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Stereotactic Radiotherapy (stereotactic + radiotherapy)

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Medical Sciences100%

Selected Abstracts

Brain metastases from testicular germ cell tumors: A retrospective analysis

INTERNATIONAL JOURNAL OF UROLOGY, Issue 11 2009
Norio Nonomura
Objectives: To review our series of testicular germ cell tumors with brain metastases and to establish an optimal treatment strategy for them. Methods: Twenty-seven cases of testicular germ cell tumors from three institutions were retrospectively reviewed. Results: Twenty-six were non-seminomatous tumors and only one was a seminoma. Based on the International Germ Cell Consensus Classification, two cases were classified as good prognosis, seven as intermediate prognosis and 18 as poor prognosis. Chemotherapy was carried out in all patients. Additionally, whole-brain radiotherapy was performed in 10 cases, stereotactic radiosurgery in six, whole-brain radiotherapy combined with stereotactic radiosurgery in three and complete surgical resection in five. Three patients received chemotherapy only. Cancer-specific 5- and 10-year survival rates were both 35.9%. The prognosis of those with brain metastases at the time of diagnosis tended to be better than those developing brain metastases during treatment. Those with a single brain metastasis showed significantly better survival than those with multiple brain metastases. No other significant prognostic factor was found at multivariate analysis. Conclusion: Testicular germ cell tumors with brain metastases can be managed with the combination of whole-brain radiotherapy, stereotactic radiotherapy, and/or surgical resection in combination with chemotherapy. [source]

Update of radiosurgery at the Royal Adelaide Hospital

JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 2 2006
DE Roos
Summary This is an update of the Royal Adelaide Hospital radiosurgery experience between November 1993 and December 2004 comprising 165 patients with 168 intracranial lesions. Including re-treatment, there were 175 treatment episodes (163 radiosurgery and 12 stereotactic radiotherapy) at an average of 1.3 per month. The commonest lesions were acoustic neuroma (65), arteriovenous malformation (58), solitary brain metastasis (23) and meningioma (14). The clinical features, treatment details and outcome are described. Our results continue to be well within the range reported in the published work. Radiosurgery provides an elegant, non-invasive alternative to neurosurgery and conventional external beam radiotherapy for many benign and malignant brain tumours. [source]

Cyclo-oxygenase-2 expression in photon-radiated and non-radiated uveal melanomas

ACTA OPHTHALMOLOGICA, Issue 5 2010
Daniela Suesskind
ABSTRACT. Purpose:, To determine and compare cyclo-oxygenase-2 (COX-2) expression in photon-radiated and non-radiated malignant uveal melanomas and to analyse the correlation between COX-2 expression and prognosis. Methods:, Immunohistochemical staining for COX-2 was performed on 21 uveal melanomas that were endoresected after prior stereotactic radiotherapy with photons and on 22 tumours that were treated by endoresection without prior radiotherapy. COX-2 staining was further analysed in respect to cell type, maximal prominence, time interval between radiotherapy and surgery, apoptotic index (AI), proliferative index (PI) and the development of metastatic disease. Results:, There was no difference in COX-2 expression between radiated and non-radiated melanomas (P > 0.15). COX-2 staining correlated with neither the tumour prominence (P > 0.40) nor the AI or the PI (both P > 0.35). Tumours with high COX-2 expression were significantly more likely to develop metastasis (P = 0.022). Conclusion:, Radiotherapy with photons does not induce COX-2 expression in malignant melanomas of the uvea. But high COX-2 expression may be a marker for poor prognosis. [source]

Management of uveal tumours

ACTA OPHTHALMOLOGICA, Issue 2009
B DAMATO
Purpose The purpose of this presentation is to describe the management of uveal melanomas and the other most common uveal tumours. Methods Choroidal melanomas are treated with plaque radiotherapy if possible, with proton beam radiotherapy, stereotactic radiotherapy, trans-scleral local resection, trans-retinal endoresection, phototherapy and enucleation being reserved for patients who cannot be managed with a plaque. Increasingly, tumour biopsy is performed for histological grading of malignancy and for cytogenetic studies aimed at determining the genomic tumour type so that risk of metastatic disease can be determined. Choroidal metastases usually respond to external beam radiotherapy. Biopsy may be needed to confirm the diagnosis. Choroidal haemangiomas are treated by photodynamic therapy, with good response in most patients. Results In the large majority of patients, it is possible to conserve the eye and vision. Patients need life-long follow-up in case tumour recurrence occurs. After radiotherapy of choroidal and ciliary body melanomas some patients develop exudative and neovascular complications needing treatment. Conclusion Successful management of uveal tumours is based on a firm diagnosis, accurate staging of disease, reliable prognostication and adequate aftercare. [source]

Long-term observations of a patient with choroidal melanoma following fractionated stereotactic radiotherapy: A case report

ACTA OPHTHALMOLOGICA, Issue 4 2000
Koichi Tokuuye
ABSTRACT. A 60-year-old man with choroidal melanoma was treated with fractionated stereotactic radiotherapy and followed for 6 years. During this period, the tumor has not changed in size, and the patient has experienced only a slight decrease in visual acuity. In this case, stereotactic radiotherapy appears to have been safe and effective and may also be a cost-effective alternative to particle or plaque therapy. [source]

Outcome of fractionated stereotactic radiotherapy in patients with pituitary adenomas resistant to conventional treatments: a 5·25-year follow-up study

CLINICAL ENDOCRINOLOGY, Issue 1 2010
Camilla Schalin-Jäntti
Summary Objective, To investigate the long-term outcome of fractionated stereotactic radiotherapy (FSRT) [45 Gy (range 45,54) in 25 fractions] in patients with pituitary adenomas characterized by tumour progression or hormonally active disease despite surgery and/or medical therapy. Design, This was an observational follow-up study of 5·25 years (median; range 1·7,10·4). Patients and measurements, Pituitary tumour volume, visual acuity/fields, hypersecretion, hypopituitarism, cerebrovascular disease, second brain tumours and mortality were examined at regular intervals after FSRT in 30 patients with pituitary adenomas (20 nonfunctioning macroadenomas, 10 functioning). Prior to FSRT, 83% had been operated 1,3 times, 47% had visual field deficits/impaired vision and 50% pituitary dysfunction. Progressive disease, stable disease, partial and complete tumour response were defined by MRI. Results, Tumour growth control was 100%. At the end of follow-up, 30% had stable disease, 60% partial and 10% complete tumour response. Visual function was preserved and 36% of patients with prior field deficits improved. GH decreased from 4·2 (range, 2·3,6·5) to 1·1 (range, 0·5,1·5) ,g/l (P < 0·001) in patients with acromegaly, and medical therapy could be reduced. In large prolactinomas, partial response or complete tumour response was achieved. FSRT was well tolerated. Pituitary function remained normal in 27%, 33% of patients had stable dysfunction, 17% deteriorated further and 23% developed new dysfunction. There were no cerebrovascular events, second brain tumours or FSRT-related deaths. Conclusion, According to this long-term follow-up study, FSRT is an efficient and safe adjuvant therapy for pituitary adenomas refractory to conventional treatments. [source]