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RadiosurgeryThis page contains recent news articles, when available, and an overview of Radiosurgery but does not offer medical advice. You should contact your physician with regard to any health issues or concerns.News: Radiosurgery PR Newswire (press release)...is the world's leading manufacturer of medical devices and software for treating cancer and other medical conditions with radiotherapy, radiosurgery, href=http://physician-assistant.advanceweb.com/editorial/content/editorial.aspx?CC=2546"Brain Cancer Patients Benefit from Mix of Radiosurgery and Whole ... - Jul 8, 2009 ADVANCE for Physician AssistantsA newly developed cancer treatment method combining stereotactic radiosurgery and whole brain radiation might provide new hope to brain cancer patients, href=http://physician-assistant.advanceweb.com/editorial/content/editorial.aspx?CC=2804"The Power of Two - Jul 12, 2009 ADVANCE for Physician AssistantsTitled, "Radiosurgery for Patients with Brain Metastases: A Multi-Institutional Analysis Stratified by the RTOG Recursive Partitioning Analysis Method," the href=http://medicalphysicsweb.org/cws/article/research/39823"Planning at 3T: no problem, but no benefit - Jul 14, 2009 Medical Physics Web (subscription)So for applications where precision targeting is essential, such as stereotactic radiosurgery, it may be better to stick with 1.5T. Not necessarily. href=http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=109&STORY=/www/story/06-24-2009/0005049498&EDATE="10th CyberKnife System Installed at an HCA Hospital - Jun 24, 2009 PR Newswire (press release)..."Our relationship with HCA has provided an additional avenue for getting patients throughout the world access to the treatment benefits of radiosurgery," href=http://www.empowher.com/news/herarticle/2009/07/09/still-learning"Still Learning - Jul 9, 2009 EmpowHerThe neck pain is slowly settling down since the radiosurgery (two weeks ago tomorrow) and I am having less and less tingling in my right arm. href=http://www.mycentraljersey.com/article/20090714/GETPUBLISHED/907140335/Capital+Health+Places+Last+Steel+Beam+-+Boost+Mercer+County+Economy"Capital Health Places Last Steel Beam - Boost Mercer County Economy - Jul 15, 2009 New Brunswick Home News TribuneThe hospital will include Capital Health's Regional Cancer Center (including the area's only CyberKnife Robotic Radiosurgery System), specialized emergency href=http://www.ktnv.com/Global/story.asp?S=10718626"How tech transforms the lives of people in need - Jul 15, 2009 KTNV Las VegasThe CyberKnife is a radiosurgery device that noninvasively treats tumors anywhere in the body by delivering very precise high-dose radiation, according to href=http://www.empowher.com/news/herarticle/2009/06/25/phase-number-next"Phase Number Next - Jun 25, 2009 EmpowHerChoices are real surgery and stereotactic radiosurgery. While there is some really amazing stuff going on with actual vertebral body replacement surgery, href=http://www.bnd.com/yourlife/story/820943.html"SLU is part of cancer study - Jun 25, 2009 Belleville News DemocratThe STARS (Stereotactic Radiosurgery vs. Surgery) trial ... will allow us to definitely say which treatment is better for these patients. href=http://www.medicalnewstoday.com/medicalnews.php?newsid=154755"Turkish Ministry Of Health Purchases Two CyberKnife(R) Systems ... - Jun 22, 2009 Medical News Today (press release)Accuray Incorporated (Nasdaq: ARAY), a global leader in the field of radiosurgery, announced that the Turkish Ministry of Health has purchased two href=http://www.goldcoast.com.au/article/2009/06/21/90785_gold-coast-top-story.html"eBay pulls pin on ashes auction - Jun 20, 2009 Gold Coast News - goldcoast.com.auShe travelled to the US with Mr Chapman for CyberKnife radiosurgery. The treatment cleared the tumours, however Ms Chapman died in 2005, aged 42, href=http://healthcare.dbusinessnews.com/shownews.php?type_news=latest&newsid=186590"North Shore Medical Center Five-Star Rated for Maternity Care by ... - Jul 13, 2009 dBusinessNews Kansas City (press release)The hospital also offers specialized centers, including the C. Gordon Griffith Comprehensive Cancer Center with IMRT and X-Knife Radiosurgery, href=http://money.cnn.com/news/newsfeeds/articles/prnewswire/200907130800PR_NEWS_USPR_____SF45184.htm"Varian Medical Systems Management to Present at the Piper Jaffray ... - Jul 13, 2009 CNNMoney.com (press release)...is the world's leading manufacturer of medical devices and software for treating cancer and other medical conditions with radiotherapy, radiosurgery, href=http://www.bizjournals.com/sanjose/stories/2009/06/22/daily69.html"Varian buys radiotherapy software companies for $2.2M - Jun 25, 2009 Bizjournals.comThe company plans to integrate it with its Eclipse treatment planning software for radiotherapy, radiosurgery, and brachytherapy. href=http://www.tradingmarkets.com/.site/news/Stock%20News/2417955/"xtremepicks.com: www.Xtremepicks.Com: Xtremepicks.Com Alerts For ... - Jul 13, 2009 Trading Markets (press release)...is the world's leading manufacturer of medical devices and software for treating cancer and other medical conditions with radiotherapy, radiosurgery, href=http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=104&STORY=/www/story/06-22-2009/0005047720&EDATE="Spinal Cancer Patient Finds New Hope at the Palo Alto Medical ... - Jun 22, 2009 PR Newswire (press release)The platform is versatile enough to deliver highly accurate radiotherapy treatments for prostate and other types of cancer, along with precise radiosurgery href=http://www.tradingmarkets.com/.site/news/Stock%20News/2390591/"xtremepicks.com: www.Xtremepicks.com: www.Xtremepicks.Com ... - Jun 25, 2009 Trading Markets (press release)...assets of Houston-based IKOEmed and IKOEtech, privately-owned suppliers of software used in the planning of radiotherapy and radiosurgery treatments. href=http://www.news-press.com/article/20090704/NEWS0102/907040308/1013/LIFESTYLES"New treatment takes aim at prostate cancer - Jul 3, 2009 The News-PressIts function also includes radiosurgery for brain and spinal cord tumors. Although Smith will continue to treat all forms of cancer at the facility, href=http://www.courant.com/community/new-haven/hc-yale_new_haven_settlement_07.artjul02,0,3880747.story"Yale-New Haven Hospital To Refund Medicare - Jul 2, 2009 Hartford CourantThe treatment in question is known as gamma knife stereotactic radiosurgery, used to treat malignant and benign tumors, vascular abnormalities and href=http://www.gantdaily.com/news/71/ARTICLE/55212/2009-06-27.html"Multidisciplinary Cancer Care - Jun 27, 2009 Gant Daily...including image-guided radiotherapy (IGRT), intensity-modulated radiotherapy (IMRT), stereotactic radiosurgery (SRS), and image-guided brachytherapy, href=http://www.indystar.com/article/20090627/SPORTS04/906270420/1004/SPORTS/A.J.+Price+appreciates+chance+with+Pacers"AJ Price appreciates chance with Pacers - Jun 26, 2009 Indianapolis StarHe was successfully treated with radiosurgery. He would live. He knew that. But play again? No one was certain. "I don't think I understood the blessing I href=http://www.prlog.org/10278285-permedics-inc-releases-version-45-of-its-odyssey-intuitive-radiation-treatment-planning-software.html"PerMedics Inc. Releases Version 4.5 Of Its Odyssey Intuitive ... - Jul 9, 2009 PRLog.Org (press release)...therapy planning techniques for treatment types such as Intensity Modulated Radiation Therapy, Stereotactic Radiosurgery and Virtual Simulation. href=http://fredericksburg.com/blogs/view?blogger_id=57&p=1246972946"MediCorp, HCA at it again - Jul 7, 2009 The Free Lance-StarMediCorp's plan is to place similar equipment for radiation therapy and stereotactic radiosurgery in a new building on the Mary Washington Hospital campus href=http://www.thedailyjournal.com/article/20090701/HAMMONTON05/907010327"AtlantiCare's high-tech cancer center opens - Jul 1, 2009 Vineland Daily JournalSlated to become operable this fall is an even more advanced tumor-treating device -- the Cyberknife, a non-invasive robotic radiosurgery system. href=http://www.gainesville.com/article/20090625/ARTICLES/906251048/1002?Title=Cancer-Center-opens-Monday"North Florida Regional Medical Center to open its new cancer ... - Jun 25, 2009 Gainesville SunAccording to Perman, the Cancer Center is one of only 13 facilities in the state to offer the Cyberknife robotic radiosurgery technology. href=http://www.californiachronicle.com/articles/yb/131952515"I Can't Find the Soundtrack of My Death - Jun 20, 2009 California ChronicleLast week at the Beatson, getting ready for my radiosurgery, they gave me a choice from hell. Not the skintight mask fixing my noggin to the table, href=http://www.pnj.com/article/20090626/BUSINESSJOURNAL/906260323/1115"Paul Wang: Neurosurgeon - Jun 25, 2009 Pensacola Business JournalI enjoy the breadth of a general neurosurgery practice, which includes various spine, brain, peripheral nerve, and radiosurgery procedures. href=http://www.empowher.com/news/herarticle/2009/07/02/little-little"A Little of This, A Little of That - Jul 2, 2009 EmpowHerAfter the radiosurgery on Thursday, I had less neck pain and no arm tingling on Friday, which was a great big yay. Saturday we headed down I-95 to href=http://www.earthtimes.org/articles/show/alliance-healthcare-services-to-participate,886283.shtml"Alliance HealthCare Services to Participate in the 3rd Annual ... - Jul 8, 2009 Earthtimes (press release)The Company also operated 22 radiation therapy centers and stereotactic radiosurgery facilities (two radiation therapy centers are in unconsolidated joint href=http://www.mindanaotimes.com.ph/?p=2077"DDH to formulate 10-year plan - Jul 6, 2009 Mindanao TimesThe equipment, is a machine used for general purpose radiation and is modified for radiosurgery or intensified modulation radiation therapy, href=http://www.treatmentabroad.net/medical-tourism/news/?EntryId82=141643"Apollo Hospitals Group expands - Jul 6, 2009 Treatment Abroad - Medical Tourism News...a new ray of hope in cancer care; and the Novalis – the world's most powerful NS versatile platforms for non-invasive, image-guided radiosurgery. href=http://content.nejm.org/cgi/content/full/NEJMoa0902579"Hearing Improvement after Bevacizumab in Patients with ... - Jul 8, 2009 New England Journal of Medicine (subscription)Results of acoustic neuroma radiosurgery: an analysis of 5 years' experience using current methods. J Neurosurg 2001;94:1-6. [Web of Science][Medline] href=http://thetyee.ca/Mediacheck/2009/07/03/WhatAcronym/"What's in an Acronym? - Jul 3, 2009 TheTyee.caA surgeon might think FSR refers to Fractionated Stereotactic Radiotherapy or Fractionated Stereotactic Radiosurgery. A pilot might conjure the Flight href=http://www.beckersasc.com/news-analysis-asc/business-financial-benchmarking/170-people-to-know-in-the-asc-industry.html"170 People to Know in the ASC Industry - Jul 7, 2009 Becker's ASC ReviewMr. Leland is a managing partner with Blue Chip Surgical Center Partners, which focuses on developing spine, ENT, sleep, radiosurgery and multi-specialty href=http://www.genengnews.com/news/bnitem.aspx?name=57438312"Elekta and Swedfund Invest in Cancer Care in Developing Countries - Jul 1, 2009 Genetic Engineering News (press release)The company develops sophisticated state of the art tools and treatment planning systems for radiation therapy and radiosurgery, as well as workflow Background information on Radiosurgery [When available] Radiosurgery is a medical procedure which allows non-invasive brain surgery, i.e., without actually opening the skull, by means of directed beams of ionizing radiation. It is a relatively recent technique (1951), which is used to destroy, by means of a precise dosage of radiation, intracranial tumors and other lesions that could be otherwise inaccessible or inadequate for open surgery. There are many nervous diseases for which conventional surgical treatment is difficult or has many deleterious consequences for the patient, due to arteries, nerves, and other vital structures being damaged. Definition and applications Radiosurgeons make use of highly sophisticated, highly precise and complex instruments, such as stereotactic devices, linear accelerators, computers and laser beams. In the last 20 years, radiosurgery has been used as a first approach, by exclusion or failure of other techniques or as supplements to them, such as other kinds of brain surgery, chemotherapy and radiotherapy. The highly precise irradiation of targets within the brain is planned by the surgeon with basis on images, such as computed tomography (CT), magnetic resonance imaging (MRI), and angiography of the brain. The radiation is applied coming from an external source, under precise mechanical orientation by a specialized apparatus. Multiple beams are directed (collimated) and centered at the intracranial lesion to be treated. In this way, healthy tissues around the target are preserved. Patients can be treated within one day of hospital stay, or even as outpatients. By comparison, the average hospital stay for a craniotomy (conventional neurosurgery, requiring the opening of the skull) is about 15 days. Radiosurgery costs about the same as a conventional surgery, but it avoids mortality, pain and post-surgical complications, such as hemorrhage and infection. The period of recovery is minimal, and in the day following the treatment the patient may return to his or her normal life style, without any discomfort. Thus, the community gains many socio-economical benefits. The major disadvantage of radiosurgery in relation to open surgery (craniotomy) it is the duration of time required to achieve the desired effects, while its non-invasive character is perhaps its major advantage. Radiosurgery has arisen as the result of many scientific developments which have occurred in the fields of neuroimaging and stereotactic surgery, continue to expand its application areas in neurosurgery, oncology (cancer), surgery of head and neck, and other specialties. History Radiosurgery started with Dr. Lars Leksell from the Karolinska Institute of Stockholm, Sweden, in 1959, in a joint development with Bjorn Larsson, a radiobiologist from Uppsala University. Leksell initially used heavy particles, protons from a to irradiate brain tumor lesions. In 1968, they developed the "gamma knife", a new device exclusively for radiosurgery, which consisted of radioactive sources of Cobalt-60 placed in a kind of helmet with central channels for irradiation, using gamma rays. In the last version of this device, 201 sources of radioactive cobalt direct gamma radiation to the center of a helmet, where the patient's head is inserted. In order to achieve high precision in the positioning of the patient's head, it is placed first on a rigid frame of reference called a stereotactic device. It uses a geometrical coordinate system for each structure of the brain, so the surgeon knows, by using a published atlas, precisely the point where the gamma rays must converge. The stereotactic frame then fits into the helmet. The "Gamma-knife" is used nowadays in four continents for carrying out what is called functional stereotactic neurosurgery, and for the superselective irradiation of tumors and brain arteriovenous malformations. Another type of radiosurgery which has enjoyed great dissemination in neurosurgery was introduced by Betti and Colombo, in the mid 80's, utilizing commercial medical linear accelerators available for radiation therapy in oncology (the so-called LinAc). High energy, narrowly focused beams of x-rays are employed. This system differs from the Gamma Knife in the way the radiation beams are delivered to the patient's head. In a similar way, a stereotactic device is used to provide a geometric coordinates reference, but the radiation beams are emitted by a single source, which rotates slowly around the patient's head. Finally, at some medical centers such as in Boston and in California, particle accelerators built for doing research in high energy physics have been used since the 1960's for the treatment of brain tumors and brain arteriovenous malformations in humans. A still experimental type of radiosurgery, that utilizes a nuclear reactor for the nuclear fission of uranium, is the Neutron Capture Therapy (NCT) which was started in the United States at the nuclear reactor of the Massachusetts Institute of Technology (MIT) in the 60's, with promising results. Nowadays it is carried out as a promising advanced clinical research in several countries, due to the progress and to the results obtained in Japan by Dr. Hiroshi Hatanaka. He used NCT in more than 100 cases in the treatment of malignant tumors and of gigantic arterio-venous malformations. How it works The fundamental principle of radiosurgery is that of selective ionization of the tissue to be operated upon, by means of high-energy beams of radiation. Ionization is the production of inorganic ions which are usually deleterious to the cells, by forming free radicals that are harmful to the cellular and nuclear membranes, and even to the RNA and DNA chains of the cells, producing an irreparable damage to these structures and then the cell's death. Thus, biological inactivation is carried out in a volume of tissue to be treated, with a precise destructive effect. The radiation dose absorbed by the treated mass of tissue is what defines the degree of biological inactivation. It usually is measured in Gray units, where one Gray (Gy) is the absorption of one joule per kg of mass. In order to perform optimal therapy, the neurosurgeon, assisted by physicists specialized in nuclear medicine and often in conjunction with a radiation oncologist, chooses the best type of radiation to be used, and how it will be delivered. Usually, the total dose of radiation required to kill a tumor, for example, is not delivered in a single, massive section, because this would cause undesirable effects on the patient. Instead, it is divided into several sessions of smaller duration and energy dose, in a procedure called dose fractioning. The aim of dose fractioning is to minimize the undesirable damage to healthy tissues, as healthy tissue cells are better than cancerous cells at repairing radiation induced damage between irradiations. In order to plan the radiation incidence and dosage, the physicists calculate a map portraying the lines of equal absorbed dose of radiation upon the patient's head (this is called a isodose map). Information about the tumor's location is obtained from a series of computerized tomograms, which are then feed to special planning computer software. There are five types of irradiation currently used in radiosurgery: electromagnetical waves (gamma rays and x-rays), subatomic particles (protons and neutrons), and carbon ions. The first type of radiation is gamma rays, which are beams of high energy photons that interact with the corona of electrons of the atoms that compose the irradiated tissue, ionizing them. Gamma radiation is used in the "Gamma Knife" device, where they are produced by fixed sources of radioactive cobalt. The second type of radiation, X-rays, are also high energy photons that are identical to gamma rays except for the way they are produced. Radiosurgery can be performed using a linear accelerator, the source being now a commercial medical device of universal use in radiotherapy. The Linac consists of a emitting tube of X radiation, with an energy of 4, 6, or 18 million electron-volts (MeV). The emission head (called "gantry") is mechanically rotated around the patient, in a full or partial circle. The table where the patient is lying, the 'couch,' can also be moved in small linear or angular steps. The combination of the movements of the gantry and of the couch makes possible the computerized planning of the volume of brain tissue which is going to be irradiated. Devices with an energy of 6 MeV are the most suitable for the treatment of the brain, due to the smaller volume to be irradiated. In addition, the diameter of the energy beam leaving the emission head can be adjusted to the size of the lesion by means of interchangeable collimators (an orifice with different diameters, varying from 5 to 40 mm, in steps of 5 mm). There are also multileaf collimators, which consist of a number of metal leaflets that can be moved dynamically during treatment in order to shape the radiation beam to conform to the mass to be ablated. The third type of radiation, protons, is used in Proton Beam Therapy (PBT). Protons are produced by cyclotrons, extracting them from proton donor materials and accelerating them in successive travels through a circular, evacuated conduit, using powerful magnets, until they reach a high energy and are released toward the irradiation target, in the patient's body. Because of the Bragg peak effect, proton therapy has some theoretical advantages over other the other forms of radiation, since most of the proton's energy is deposited within a limited distance, and so tissue beyond this range is spared from the effects of radiation. This property of protons allows for conformal dose distributions to be created around even very irregularly shaped targets. In recent years, however, so-called "intensity modulated" techniques have allowed for similar conformities to be attained using linear accelerator radiosurgery. Neutrons, the fourth type of radiation, are used in Boron neutron capture therapy (BNCT). BCNT depends on the interaction of slow neutrons with boron-10 to produce alpha particles, another type of radiation. Patients are first given an intravenous injection of a boron-10 tagged chemical that preferentially binds tumor cells. The neutrons are created either in a nuclear reactor or by colliding high-energy protons into a Lithium target. The neutrons pass through a moderator, which shapes the neutron energy spectrum suitable for BNCT treatment. Before entering the patient the neutron beam is shaped by a beam collimator. While passing through the tissue of the patient, the neutrons are slowed by collisions and become low energy thermal neutrons. The thermal neutrons undergo reaction with the boron-10 nuclei, forming an unstable boron-11 nucleus which then undergoes spontaneous decay to lithium-7 and an alpha particle. Both the alpha particle and the lithium ion produce closely spaced ionizations in the immediate vicinity of the reaction, with a range of approximately 10 micrometres, or one cell diameter. This technique is advantageous since the radiation damage occurs over a short range and thus normal tissues can be spared. Also, there are two mechanisms for tumor selectivity, since both the boron compound is made to bind to tumor cells and the neutron beam is aimed at the location of the tumor. BNCT has been developed in only in an experimental basis, and it has not entered surgical routine. The selection of the proper kind of radiation and device depends on many factors including lesion type, size and location in relation to critical structures. Data suggests that similar clinical outcomes are possible with all of these methods. More important than the device used are issues regarding indications for treatment, total dose delivered, fractionation schedule and conformity of the treatment plan. Latest generation Linacs are capable of achieving extremely narrow beam geometries, such as 0,15 to 0,3 mm. Therefore, they can be used for several kinds of surgeries which hitherto are carried out by open or endoscopic surgery, such as for trigeminal neuralgia, etc. Radiosurgery of brain tumors Radiosurgery has been especially helpful for the localized, highly precise treatment of brain tumors. Due to the steep fall of the irradiation fields (isodoses) from the center of the target to be destroyed, the biological inactivation happens only on it; while the brain, and other vascular and neural structures around it, are protected. This is achieved through the high mechanical precision of the radiation source, and the assured reproducibility of the target. The precision in the positioning of the patient, in the calculation of dosages, and in the safety of the patient, are all extremely high. Radiosurgery is indicated primarily for the therapy of tumors, vascular lesions and functional disorders. Significant clinical judgment must be used with this technique and considerations must include lesion type, pathology if available, size, location and age and general health of the patient. General contraindications to radiosurgery include excessively large size of the target lesion or lesions too numerous for practical treatment. The non-interference with the quality of life of the patient in the post-operatory period competes with the inconvenience of the latency of months until the result of the radiosurgery is accomplished. Patients with a bad general state of health and those with tumors which are unreachable by conventional means, are specially helped. Rbecome may not be evident for months after the treatment. Since radiosurgery does not remove the tumor, but results in a biological inactivation of the tumor, lack of growth of the lesion is normally considered to be treatment success. Radiosurgery has been used to treat many kinds of brain tumors, such as acoustic neuromas, astrocytomas, gliomas, germinomas, meningiomas, among others. Even highly fatal cancerous metastases in the brainstem can be reduced, leaving the patient neurologically intact. It has been demonstrated by the thousands of successfully treated cases, that radiosurgery can be a very safe and efficient method for the management of many difficult brain lesions, while it avoids the loss in quality of life associated to other more invasive methods. For many indications, such as acoustic neuroma, brain arteriovenous malformations and skull base tumors, radiosurgery has emerged as the treatment of choice. Patients are being treated for lesions which only radiosurgery can solve, or because they prefer it as a first treatment, after receiving complete information of its risks and benefits as compared to the conventional surgery, when the choice is available. In the future, advanced computer methods, such as intensity-modulated radiosurgery will be used to improve the accuracy and scope of radiosurgery. From Wikipedia Background information on Search the web for more resources on Radiosurgery |
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