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1996-03-30
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Document 1076
DOCN M9651076
TI Gamma Knife radiosurgery of primary and metastatic malignant brain
tumors, a preliminary report.
DT 9505
AU Gerosa MA; Nicolato A; Berlucchi S; Piovan E; Zampieri PG; Pasoli A;
Foroni R; Giri MG; Marchini G; Babighian S; et al; Department of
Neurosurgery, University Hospital, Verona, Italy.
SO Stereotact Funct Neurosurg. 1995;64 Suppl 1:56-66. Unique Identifier :
AIDSLINE MED/96151256
AB Between February 1993 and March 1994, 75 metastases, 16 gliomas and 2
AIDS-related malignant lymphomas were treated with Gamma Knife
radiosurgery. Metastatic brain tumors (54% lung cancer, 14% breast
cancer, 13.5% melanoma) were the most frequent and clinically rewarding
cases. So-called local control was achieved in almost all patients, the
vast majority showing neurological improvement associated with
radiological disappearance or dramatic shrinkage of the tumor within
9-12 weeks from treatment. According to our modified 'Pittsburgh'
protocol, we have treated up to four distinct intracranial lesions, up
to a total maximum volume of 20 cm3, with an average surface dose of 25
Gy, with or without additional whole brain radiotherapy (WBR).
Preliminary follow-up data seem to confirm increased quality of life and
survival rates. The results were particularly striking whenever primary
tumors were under control, and were poorly influenced by associated WBR.
Gamma Knife treatment was also performed in a selected group of patients
with small-to-medium-sized, well-defined, histologically proven,
cerebral gliomas. The main indications for radiosurgery were high-risk
surgery, multifocal disease, ventricular seeding and unresected or
recurrent tumor. The prescription doses ranged from 18 to 30 Gy, with a
mean of 27 Gy. Low-grade astrocytomas (9/16 cases) showed the better
clinical and radiological response to treatment, with neurological
recovery and significant reduction in tumor volume within 3-5 months in
5 of the 9 patients. In 4 of 7 high-grade gliomas, there was little or
no response. However, an impressive radiological regression with full
clinical recovery was observed in 2 high-grade cases with small tumor
volumes: a recurrent, anaplastic 'mixed glioma' of the pineal region and
a double ventricular seeding of a previously operated anaplastic
astrocytoma.
DE Brain Neoplasms/SECONDARY/*SURGERY Female Follow-Up Studies
Glioma/*SURGERY Human Lymphoma, AIDS-Related/*SURGERY Magnetic
Resonance Imaging Male Middle Age *Radiosurgery Retrospective
Studies Treatment Outcome JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).