[Proton therapy in clinical neurosurgery]

The use of proton beam irradiation in neurosurgical clinical practice helps to find a solution to the problem of the treatment of inoperable malformations employing this method in some cases as an alternative to surgical intervention. Hypophyseal tumors, tumors of the cavernous sinus, arteriosinusal anastomoses in the cavernous sinus area, and arteriovenous malformations are irradiated at the N. N. Burdenko Institute of Neurosurgery, USSR, AMS using the medical proton beam of the Institute of Theoretical and Experimental Physics. Methods of "piercing" irradiation and methods with the use of Bragg's peak are being developed. At present over 200 patients with hormonally active hypophyseal tumors, 30 patients with tumors of the cavernous sinus, 23 patients with deep seated arteriovenous malformations, and 10 patients with spontaneous arteriosinusal anastomoses in the cavernous sinus area have been irradiated. This method seems to hold promise in neurosurgical practice. Extension of the range of clinical applications of proton beam therapy in neurosurgery requires the development of various techniques of irradiation, all possible approaches to various targets on the basis of contemporary methods of computerized diagnosis, topometry and irradiation design.