Abstract:
OBJECT:To determine the feasibility of utilizing a Gamma Knife stereotactic boost for patients at high risk of local recurrence from minor salivary gland tumors invading the base of skull. METHODS:Eight patients with minor salivary gland tumors invading the base of skull were treated with primary neutron radiotherapy followed by a Gamma Knife radiosurgical boost to the base of skull. Patients had the following characteristics: (1) primary site of disease: paranasal sinuses (n = 3), nasopharynx (n = 3), hard palate (n = 1), pterygopalatine fossa (n = 1); (2) median age 59 years (range 37-80); (3) interval from completion of neutron radiotherapy to Gamma Knife boost 4 weeks (range 2-8 weeks); (4) median stereotactic dose delivered 10 Gy (prescribed to 50% isodose line, range 8-12 Gy), and (5) median number of isocenters treated 16 (range 14-21). Dosimetry from the neutron radiotherapy was used to determine both the volume boosted and the dose utilized. The median follow-up interval from the time of Gamma Knife treatment was 21.5 months (range 16-23 months). RESULTS:All patients tolerated the procedure well. Acute side effects were minimal and included 1 patient with a delayed fatigue reaction at 2 months, 1 patient with vertigo of limited duration, and a third patient with prolonged nausea requiring steroid use. All patients were placed on a tapering dose of steroids after the procedure. One patient suffered a local relapse, with a 2-year actuarial disease-free survival rate of 80%. CONCLUSIONS:Gamma Knife radiosurgical boost following primary neutron radiotherapy for patients with a high risk of local failure is feasible and well tolerated acutely. Careful attention must be given to the previously treated regions in regard to volume treated and dose delivered. Further follow-up will be necessary to determine the long-term effectiveness and complications of such a boost in these high-risk patients.
journal_name
Stereotact Funct Neurosurgjournal_title
Stereotactic and functional neurosurgeryauthors
Douglas JG,Silbergeld DL,Laramore GEdoi
10.1159/000077457keywords:
subject
Has Abstractpub_date
2004-01-01 00:00:00pages
84-9issue
2-3eissn
1011-6125issn
1423-0372pii
77457journal_volume
82pub_type
杂志文章abstract::The underlying electrophysiologic abnormality in patients with chronic pain syndrome is demonstrated in 2 patients whose pain and associated symptoms were incapacitating. Mechanical perturbation evoked discharges most easily at the mesodiencephalic junction. Discharging tissue at that level appears to be oriented in b...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099499
更新日期:1989-01-01 00:00:00
abstract::With the recent approval of reimbursement for positron emission tomography (PET), it has become important to clarify the utility of this diagnostic study. We evaluated the utility of PET to distinguish radiation necrosis from recurrent tumor in a retrospective review of patients with primary glial neoplasms. Fifteen p...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000029743
更新日期:1999-01-01 00:00:00
abstract::A computerized method of determining the focal point of electrical activity in the pallidum of parkinsonian patients was developed using on-line quantitative physiological data analysis. Thirty patients in a series of 70 were studied in depth. Neuronal activity was recorded from the pallidum using a semi-microelectrod...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000048378
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:A therapeutic radiosurgery procedure usually follows a separate diagnostic stereotactic procedure after days or weeks. OBJECTIVES:To define the clinical reliability, safety, and cost implications of same-day diagnostic stereotactic biopsy and therapeutic radiosurgery. METHODS:During an 8-year interval, 26 ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000332057
更新日期:2011-01-01 00:00:00
abstract::As a part of the systematic analysis of parameters involved in electrical epidural spinal cord stimulation therapy, distribution of paresthesiae in accordance with the position of contacts, as related to midline and vertebral level of contacts, was investigated. A preliminary analysis performed for 266 combinations ha...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100632
更新日期:1993-01-01 00:00:00
abstract::Background: Stimulation parameters are crucial for the efficacy and safety of motor cortex stimulation (MCS). Motor threshold (MT) can be defined as the lowest voltage that produces motor contraction. The final stimulation parameters are always a smaller percentage of MT in order to avoid seizures. We determined how p...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000369355
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND/AIMS:Our study aimed to evaluate the efficiency and morbidity of Gamma Knife radiosurgery (GKS) in the treatment of hemorrhagic brainstem cavernous malformations (CMs). METHODS:We included in this study all patients who underwent GKS for the treatment of a hemorrhagic brainstem CM(s) in our institution betw...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000452844
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND/AIMS:Parkinson's disease (PD) is an idiopathic progressive neurological disorder. Improvement in motor function of PD patients has been established with subthalamic nucleus (STN) deep brain stimulation (DBS). While variations in DBS settings (i.e. amplitude, frequency and pulse width) on motor function have ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1159/000163554
更新日期:2008-01-01 00:00:00
abstract::Electric stimulation applied to the posterior surface of the spinal cord (SCS) is an established treatment in certain chronic pain syndromes resistant to conventional therapeutic procedures. Despite the clinical value of SCS, the mechanisms behind the efficacy of the method are largely unknown. Several neurotransmitte...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100634
更新日期:1993-01-01 00:00:00
abstract::Stereotactic bilateral electrode implantation in the medial portion of the posterior hypothalamus was performed on a 22-year-old male with drug-resistant aggressiveness. To localize the targets during implantation, microrecording was performed, and the clinical and electroencephalographic responses to intraoperative s...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000131659
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Targeting for functional stereotactic procedures is traditionally carried out in a noninteractive fashion, without real-time positional feedback. In addition, stereotactic frames are uncomfortable for patients and may impede intraoperative neurological evaluation. As an initial step toward a fully frameless ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000081345
更新日期:2004-01-01 00:00:00
abstract::The diagnostic yield of stereotactic biopsies depends upon safely sampling the most representative regions of masses. Potentially, localization information presently available from CT and MR scans might be improved by considering regional levels of cerebral metabolism by PET. In 10 selected stereotactic biopsies of in...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098986
更新日期:1992-01-01 00:00:00
abstract::A 25-year-old woman with a large acoustic schwannoma underwent surgical excision 18 months after Gamma Knife radiosurgery because of transient expansion of the tumor causing ataxia. Histopathologial investigation by the TUNEL method revealed the presence of some apoptotic cells. The findings were compared with finding...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000056411
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:Since a simple, rapid and accurate stereotactic system allowing CT monitoring would offer the neurosurgeon several advantages, the feasibility and application accuracy of frameless laser-guided freehand point stereotaxis for neurosurgical interventions was studied. METHODS:A Cartesian coordinate grid mounted...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000029649
更新日期:1998-01-01 00:00:00
abstract::Resection of epileptogenic lesions and pathological studies were performed in all 35 patients with temporal lobe epilepsy, 20 male and 15 female. Their ages ranged from 6 to 48 years with an average of 22 years. Various examinations including CT scan were carried out without any positive finding. EEG showed spike form...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:Stereotactic biopsies are subject to sampling errors (essentially due to target selection). The presence of contrast enhancement is not a reliable marker of malignancy. The goal of the present study was to determine whether perfusion-weighted imaging can improve target selection in stereotactic biopsies. MET...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000338092
更新日期:2012-01-01 00:00:00
abstract::Postoperative magnetic resonance imaging (MRI) of basal ganglia functional lesions illustrates the accuracy of preoperative target localization. The technique of perioperative MRI and CT localization for pallidotomy will be discussed and correlated with the center of the lesion on postoperative standard MRI as well as...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098598
更新日期:1994-01-01 00:00:00
abstract::Dorsal root entry zone (DREZ) lesions are effective in treating specific pain syndromes, most notably post-brachial plexus avulsion. There is limited experience, however, with lesions in the conus medullaris. We review the case of a patient having pelvic pain and urinary retention who failed to improve despite multipl...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098920
更新日期:1992-01-01 00:00:00
abstract::Fourteen patients with recurrent epipharyngeal carcinoma (EPC) were treated by gamma knife stereotactic radiosurgery. The tumor volume ranged from 0.3 to 80 ml (median 18.9 ml). Treatment was done with a tumor margin dose of 10-27 Gy (median 15 Gy). The median follow-up period was 15 months (range 2-47 months). Ten pa...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000094461
更新日期:2006-01-01 00:00:00
abstract:OBJECT:To estimate the efficacy of Gamma Knife radiosurgery (GKR) especially as a primary surgical treatment for hypersecreting pituitary adenomas. METHODS:274 patients were treated with GKR. The mean tumor volume was 1.86 cm(3). The mean peripheral dose was 28.7 Gy. RESULTS:223 patients were followed up for an avera...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000048393
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Percutaneous trigeminal rhizotomy or balloon compression for trigeminal neuralgia carries a potential risk for the brainstem, the carotid artery, and the basilar artery. OBJECTIVE:To detail the relation of critical neural and vascular structures to expanded balloons used for percutaneous compression of the ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000489947
更新日期:2018-01-01 00:00:00
abstract::Transient postoperative confusion (POC) occurs in 5-25% of patients following bilateral subthalamic nucleus stimulation. We retrospectively reviewed data on 96 patients who underwent bilateral subthalamic nucleus deep brain stimulation for Parkinson's disease. Nine percent of patients developed POC. There was no signi...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000086676
更新日期:2005-01-01 00:00:00
abstract::During percutaneous microcompression of the gasserian ganglion for the relief of trigeminal neuralgia, a computerized technique for monitoring the pressure inside Meckel's cave was employed in 22 patients. A dedicated transducer connected to a computer records the balloon inflation pressure. Its variations are discern...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099391
更新日期:1991-01-01 00:00:00
abstract::Treatment of patients with nasopharyngeal carcinoma (NPC) using external beam radiation therapy (XRT) alone results in significant local recurrence. To improve local control, stereotactic radiosurgery (SRS) was used to boost radiation to the primary tumor site following XRT in 23 patients with NPC. SRS was delivered u...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000029753
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Directional leads are increasingly used in deep brain stimulation. They allow shaping the electrical field in the axial plane. These new possibilities increase the complexity of programming. Thus, optimized programming approaches are needed to assist clinical testing and to obtain full clinical benefit. OBJ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000509781
更新日期:2020-10-20 00:00:00
abstract::The quantitative functional analysis of firing patterns has made it possible to classify human VL neurons into two basic types: (1), units with irregular unitary 3-to 20-imp/s activity (A type) and (2) units with short (10-30 ms) rhythmic (3-6 Hz) burst discharges (B type). These two basic types of VL neurons, determi...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100206
更新日期:1990-01-01 00:00:00
abstract::Background: Trigeminal neuralgia (TN) is mostly caused by vascular compression of the nerve's root entry zone due to an ectatic artery. Rarer causes include compression from tumors, vascular malformations or multiple sclerosis plaques. Developmental venous anomalies (DVAs) are benign, aberrantly appearing venous struc...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000369562
更新日期:2015-01-01 00:00:00
abstract::Computerized brain atlas is a new application area in the practical use of stereotactic neurosurgery. Our approach provides a solution for the straightforward definition of a coordinate system (CA-CP), localization of the selected target point, trepanation points and trajectory transformation of the stereotactic elect...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099858
更新日期:1997-01-01 00:00:00
abstract::There is no clear consensus regarding the optimal location for placing deep brain stimulation (DBS) electrodes within the subthalamic nucleus (STN) target region in Parkinson's disease. In cases of poor symptom control or adverse effects following lead placement, leads presumed to be inadequately positioned may be cor...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000230692
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Evidence has been provided that the subiculum may play an important role in the generation of seizures. Electrical stimulation at this target has been reported to have anticonvulsive effects in kindling and pilocarpine rat models, while in a clinical study of hippocampal deep brain stimulation (DBS), conta...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000510295
更新日期:2020-10-28 00:00:00