069748 Article OPEN ACCESS International Journal of Molecular Sciences ISSN 1422-0067 www.mdpi.com/journal/ijms Gamma Knife Treatment of Brainstem
More informationLung cancer is the most common malignancy in the. Gamma Knife radiosurgery for the management of cerebral metastases from non small cell lung cancer
clinical article J Neurosurg 122:766 772, 2015 Gamma Knife radiosurgery for the management of cerebral metastases from non small cell lung cancer Greg Bowden, MD, MSc, 1,3,5 Hideyuki Kano, MD, PhD, 1,3
More informationBr a i n metastases are the tumors most frequently. Safety and efficacy of Gamma Knife surgery for brain metastases in eloquent locations
J Neurosurg 113:79 83, 2010 Safety and efficacy of Gamma Knife surgery for brain metastases in eloquent locations Clinical article Ni c o l a s De a, M.D., Mar t i n Bo r d u a s, Br e n d a n Ke n n y,
More informationClinical Indications for Gamma Knife Radiosurgery
Clinical Indications for Gamma Knife Radiosurgery A Review of the Published Clinical Evidence through 2014 Prof Bodo Lippitz Consultant Neurosurgeon Co-Director Cromwell Gamma Knife Centre Bupa Cromwell
More informationAlleinige Radiochirurgie und alleinige Systemtherapie zwei «extreme» Entwicklungen in der Behandlung von Hirnmetastasen?
Department of Radiation Oncology Chairman: Prof. Dr. Matthias Guckenberger Alleinige Radiochirurgie und alleinige Systemtherapie zwei «extreme» Entwicklungen in der Behandlung von Hirnmetastasen? Matthias
More informationComparative Analysis of Efficacy and Safety of Multisession Radiosurgery to Single Dose Radiosurgery for Metastatic Brain Tumors
ORIGINAL ARTICLE Brain Tumor Res Treat 2015;3(2):95-102 / pissn 2288-2405 / eissn 2288-2413 http://dx.doi.org/10.14791/btrt.2015.3.2.95 Comparative Analysis of Efficacy and Safety of Multisession Radiosurgery
More informationProtocolos de consenso: MTS Cerebrales Resumen ASTRO. Javier Aristu y Germán Valtueña Servicio Oncología Rad. Depart.
Protocolos de consenso: MTS Cerebrales Resumen ASTRO Javier Aristu y Germán Valtueña Servicio Oncología Rad. Depart. ASTRO 2013 Brain met SRS Abstracts 97. Comparative Effectiveness of SRS versus WBRT
More informationVINCENT KHOO. 8 th EIKCS Symposium: May 2013
8 th EIKCS Symposium: May 2013 VINCENT KHOO Royal Marsden NHS Foundation Trust & Institute of Cancer Research St George s Hospital & University of London Austin Health & University of Melbourne Disclosures
More informationResearch Article Have Changes in Systemic Treatment Improved Survival in Patients with Breast Cancer Metastatic to the Brain?
Oncology Volume 2008, Article ID 417137, 5 pages doi:10.1155/2008/417137 Research Article Have Changes in Systemic Treatment Improved Survival in Patients with Breast Cancer Metastatic to the Brain? Carsten
More informationJefferson Digital Commons. Thomas Jefferson University. Mark E Linskey Department of Neurosurgery, University of California-Irvine Medical Center
Thomas Jefferson University Jefferson Digital Commons Department of Neurosurgery Faculty Papers Department of Neurosurgery 1-1-2010 The role of stereotactic radiosurgery in the management of patients with
More informationAn update on radiation therapy for brain metastases
Review Article Page 1 of 8 An update on radiation therapy for brain metastases Tai-Chung Lam 1, Arjun Sahgal 2, Simon S. Lo 3, Eric L. Chang 4 1 Department of Clinical Oncology, Li Ka Shing Faculty of
More informationDepartment of Oncology and Palliative Medicine, Nordland Hospital, 8092 Bodø, Norway 2
The Scientific World Journal Volume 212, Article ID 69323, 5 pages doi:1.11/212/69323 The cientificworldjournal Clinical Study Towards Improved Prognostic Scores Predicting Survival in Patients with Brain
More informationCollection of Recorded Radiotherapy Seminars
IAEA Human Health Campus Collection of Recorded Radiotherapy Seminars http://humanhealth.iaea.org The Management of Brain Metastases Dr. Luis Souhami Professor Department of Radiation Oncology University,
More informationStereotactic radiosurgery (SRS) has become highly
clinical article J Neurosurg 124:1018 1024, 2016 Changing practice patterns of Gamma Knife versus linear accelerator based stereotactic radiosurgery for brain metastases in the US Henry S. Park, MD, MPH,
More informationClinical Study Does Time between Imaging Diagnosis and Initiation of Radiotherapy Impact Survival after Whole-Brain Radiotherapy for Brain Metastases?
ISRN Oncology Volume 2013, Article ID 214304, 4 pages http://dx.doi.org/10.1155/2013/214304 Clinical Study Does Time between Imaging Diagnosis and Initiation of Radiotherapy Impact Survival after Whole-Brain
More informationCME. Special Article. Received 27 October 2011; revised 9 December 2011; accepted 15 December Practical Radiation Oncology (2012) 2,
Practical Radiation Oncology (2012) 2, 210 225 CME www.practicalradonc.org Special Article Radiotherapeutic and surgical management for newly diagnosed brain metastasis(es): An American Society for Radiation
More informationManagement of single brain metastasis: a practice guideline
PRACTICE GUIDELINE SERIES Management of single brain metastasis: a practice guideline A. Mintz MD,* J. Perry MD, K. Spithoff BHSc, A. Chambers MA, and N. Laperriere MD on behalf of the Neuro-oncology Disease
More informationRyoko Suzuki 1, Xiong Wei 1, Pamela K. Allen 1, James W. Welsh 1, James D. Cox 1, Ritsuko Komaki 1 and Steven H. Lin 1,2*
Suzuki et al. Radiation Oncology (2018) 13:258 https://doi.org/10.1186/s13014-018-1205-9 RESEARCH Open Access Outcomes of re-irradiation for brain recurrence after prophylactic or therapeutic whole-brain
More informationCost-effectiveness of stereotactic radiosurgery versus whole brain radiation therapy for up to 10 brain metastases
Cost-effectiveness of stereotactic radiosurgery versus whole brain radiation therapy for up to 10 brain metastases Nataniel H. Lester-Coll, MD, Arie P. Dosoretz, MD, MBA, Maxwell S. Laurans, MD, Veronica
More informationOutline. WBRT field. Brain Metastases. Whole Brain RT Prophylactic WBRT Stereotactic radiosurgery (SRS) 1 fraction Stereotactic frame
Radiation Therapy for Advanced NSC Lung Ca Alexander Gottschalk, M.D., Ph.D. Associate Professor Director of CyberKnife Radiosurgery Department of Radiation Oncology University of California San Francisco
More informationBrain metastases arise in 10% 40% of patients
J Neurosurg (Suppl) 117:38 44, 2012 Validation of Recursive Partitioning Analysis and Diagnosis-Specific Graded Prognostic Assessment in patients treated initially with radiosurgery alone Clinical article
More informationEvidence Based Medicine for Gamma Knife Radiosurgery. Metastatic Disease GAMMA KNIFE SURGERY
GAMMA KNIFE SURGERY Metastatic Disease Evidence Based Medicine for Gamma Knife Radiosurgery Photos courtesy of Jean Régis, Timone University Hospital, Marseille, France Brain Metastases The first report
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES CENTRAL NERVOUS SYSTEM BRAIN METASTASES CNS Site Group Brain Metastases Author: Dr. Norm Laperriere Date: February 20, 2018 1. INTRODUCTION
More informationUpdate on management of metastatic brain disease. Peter Hoskin Mount Vernon Cancer Centre Northwood UK
Update on management of metastatic brain disease Peter Hoskin Mount Vernon Cancer Centre Northwood UK Incidence 15-30% of patients with solid tumours will develop brain metastases Most common primary sites
More informationINTRODUCTION. Tae Yong Park, Young Chul Na, Won Hee Lee, Ji Hee Kim, Won Seok Chang, Hyun Ho Jung, Jong Hee Chang, Jin Woo Chang, Young Gou Park
ORIGINAL ARTICLE Brain Tumor Res Treat 2013;1:78-84 / Print ISSN 2288-2405 / Online ISSN 2288-2413 online ML Comm Treatment Options of Metastatic Brain Tumors from Hepatocellular Carcinoma: Surgical Resection
More informationHong Kong Hospital Authority Convention 2018
Hong Kong Hospital Authority Convention 2018 Stereotactic Radiosurgery in Brain Metastases - Development of the New Treatment Paradigm in HA, Patients Profiles and Their Clinical Outcomes 8 May 2018 Dr
More informationTargeted/Immunotherapy & Molecular Profiling State-of-the-art in Cancer Care
Targeted/Immunotherapy & Molecular Profiling State-of-the-art in Cancer Care Manmeet Ahluwalia, MD, FACP Miller Family Endowed Chair in Neuro-Oncology Director Brain Metastasis Research Program Cleveland
More informationDistant brain recurrence in patients with five or more newly diagnosed brain metastases treated with focal stereotactic radiotherapy alone
Jour. of Radiosurgery and SBRT, Vol. 4, pp. 255-263 Reprints available directly from the publisher Photocopying permitted by license only 2017 Old City Publishing, Inc. Published by license under the OCP
More informationShoji Yomo 1,2* and Motohiro Hayashi 2
Yomo and Hayashi BMC Cancer (2016) 16:948 DOI 10.1186/s12885-016-2983-9 RESEARCH ARTICLE Is upfront stereotactic radiosurgery a rational treatment option for very elderly patients with brain metastases?
More informationSurvival following gamma knife radiosurgery for brain metastasis from breast cancer
Washington University School of Medicine Digital Commons@Becker Open Access Publications 2013 Survival following gamma knife radiosurgery for brain metastasis from breast cancer Jerry J. Jaboin Washington
More informationDiscovery of additional brain metastases on the day of stereotactic radiosurgery: risk factors and outcomes
CLINICAL ARTICLE J Neurosurg 126:1756 1763, 2017 Discovery of additional brain metastases on the day of stereotactic radiosurgery: risk factors and outcomes Michael A. Garcia, MD, MS, 1 Ann Lazar, PhD,
More informationRadiotherapy for Brain Metastases
Radiotherapy for Brain Metastases Robert B. Den, MD a, David W. Andrews, MD b, * KEYWORDS Brain metastases Treatment approaches SRS WBRT The optimal treatment of brain metastases remains controversial.
More informationOriginal Article Value of Adding Boost to Whole Brain Radiotherapy after Surgical Resection of Limited Brain Metastases
Egyptian Journal of Neurosurgery Volume 29 / No. 4 / October - December 2014 39-44 Original Article Value of Adding Boost to Whole Brain Radiotherapy after Surgical Resection of Limited Brain Metastases
More informationCNS Metastases in Breast Cancer
Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer CNS Metastases in Breast Cancer CNS Metastases in Breast Cancer Version 2006: Maass / Junkermann Version 2007 2009: Bischoff
More informationYuzuru Niibe 1,8*, Tetsuo Nishimura 2, Tetsuya Inoue 3, Katsuyuki Karasawa 4, Yoshiyuki Shioyama 5,6, Keiichi Jingu 7 and Hiroki Shirato 3
Niibe et al. BMC Cancer (2016) 16:659 DOI 10.1186/s12885-016-2680-8 RESEARCH ARTICLE Open Access Oligo-recurrence predicts favorable prognosis of brain-only oligometastases in patients with non-small cell
More informationMelanoma, a deadly and aggressive cancer, is the
See the corresponding editorial in this issue, pp 225 226. J Neurosurg 117:227 233, 2012 Radiosurgery for melanoma brain metastases in the ipilimumab era and the possibility of longer survival Clinical
More informationThe role of WBRT in the management of a resected. Cavity-directed radiosurgery as adjuvant therapy after resection of a brain metastasis
J Neurosurg 114:1585 1591, 2011 Cavity-directed radiosurgery as adjuvant therapy after resection of a brain metastasis Clinical article Courtney A. Jensen, M.D., 1 Michael D. Chan, M.D., 1 Thomas P. McCoy,
More informationFactors influencing survival in patients with breast cancer and single or solitary brain metastasis
Factors influencing survival in patients with breast cancer and single or solitary brain metastasis A. Niwińska, K. Pogoda, M. Murawska, P. Niwiński To cite this version: A. Niwińska, K. Pogoda, M. Murawska,
More informationIs it cost-effective to treat brain metastasis with advanced technology?
Is it cost-effective to treat brain metastasis with advanced technology? Cost-effectiveness analysis of whole brain RT, stereotactic radiosurgery and craniotomy in HA setting Lam, Tai-Chung, Choi CW Horace,
More informationTreatment results of proton beam therapy with chemo-radiotherapy for stage I-III esophageal cancer
Treatment results of proton beam therapy with chemo-radiotherapy for stage I-III esophageal cancer Nobukazu Fuwa 1, Akinori Takada 2 and Takahiro Kato 3 1;Departments of Radiology, Hyogo Ion Beam Medical
More informationES-SCLC Joint Case Conference. Anthony Paravati Adam Yock
ES-SCLC Joint Case Conference Anthony Paravati Adam Yock Case 57 yo woman with 35 pack year smoking history presented with persistent cough and rash Chest x-ray showed a large left upper lobe/left hilar
More informationNews Briefing New Developments in Pediatric & Adult CNS Malignancies
News Briefing New Developments in Pediatric & Adult CNS Malignancies Tuesday, Sept. 24, 2013 2:45 p.m. Daphne Haas-Kogan, MD University of California, San Francisco Cost-effectiveness of Proton Therapy
More informationNonsmall Cell Lung Cancer Presenting with Synchronous Solitary Brain Metastasis
1998 Nonsmall Cell Lung Cancer Presenting with Synchronous Solitary Brain Metastasis Chaosu Hu, M.D. 1 Eric L. Chang, M.D. 2 Samuel J. Hassenbusch III, M.D., Ph.D. 3 Pamela K. Allen, Ph.D. 2 Shiao Y. Woo,
More informationLong term survival study of de-novo metastatic breast cancers with or without primary tumor resection
Long term survival study of de-novo metastatic breast cancers with or without primary tumor resection Dr. Michael Co Division of Breast Surgery Queen Mary Hospital The University of Hong Kong Conflicts
More information3/8/2014. Case Presentation. Primary Treatment of Anal Cancer. Anatomy. Overview. March 6, 2014
Case Presentation Primary Treatment of Anal Cancer 65 year old female presents with perianal pain, lower GI bleeding, and anemia with Hb of 7. On exam 6 cm mass protruding through the anus with bulky R
More informationRadiation Therapy for Liver Malignancies
Outline Radiation Therapy for Liver Malignancies Albert J. Chang, M.D., Ph.D. Department of Radiation Oncology, UCSF March 23, 2014 Rationale for developing liver directed therapies Liver directed therapies
More informationLong-term survival without surgery in NSCLC patients with synchronous brain oligometastasis: systemic chemotherapy revisited
Original Article Long-term survival without surgery in NSCLC patients with synchronous brain oligometastasis: systemic chemotherapy revisited Jun Sato 1,2, Hidehito Horinouchi 1, Yasushi Goto 1, Shintaro
More informationStereotactic radiosurgery for intracranial hemangioblastomas: a retrospective international outcome study
clinical article J Neurosurg 122:1469 1478, 2015 Stereotactic radiosurgery for intracranial hemangioblastomas: a retrospective international outcome study Hideyuki Kano, MD, PhD, 1 Takashi Shuto, MD, 2
More informationOutcome of Surgical Resection of Symptomatic Cerebral Lesions in Non-Small Cell Lung Cancer Patients with Multiple Brain Metastases
ORIGIL ARTICLE Brain Tumor Res Treat 2013;1:64-70 / Print ISSN 2288-2405 / Online ISSN 2288-2413 online ML Comm Outcome of Surgical Resection of Symptomatic Cerebral Lesions in Non-Small Cell Lung Cancer
More informationOtolaryngologist s Perspective of Stereotactic Radiosurgery
Otolaryngologist s Perspective of Stereotactic Radiosurgery Douglas E. Mattox, M.D. 25 th Alexandria International Combined ORL Conference April 18-20, 2007 Acoustic Neuroma Benign tumor of the schwann
More informationOutcomes after Reirradiation for Brain Metastases
Original Article PROGRESS in MEDICAL PHYSICS Vol. 26, No. 3, September, 2015 http://dx.doi.org/10.14316/pmp.2015.26.3.137 Outcomes after Reirradiation for Brain Metastases Jesang Yu, Ji Hoon Choi, Sun
More informationAUTHOR S PERSONAL COPY
Clinical Outcomes of Stereotactic Radiosurgery in the Treatment of Patients with Metastatic Brain Tumors Ameer L. Elaimy 1,2, Alexander R. Mackay 1,3, Wayne T. Lamoreaux 1,2, Robert K. Fairbanks 1,2, John
More informationPlace of surgery in diagnos1c and therapeu1c strategies: New challenges
Place of surgery in diagnos1c and therapeu1c strategies: New challenges Philippe Métellus M.D., Ph.D. Department of Neurosurgery, CHU Timone, Marseille, France Place of surgery in diagnos1c and therapeu1c
More informationINTRODUCTION.
www.jkns.or.kr http://dx.doi.org/10.3340/jkns.2016.59.4.392 J Korean Neurosurg Soc 59 (4) : 392-399, 2016 Print ISSN 2005-3711 On-line ISSN 1598-7876 Copyright 2016 The Korean Neurosurgical Society Clinical
More informationRadiotherapy and Brain Metastases. Dr. K Van Beek Radiation-Oncologist BSMO annual Meeting Diegem
Radiotherapy and Brain Metastases Dr. K Van Beek Radiation-Oncologist BSMO annual Meeting Diegem 24-02-2017 Possible strategies Watchful waiting Surgery Postop RT to resection cavity or WBRT postop SRS
More informationTania Kaprealian, M.D. Assistant Professor UCLA Department of Radiation Oncology August 22, 2015
Tania Kaprealian, M.D. Assistant Professor UCLA Department of Radiation Oncology August 22, 2015 Most common brain tumor, affecting 8.5-15% of cancer patients. Treatment options: Whole brain radiation
More informationTreating Multiple. Brain Metastases (BM)
ESTRO 36 5-9 May 2017, Vienna Austria, Accuray Symposium Treating Multiple Brain Metastases (BM) with CyberKnife System Frederic Dhermain MD PhD, Radiation Oncologist Gustave Roussy University Hospital,
More information