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Interstitial stereotactic radiosurgery.

P C Warnke1, K Kopitzki, C B Ostertag

  • 1Department of Neurological Science, The University of Liverpool, The Walton Centre for Neurology and Neurosurgery, Liverpool, UK. p.c.warnke@liv.ac.uk

Acta Neurochirurgica. Supplement
|October 9, 2003
PubMed
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Interstitial stereotactic radiosurgery effectively treats circumscribed brain tumors like low-grade gliomas. However, this technique is not effective for malignant gliomas, limiting its role in brain tumor treatment.

Area of Science:

  • Neurosurgery
  • Radiation Oncology
  • Oncology

Background:

  • Interstitial stereotactic radiosurgery is a specialized technique for brain tumors.
  • Limited centers possess the expertise and data for scientific evaluation.
  • The technique is suitable for circumscribed lesions up to 3.5 cm.

Purpose of the Study:

  • To evaluate the efficacy of interstitial stereotactic radiosurgery in various brain tumors.
  • To elaborate on the radiobiology, doses, dose rates, and physiological effects.
  • To compare outcomes in low-grade versus malignant gliomas.

Main Methods:

  • Utilized interstitial application of radionuclides (e.g., 125-I sources) or radiation devices.
  • Evaluated different implantation modes, including single-fraction treatment with a miniature linear accelerator (Photoelectron).

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  • Conducted a prospective, randomized, controlled trial for malignant gliomas.

    • Main Results:

    • Efficacy in low-grade gliomas is well-documented by European centers.
    • Radiobiology, including doses and vascular effects, is well-established.
    • Interstitial radiosurgery showed no effectiveness in malignant gliomas.

    Conclusions:

    • Interstitial stereotactic radiosurgery is a powerful option for circumscribed CNS tumors, including some low-grade gliomas and metastases.
    • It plays a limited role in the treatment of malignant gliomas.
    • The technique's applicability is restricted to specific tumor types and sizes.