Image-Guided, Linac-Based, Surgical Cavity-Hypofractionated Stereotactic Radiotherapy in 5 Daily Fractions for Brain Metastases.

Abstract:

BACKGROUND:Cavity stereotactic radiotherapy has emerged as a standard option following resection of brain metastases. However, the optimal approach with either single-fraction or hypofractionated stereotactic radiotherapy (HSRT) remains a significant question. OBJECTIVE:To report outcomes for 5-fraction HSRT to the surgical cavity, based on contouring according to a recently reported international consensus guideline. METHODS:Patients treated with cavity HSRT were identified from a prospective institutional database. Local brain control (LC), distant brain failure (DBF), leptomeningeal disease (LMD), and overall survival rates were determined. Univariate and multivariable analyses were performed on potential predictive factors. RESULTS:One hundred thirty-seven cavities in 122 patients were treated at a median total dose of 30 Gy (range, 25-35 Gy). The median follow-up was 16 mo (range, 1-60 mo). Nonsmall cell lung cancer was the most common histology (44%), followed by breast cancer (21%). In 57% of surgical cavities, the preoperative tumor diameter was >3 cm. One-year LC, DBF, LMD, and overall survival rates were 84%, 45%, 22%, and 62%, respectively. Multivariable analyses identified colorectal (hazard ratio [HR] 4.1, P = .0066) and melanoma (HR 2.4, P = .012) metastases as predictors of local recurrence; preoperative tumor diameter >2 cm (HR 8.9, P = .012) and absence of targeted therapy (HR 4.4, P = .03) as predictors of DBF; and breast cancer histology (HR 2.1, P = .05) and subtotal resection (HR 2.6, P = .009) as predictors of LMD. Symptomatic radiation necrosis was observed in 7 patients (6%). CONCLUSION:High rates of LC were observed following this 5-fraction HSRT regimen. Superiority as compared to single-fraction SRS requires a randomized trial.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Soliman H,Myrehaug S,Tseng CL,Ruschin M,Hashmi A,Mainprize T,Spears J,Das S,Yang V,da Costa L,Maralani P,Heyn C,Atenafu EG,Sahgal A

doi

10.1093/neuros/nyz162

subject

Has Abstract

pub_date

2019-11-01 00:00:00

pages

E860-E869

issue

5

eissn

0148-396X

issn

1524-4040

pii

5512277

journal_volume

85

pub_type

杂志文章
  • Infants with medulloblastoma: a single institution review of survival.

    abstract::Although the prognoses of children with medulloblastoma have improved dramatically over the last several decades, the reported survival for very young children with this tumor remains poor. We undertook a retrospective review of patients less than 36 months of age at the time of the diagnosis of a medulloblastoma who ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Geyer R,Levy M,Berger MS,Milstein J,Griffin B,Bleyer WA

    更新日期:1991-11-01 00:00:00

  • Comparison of laser and radiofrequency dorsal root entry zone lesions in cats.

    abstract::Dorsal root entry zone lesions are effective in the control of intractable pain in several types of spinal cord injuries. Traditionally, these lesions have been made with the radiofrequency technique. This is effective, but has the drawback of being laborious, and there is a significant incidence of permanent weakness...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198503000-00008

    authors: Levy WJ,Gallo C,Watts C

    更新日期:1985-03-01 00:00:00

  • International education: 20 years after implementation of a training program.

    abstract::Medical care in developing countries may be improved by various means. Advances in the medical education and training of specialists play an important role in improving health care systems. The results of the efforts of a neurosurgeon from North America who helped establish neurosurgical training in Taiwan are reporte...

    journal_title:Neurosurgery

    pub_type: 传,历史文章,杂志文章

    doi:10.1097/00006123-200106000-00035

    authors: Lee ST

    更新日期:2001-06-01 00:00:00

  • Chained lightning: part III--Emerging technology, novel therapeutic strategies, and new energy modalities for radiosurgery.

    abstract::Radiosurgery is fundamentally the harnessing of energy and delivering it to a focal target for a therapeutic effect. The evolution of radiosurgical technology and practice has served toward refining methodologies for better conformal energy delivery. In the past, this has resulted in developing strategies for improved...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000306089.22894.4e

    authors: Hoh DJ,Liu CY,Chen JC,Pagnini PG,Yu C,Wang MY,Apuzzo ML

    更新日期:2007-12-01 00:00:00

  • Scalp marking for a craniotomy using a laser pointer during preoperative computed tomographic imaging: technical note.

    abstract:OBJECTIVE:The preoperative localization of superficial intracranial lesions is often necessary for accurate burr hole placement or craniotomy siting. It is not always easy, however, to localize the lesions over the scalp working only from computed tomographic images. We developed a simple method for such localization u...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-200005000-00045

    authors: Kubo S,Nakata H,Sugauchi Y,Yokota N,Yoshimine T

    更新日期:2000-05-01 00:00:00

  • Prophylactic vena cava filter insertion in patients with traumatic spinal cord injury: preliminary results.

    abstract::Pulmonary embolism (PE) is a devastating complication in patients with traumatic spinal cord injury (SCI). Prophylactic measures such as venous compression hose or low-dose heparin are only partially protective in reducing the risk of venous thromboembolism and are contraindicated in some patients. Because of extended...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199408000-00008

    authors: Wilson JT,Rogers FB,Wald SL,Shackford SR,Ricci MA

    更新日期:1994-08-01 00:00:00

  • Motor evoked potentials elicited from pyramidal stimulation and recorded from the spinal cord in the rat.

    abstract::This study investigated the spinal evoked response to focal electrical stimulation of the sensorimotor cortex in 32 rats. The results demonstrate a long-latency response (beginning at 8 milliseconds) elicited by electrical stimulation, which is distinct from the short-latency motor evoked potential previously reported...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199104000-00011

    authors: Ryder J,Zappulla R,Nieves J

    更新日期:1991-04-01 00:00:00

  • Cerebral salt wasting after pituitary exploration and biopsy: case report.

    abstract::We report a case of hyponatremia associated with volume depletion after pituitary exploration and biopsy. The presence of clinical dehydration precluded diagnosis of the syndrome of inappropriate secretion of antidiuretic hormone. The absence of a hypoadrenal state and the patient's response to volume reexpansion were...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198604000-00015

    authors: Andrews BT,Fitzgerald PA,Tyrell JB,Wilson CB

    更新日期:1986-04-01 00:00:00

  • Overexpression of hyaluronan synthase-2 reduces the tumorigenic potential of glioma cells lacking hyaluronidase activity.

    abstract:OBJECTIVE:The interactions of CD44 with hyaluronan are thought to be crucial for tumor cell attachment to the extracellular matrix, migration, and invasion. For migration to occur, however, the interactions between hyaluronan and cell surface receptors need to be transient. Hyaluronidases may facilitate the degradation...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-200206000-00023

    authors: Enegd B,King JA,Stylli S,Paradiso L,Kaye AH,Novak U

    更新日期:2002-06-01 00:00:00

  • Image-guided endoscopic transnasal removal of recurrent pituitary adenomas.

    abstract:OBJECTIVE:To assess the role that neuronavigation plays in assisting endoscopic transsphenoidal reoperations for recurrent pituitary adenomas. METHODS:During a 45-month period, 19 endoscopic endonasal transsphenoidal reoperations were performed for recurrent pituitary adenomas. In 11 of 19 patients, the procedure was ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-200207000-00020

    authors: Lasio G,Ferroli P,Felisati G,Broggi G

    更新日期:2002-07-01 00:00:00

  • Choroid plexus papillomas: an immunohistochemical study with particular reference to the coexpression of prealbumin.

    abstract::Immunocytochemical characterization of choroid plexus neoplasms was performed in seven cases, five being of benign choroid plexus papilloma (CPP) and the other two of malignant choroid plexus papilloma (choroid plexus carcinoma CPC). Immunohistochemical examination was performed with antibodies to glial fibrillary aci...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198809000-00021

    authors: Matsushima T,Inoue T,Takeshita I,Fukui M,Iwaki T,Kitamoto T

    更新日期:1988-09-01 00:00:00

  • Chemotherapy in brain metastases.

    abstract::The use OF chemotherapy to treat patients with brain metastases has been viewed historically with skepticism. To date, a survival benefit has not been demonstrated with the use of systemic chemotherapy in patients with brain metastases. However, the introduction of novel agents and delivery techniques warrants a reexa...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1227/01.neu.0000182740.39014.9a

    authors: Peereboom DM

    更新日期:2005-11-01 00:00:00

  • Supraorbital-pterional approach to skull base lesions.

    abstract::A surgical approach to the skull base is described. It allows excellent exposure of the cranial base with minimal brain retraction. Deep lesions can be handled via subfrontal, transsylvian, or subtemporal routes during the same operation. This approach is most suitable for large lesions in the suprasellar, parasellar,...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198710000-00006

    authors: Al-Mefty O

    更新日期:1987-10-01 00:00:00

  • Pyogenic abscess of the medulla oblongata.

    abstract::Pyogenic brain stem abscess is rare. A case of spontaneous abscess of the medulla oblongata is reported in which the diagnosis was made preoperatively by computed tomography. Surgical drainage resulted in good functional recovery and radiological resolution of the lesion. This is the first reported case of survival in...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198603000-00024

    authors: Dake MD,McMurdo SK,Rosenblum ML,Brant-Zawadzki M

    更新日期:1986-03-01 00:00:00

  • Pheochromocytoma presenting as a skull metastasis with massive extracranial and intracranial extension.

    abstract::A case of metastatic pheochromocytoma is reported in which the diagnosis was determined on the basis of a painless scalp mass. Subsequent to biopsy and histological diagnosis, further investigations revealed a large skull lesion with intracranial extension, an adrenal mass, and various catecholamine abnormalities. The...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199007000-00021

    authors: Grabel JC,Gottesman RI,Moore F,Averbuch S,Zappulla R

    更新日期:1990-07-01 00:00:00

  • Prediction of obliteration after gamma knife surgery for cerebral arteriovenous malformations.

    abstract:OBJECTIVE:To define the factors of importance for the obliteration of cerebral arteriovenous malformations (AVMs), thus making a prediction of the probability for obliteration possible. METHODS:In 945 AVMs of a series of 1319 patients treated with the gamma knife during 1970 to 1990, the relationship between patient, ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199703000-00001

    authors: Karlsson B,Lindquist C,Steiner L

    更新日期:1997-03-01 00:00:00

  • Intraventricular hematoma secondary to a ventriculoperitoneal shunt.

    abstract::A rare and serious complication of ventriculoperitoneal shunt is reported. A huge intraventricular hematoma was confirmed by computed tomography scanning and autopsy. This is the first report of such a complication in a newborn with hydrocephalus. ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198203000-00016

    authors: Kuwamura K,Kokunai T

    更新日期:1982-03-01 00:00:00

  • Intracranial meningioma unmasked by elective general anesthesia: report of three cases.

    abstract::Three cases of intracranial meningioma unmasked by elective general anesthesia are reported. In each case, the meningioma was either asymptomatic or so subtly symptomatic that no suspicion of intracranial tumor had been entertained preoperatively. Each patient presented with failure to wake up after routine general an...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198403000-00012

    authors: Young HA,Smith H,Gregory SA,Gleave J

    更新日期:1984-03-01 00:00:00

  • Intraoperative computed tomography for complex craniocervical operations and spinal tumor resections.

    abstract:OBJECTIVE:To improve intraoperative observation of unexposed anatomic features and to verify surgical correction, a mobile computed tomographic (CT) scanner has been introduced into the operating room. To date, intraoperative CT scanning has been used predominantly for intracranial procedures. We report on the expanded...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-200008000-00019

    authors: Hum B,Feigenbaum F,Cleary K,Henderson FC

    更新日期:2000-08-01 00:00:00

  • Scalp Cirsoid Aneurysms: Case Illustration and Systematic Review of Literature.

    abstract:BACKGROUND:Scalp cirsoid aneurysms are rare subcutaneous arteriovenous fistulae affecting the scalp. They can be easily misdiagnosed and mistreated. OBJECTIVE:To review reported cases of scalp cirsoid aneurysms for their incidence, etiology, clinical presentation, treatment, and outcomes using an illustrative case. M...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyz303

    authors: Sofela A,Osunronbi T,Hettige S

    更新日期:2020-02-01 00:00:00

  • Operative nuances of myelomeningocele closure.

    abstract::ALTHOUGH ADVANCES IN prenatal care and diagnosis have reduced the incidence of spina bifida, repair of neural tube defects remains one of the standard cases encountered by pediatric neurosurgeons. The operative techniques used in closure of these congenital defects have remained essentially unchanged during the past 2...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Perry VL,Albright AL,Adelson PD

    更新日期:2002-09-01 00:00:00

  • Effect of mannitol on experimental focal ischemia in awake monkeys.

    abstract::The effect of mannitol on focal cerebral ischemia in cynomolgus monkeys was studied. After the implantation of a snare ligature about the right middle cerebral artery (MCA) and of deep electrodes for measurement of cerebral blood flow, unanesthetized animals underwent 4-hour MCA occlusion. Ten monkeys were untreated, ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Peña H,Gaines C,Suess D,Crowell RM,Waggener JD,DeGirolami U

    更新日期:1982-10-01 00:00:00

  • Glioma invasion in the central nervous system.

    abstract::Invading glioma cells seem to follow distinct anatomic structures within the central nervous system. Tumor cell dissemination may occur along structures, such as the basement membranes of blood vessels or the glial limitans externa, that contain extracellular matrix (ECM) proteins. Frequently, invasive glioma cells ar...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1097/00006123-199608000-00001

    authors: Giese A,Westphal M

    更新日期:1996-08-01 00:00:00

  • Intravenous Tissue Plasminogen Activator for Large Vessel Ischemic Stroke - Is There Still a Role?

    abstract::While the efficacy of Intravenous tissue plasminogen activator (tPA) is well established, its impact on large vessel occlusion (LVO) is controversial. Whether IV tPA should be bypassed in favor of endovascular thrombectomy (MT) will be addressed. Compelling evidence exists to suggest tPA administration might be bypass...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyz083

    authors: Sawyer RN

    更新日期:2019-07-01 00:00:00

  • Endovascular treatment for dural arteriovenous fistulae of the superior petrosal sinus.

    abstract:OBJECTIVE:To determine the usefulness of endovascular embolization for treatment of dural arteriovenous fistulae of the superior petrosal sinus. METHODS:We performed a retrospective review of 18 patients treated during a 16-year period. Transarterial and/or transvenous embolizations were performed as a preoperative ad...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000068790.37318.24

    authors: Ng PP,Halbach VV,Quinn R,Balousek P,Caragine LP,Dowd CF,Higashida RT,Wilson C

    更新日期:2003-07-01 00:00:00

  • Expressive and receptive language areas determined by a non-invasive reliable method using functional magnetic resonance imaging and magnetoencephalography.

    abstract:OBJECTIVE:It is known that functional magnetic resonance imaging (fMRI) and magnetoencephalography (MEG) are sensitive to the frontal and temporal language function, respectively. Therefore, we established combined use of fMRI and MEG to make reliable identification of the global language dominance in pathological brai...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000249262.03451.0E

    authors: Kamada K,Sawamura Y,Takeuchi F,Kuriki S,Kawai K,Morita A,Todo T

    更新日期:2007-02-01 00:00:00

  • Evaluation of the Risk Assessment and Prediction Tool for Postoperative Disposition Needs After Cervical Spine Surgery.

    abstract:BACKGROUND:Bundled care payment models are becoming more prevalent in neurosurgery. Such systems place the cost of postsurgical facilities in the hands of the discharging health system. Opportunity exists to leverage prediction tools for discharge disposition by identifying patients who will not benefit from prolonged ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyz161

    authors: Berger I,Piazza M,Sharma N,Glauser G,Osiemo B,McClintock SD,Lee JYK,Schuster JM,Ali Z,Malhotra NR

    更新日期:2019-11-01 00:00:00

  • In-Pipeline Stenosis: Incidence, Predictors, and Clinical Outcomes.

    abstract:BACKGROUND:The Pipeline Embolization Device is a widely utilized flow diverter in the treatment of intracranial aneurysms. OBJECTIVE:To assess the incidence, clinical significance, predictors, and outcomes of in-Pipeline stenosis (IPS). METHODS:Angiographic studies in 139 patients treated between 2011 and 2013 were i...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0000000000000908

    authors: Chalouhi N,Polifka A,Daou B,Kung D,Barros G,Tjoumakaris S,Gonzalez LF,Starke RM,Hasan D,Judy B,Rosenwasser RH,Jabbour P

    更新日期:2015-12-01 00:00:00

  • Ranging accuracy test of the sonic microstereometric system.

    abstract::We have recently introduced a new type of ultrasonic-based, three-dimensional ranging system for the localization of small handheld surgical tools to be used during operation in open stereotactic brain surgery. This targeting system has now been extensively laboratory tested during thousands of measuring cycles with a...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199404000-00030

    authors: Horstmann GA,Reinhardt HF

    更新日期:1994-04-01 00:00:00

  • Language and motor mapping during resection of brain arteriovenous malformations: indications, feasibility, and utility.

    abstract:BACKGROUND:Microsurgical resection of arteriovenous malformations (AVMs) located in the language and motor cortex is associated with the risk of neurological deterioration, yet electrocortical stimulation mapping has not been widely used. OBJECTIVE:To demonstrate the usefulness of intraoperative mapping with language/...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0b013e318207a9a7

    authors: Gabarrós A,Young WL,McDermott MW,Lawton MT

    更新日期:2011-03-01 00:00:00