Charged-Particle Radiosurgery of the Brain

Heavy-Charged-Particle Radiosurgery of the Pituitary Gland: Clinical Results of 840 Patients

“…In the earlier years of the program, patients with vario.us disorders underwent treatment to effect hormonal suppression of disease by induction of hypopituitarism; this included 183 patients with metastatic breast carcinoma and 169 patients with diabetic retinopathy, as well as selected patients with prostatic carcinoma and other adenohypophyseal hormoneresponsive malignancies (Table 1) [6,7,8,9,10,11,12]. In 1958, the charged-particle radiosurgery program was expanded to include patients with endocrine and metabolic disorders of the pituitary gland, i.e., acromegaly, Cushing's disease, Nelson's syndrome, prolactinsecreting adenomas and chromophobe adenomas [8,11,13,14,15,16].…”

“…In 1958, the charged-particle radiosurgery program was expanded to include patients with endocrine and metabolic disorders of the pituitary gland, i.e., acromegaly, Cushing's disease, Nelson's syndrome, prolactinsecreting adenomas and chromophobe adenomas [8,11,13,14,15,16]. ·In the 441 patients with hormone-secreting tumors, the therapeutic goal has been to destroy or inhibit the growth of the pituitary tumor and control hormonal hypersecretion, while preserving a functional rim of tissue with normal hormone-secreting capacity, and minimizing neurologic injury [11,13,15]; an additional 34 patients with nonsecreting chromophobe adenomas were treated to alleviate sequelae of an expanding mass lesion (Table 1).…”

“…Bragg Peak: Each charged-particle beam can be directed stereotactically te place uniquely shaped three-dimensienal high-dese regiens precisely within the brain by adjusting the range, by spreading the Bragg peak, by intreducing tissue-equivalent cempensaters, and by using an apprepriately-shaped aperture [11,17]. Several entry angles are chesen se that the high-dese regiens .of the individual beams intersect within the target velume.…”

“…The tumor and its relati<:mships to adjacent neural structures are defined on stereotactiC MRI scans, and the radio surgiCal target is delineated [11]. The radiosurgical treatment plan is designed to place higher dose in the tumor mass lying within the sella and lower dose in any tumor mass extending into extrasellar tissues.…”

Image correlation of MRI and CT in treatment planning for radiosurgery of intracranial vascular malformations

“…The radiosurgical treatment of AVMs is based on the delivery of a uniform radiation dose to the arterial com~onent of the lesion while attempting to spare the venous stru.ctures, damage to which could compromise normal tissue [3,4,8,9].…”