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European J Cancer Brain Mets 2014 Chen

Taich Chen Goetsch TNA World Neurosurgery June 2016

Chen Met Article Neuro-Oncology

Acoustic Hearing Preservation Linskey JNS 2008

Ott Cluster Headache

Essential Tremors 2012

 

MESTASTIC BRAIN TUMORS

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Gamma Knife surgery for the treatment of 5 to 15 metastases to the brain

DaviD J. Salvetti, B.e., tara G. NaGaraJa, B.S., iaN t. McNeill, M.S., ZhiyuaN Xu, M.D., aND JaSoN SheehaN, M.D., Ph.D.

Conclusions. In patients with 5–15 brain metastases at presentation, the number of lesions did not predict sur- vival after GKS; however, the RPA class was predictive of OS in this group of patients. Gamma Knife surgery for such patients offers an excellent rate of local tumor control.

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9

A Phase 3 Trial of Whole Brain Radiation Therapy and Stereotactic Radiosurgery Alone Versus WBRT and SRS With Temozolomide or Erlotinib for Non-Small Cell Lung Cancer and 1 to 3 Brain Metastases: Radiation Therapy Oncology Group 0320

Paul W. Sperduto, MD, MPP,* Meihua Wang, PhD,y H. Ian Robins, MD, PhD,z Michael C. Schell, PhD,x Maria Werner-Wasik, MD,jj Ritsuko Komaki, MD,{
Luis Souhami, MD,# Mark K. Buyyounouski, MD,** Deepak Khuntia, MD,yy
William Demas, MD,zz Sunjay A. Shah, MD,xx Lucien A. Nedzi, MD,jjjj Gad Perry, MD,{{ John H. Suh, MD,## and Minesh P. Mehta, MD***

Summary

Patients with non-small cell lung cancer and 1 to 3 brain metastases were randomly assigned to whole brain radiation therapy (WBRT) þ stereotactic radiosurgery (SRS), WBRT þ SRS þ temozolamide, or WBRT þ SRS þ erlotinib. The median survival times for the 3 arms were 13.4, 6.3, and 6.1 months, respectively. Grade 3 to 5 toxicity was 11%, 41%, and 49%, respectively. Possible explanations for these findings are discussed.

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ARTERIOVENOUS MALFORMATION (AVM)

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Stereotactic radiosurgery for arteriovenous malformations, Part 1: management of Spetzler-Martin Grade I and II arteriovenous malformations

Hideyuki kano, M.d., PH.d.,1,3 L. dade Lunsford, M.d.,1–3 JoHn C. fLiCkinger, M.d.,1–3 Huai-CHe yang, M.d.,1,3,4 THoMas J. fLannery, M.d., PH.d.,1,3 nasir r. awan, f.C.P.s.,1,3 aJay niranJan, M.CH., M.B.a.,1,3 Josef novoTny Jr., PH.d.,2,3
and dougLas kondzioLka, M.d.1,3

Conclusions. Stereotactic radiosurgery is a gradually effective and relatively safe option for patients with small- er volume Spetzler-Martin Grade I or II AVMs who decline initial resection. Hemorrhage after obliteration did not occur in this series. Patients remain at risk for a bleeding event during the latency interval until obliteration occurs. Patients with aneurysms and an AVM warrant more aggressive surgical or endovascular treatment to reduce the risk of a hemorrhage in the latency period after SRS.

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9

Analysis of nidus obliteration rates after gamma knife surgery for arteriovenous malformations based on long-term follow-up data: the University of Tokyo experience

MASAHIRO SHIN, M.D., KEISUKE MARUYAMA, M.D., HIROKI KURITA, M.D., SHUNSUKE KAWAMOTO, M.D., MASAO TAGO, M.D., ATSURO TERAHARA, M.D., AKIO MORITA, M.D., KEISUKE UEKI, M.D., KINTOMO TAKAKURA, M.D,
AND TAKAAKI KIRINO, M.D.

Conclusions. After the introduction of CT and MR images into dose planning, the conformity and selectivity of dosime- try improved remarkably, although the latency intervals until obliteration were prolonged. Imaging outcomes for AVMs should be evaluated using data provided by longer follow-up periods. The timing of additional treatments for residual AVMs should be decided cautiously, considering the size of the AVM, the patient age and sex, and the history of hemor- rhage before radiosurgery.

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TRIGEMINAL NEURALGIA

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Fifteen years of Gamma Knife surgery for trigeminal neuralgia in the Journal of Neurosurgery: history of a revolution in functional neurosurgery

Jean Régis, M.D., anD Constantin tuleasCa, M.D.

In conclusion, this series of the Top 25 papers in JNS on GKS for trigeminal neuralgia bears witness to the fact that radiosurgery is an example of a true disruptive in- novation in the eld of functional neurosurgery and, spe- ci cally, in the neurosurgical management of trigeminal neuralgia. These articles demonstrate how greatly this innovation has changed neurosurgical practice in just a few years.

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9
GAMMA KNIFE RADIOSURGERY FOR TRIGEMINAL NEURALGIA: RESULTS AND POTENTIALLY PREDICTIVE PARAMETERS— PART I: IDIOPATHIC TRIGEMINAL NEURALGIA

Michele Longhi, M.D., Paolo Rizzo, M.D., Antonio Nicolato, M.D., Roberto Foroni, Ph.D., Mario Reggio, Ph.D., Massimo Gerosa, M.D.

CONCLUSION: According to our experience, GKR represents a reliable second-line therapeutic approach for TN after pharmacological failure. Favorable prognostic fac- tors include “primary GKR” and maximal GKR dose ranging between 80 and 90 Gy.

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MENINGIOMAS

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Single-fraction radiosurgery of benign cavernous sinus meningiomas

Bruce e. Pollock, M.D.,1,2 Scott l. StafforD, M.D.,2 Michael J. link, M.D.,1 YolanDa i. GarceS, M.D.,2 anD roBert l. foote, M.D.2

Conclusions. Single-fraction SRS at the radiation doses used in this series provided durable tumor control for patients with benign CSM. Larger tumor volume remains the primary factor associated with complications after single-fraction SRS of benign CSM despite advancements in SRS technique.

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9

LONG-TERM OUTCOMES OF STEREOTACTIC RADIOSURGERY FOR TREATMENT OF CAVERNOUS SINUS MENINGIOMAS

MARCOS ANTONIO DOS SANTOS, M.D.,* JOSE BUSTOS PE REZ DE SALCEDO, M.D., PH.D.,*y
JOSE ANGEL GUTIE RREZ DIAZ, M.D., PH.D.,*y FELIPE A. CALVO, M.D.,*z JOSE SAMBLA S, M.D., PH.D.,*y HUGO MARSIGLIA, M.D.,* AND KITA SALLABANDA, M.D.*y

Conclusions: SRS is an effective and safe treatment for CSM, feasible either in the primary or the postsurgical setting. Incomplete coverage of the target did not worsen outcomes. More than 80% of the patients remained free of disease progression during long-term follow-up.

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ACOUSTIC NEUROMA

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Early Radiosurgery Improves Hearing Preservation in Vestibular Schwannoma Patients With Normal Hearing at the Time of Diagnosis

Berkcan Akpinar, BA,* Seyed H. Mousavi, MD,y Michael M. McDowell, MD,y Ajay Niranjan, MD,y Amir H. Faraji, MD, PhD,y John C. Flickinger, MD,z and L. Dade Lunsford, MD

Conclusions: SRS within 2 years after diagnosis of VS in normal hearing patients re- sulted in improved retention of all hearing measures compared with later SRS.

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9

LONG-TERM OUTCOMES OF STEREOTACTIC RADIOSURGERY FOR TREATMENT OF CAVERNOUS SINUS MENINGIOMAS

MARCOS ANTONIO DOS SANTOS, M.D.,* JOSE BUSTOS PE REZ DE SALCEDO, M.D., PH.D.,*y
JOSE ANGEL GUTIE RREZ DIAZ, M.D., PH.D.,*y FELIPE A. CALVO, M.D.,*z JOSE SAMBLA S, M.D., PH.D.,*y HUGO MARSIGLIA, M.D.,* AND KITA SALLABANDA, M.D.*y

Conclusions: SRS is an effective and safe treatment for CSM, feasible either in the primary or the postsurgical setting. Incomplete coverage of the target did not worsen outcomes. More than 80% of the patients remained free of disease progression during long-term follow-up.

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FACULTY PUBLICATIONS

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LINEAR ACCELERATOR AND GAMMA KNIFE–BASED STEREOTACTIC CRANIAL RADIOSURGERY: CHALLENGES AND SUCCESSES OF EXISTING QUALITY ASSURANCE GUIDELINES AND PARADIGMS

STEVEN J. GOETSCH, PH.D.*y
* San Diego Gamma Knife Center, Grossmont Cancer Center, La Jolla, CA; y Department of Medical Physics, San Diego State University, La Jolla, CA

The remaining challenges for this now well-accepted field include:

(1) Continuing to develop training programs for new radio- therapy centers beginning to develop SRS and stereotac- tic radiotherapy programs.

(2) Updating QA guidelines to account for new develop- ments in SRS and stereotactic radiotherapy, including computer-controlled equipment and automatic position- ing devices.

(3) Writing new dosimetry protocols to account for the novel geometries used in SRS systems.

(4) Developing protocols for accurate and appropriate stereotactic image acquisition and registration.

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9
Stereotactic Radiosurgery Treatment of Trigeminal Neuralgia: Clinical Outcomes and Prognostic Factors

Zachary J. Taich1, Steven J. Goetsch2, Elsa Monaco2, Bob S. Carter1, Kenneth Ott2, John F. Alksne1, Clark C. Chen1

CONCLUSIONS: Excellent TN pain relief was achieved with the delivery of 85 Gy in a single-shot, 4-mm isocenter SRS targeting the dorsal root entry zone. Patients with classical TN, with age older than 70 years, or who under- went previous percutaneous procedures were more likely to benefit from SRS. SRS is efficacious in patients with classical TN despite concurrent diagnosis of MS.

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San Diego Gamma Knife Center

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