RESUMO
Sixty-three patients with metastatic brain tumors have had stereotactic radiosurgery 90 times with the Leksell Gamma Knife over a 29-month period. Initially, a single treatment of 35 to 45 Gy was delivered to the enhanced CT margin. This dose was found to be inadequate for tumor control. We then raised the marginal dose to 50 to 55 Gy, but even this radiosurgical dose did not appear to control tumor growth. However, we have found that metastatic brain tumors can be controlled successfully using enhanced MR scans and a peripheral dose of 60 Gy or even 65 Gy adjacent to the enhanced margins of the metastatic brain tumors, especially melanomas.
Assuntos
Neoplasias Encefálicas/secundário , Radiocirurgia , Adulto , Idoso , Encéfalo/patologia , Encéfalo/cirurgia , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Evolução Fatal , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Melanoma/patologia , Melanoma/secundário , Melanoma/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Neoplasia Residual/patologia , Neoplasia Residual/cirurgia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
The Leksell Gamma Knife is a useful and safe method to perform thalamotomy and pallidotomy in selected older patients with Parkinson's disease and related movement disorders. In this preliminary report, 2 of 3 patients with severe intention tremor were relieved of their symptoms by thalamotomy, as were 4 of 7 patients with Parkinson's tremor. Four of 8 patients had significant improvement of contralateral rigidity following pallidotomy.
Assuntos
Globo Pálido/cirurgia , Doença de Parkinson Secundária/cirurgia , Doença de Parkinson/cirurgia , Radiocirurgia/métodos , Tálamo/cirurgia , Idoso , Idoso de 80 Anos ou mais , Feminino , Globo Pálido/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Rigidez Muscular/patologia , Rigidez Muscular/cirurgia , Exame Neurológico , Doença de Parkinson/patologia , Doença de Parkinson Secundária/patologia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/patologia , Tálamo/patologia , Resultado do Tratamento , Tremor/patologia , Tremor/cirurgiaRESUMO
Stereotactic radiosurgery under local anesthesia with the Leksell Gamma Knife can effectively treat some patients with recurrent tic douloureux after unsuccessful medical/surgical procedures. Seven of 12 patients have shown complete relief or improvement of their trigeminal neuralgia. No complications have been observed.
Assuntos
Complicações Pós-Operatórias/cirurgia , Neuralgia do Trigêmeo/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Medição da Dor , Complicações Pós-Operatórias/fisiopatologia , Recidiva , Reoperação , Raízes Nervosas Espinhais/fisiopatologia , Raízes Nervosas Espinhais/cirurgia , Tomografia Computadorizada por Raios X , Gânglio Trigeminal/fisiopatologia , Gânglio Trigeminal/cirurgia , Nervo Trigêmeo/fisiopatologia , Nervo Trigêmeo/cirurgia , Neuralgia do Trigêmeo/fisiopatologiaRESUMO
Aggressive radiation therapy for the management of inoperable lung cancer has increased tumor control and survival. However, approximately 20% of patients continue to experience local recurrence as the sole manifestation of treatment failure. Seven hundred thirty-four patients were initially treated by radiation therapy for inoperable lung cancer, for recurrence after resection, or as adjunct postoperative therapy. Twenty-nine patients were referred for retreatment of cancer that recurred within the original treatment field. Following retreatment, 14 of 29 patients (48%) had a favorable subjective response, and 20 of 27 patients (74%) a favorable objective response. A favorable response was observed for all cell types and over a wide range of retreatment dosages. Symptomatic radiation pneumonitis developed in one patient, rib sclerosis and fracture developed in another. Th median survival after onset of retreatment was five months with a range of one month to 54 months. The clinically determined mechanisms of death were persistent intrathoracic disease in 14 of 25 patients (56%), intrathoracic disease and distant metastasis in 7 of 25 (28%), distant metastasis in 3 of 25 (12%), and unknown in 1 of 25 (4%).
Assuntos
Neoplasias Pulmonares/radioterapia , Recidiva Local de Neoplasia/radioterapia , Adulto , Idoso , Feminino , Humanos , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/cirurgia , Masculino , Neoplasias do Mediastino/secundário , Pessoa de Meia-Idade , Prognóstico , Fatores de TempoAssuntos
Intestino Delgado/lesões , Neoplasias da Próstata/radioterapia , Lesões por Radiação/etiologia , Idoso , Humanos , Intestino Delgado/diagnóstico por imagem , Intestino Delgado/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Lesões por Radiação/prevenção & controle , Radiografia , Radioterapia de Alta EnergiaRESUMO
Between 1965 and 1973, 80 patients with prostatic carcinoma were treated with definitive supervoltage irradiation; 35 patients received adjuvant estrogens. A favorable tumor response was uniformly observed in patients with less advanced tumors who received a minimum of 6,000 rads tumor dose and adjuvant estrogens. Radiation complications were frequent and severe in patients with locally advanced tumors who had antecedent lower urinary tract surgery and received a minimum of 7,000 rads tumor dose. Complications were less frequent in patients who received adjuvant estrogens, and complications were uncommon and mild in patients who received less than 7,000 rads.
