Continuous scientific update and training on Stereotactic Radiosurgery (SRS)

Stereotactic Radiosurgery (SRS) Brain meningioma: treatment with success rates up to 99%

Stereotactic Radiosurgery (SRS) brain metastases:
Treatment in one session with success rates> 95%

Stereotactic Radiosurgery (SRS) brain tumors:

non-invasive, radical treatment

Stereotactic Radiosurgery (SRS):

possibility of repeat treatment

Stereotactic Radiosurgery (SRS)

brain and spinal cord:
treatment with an accuracy of less than 1 mm

Stereotactic Radiosurgery (SRS) :

complete treatment in less than an hour

Introduction Note

Stereotactic Radiosurgery (SRS) is a specialized treatment using external ionizing radiation in order to inactivate or destroy strictly defined intracranial and spinal targets, with no need of surgical operation (surgical excision).

The purpose of creating this Stereotactic Radiosurgery portal is to inform both scientists and patients about SRS treatment, as well as the indications and requirements needed, so it can be safely and effectively done.

Through the pages of “radiosurgery.gr” we will provide you with all the latest treatment and research developments regarding Stereotactic Radiosurgery in Greece and worldwide.

We remain available for any further information you may need.

We aspire this portal to be a gateway to scientific facts and information, for patients and healthcare professionals.

Christos Boskos

Radiation Oncologist / Radiosurgeon

Diplome Universitaire in Stereotactic Radiosurgery, Curie University, (Paris VI)

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✔ SPECIALIZED

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✔ RELIABLE SCIENTIFIC NETWORK

✔ SPECIALIZED SYSTEMS OF STEREOTACTIC RADIOSURGERY

The History of «Stereotactic Radiosurgery»

Considering the definition given by Lars Leksell, a Swedish neurosurgeon, a few decades ago, when he invented the first SRS device (the first Gamma-knife), we could still describe “Stereotactic Radiosurgery” as a form of treatment delivering a high-dose of ionizing radiation to a precise target (stereo tactic) in a pre-defined space.

Since 1951, when Leksell introduced in his article this “minimal invasive” treatment a lot of things has changed. However, the principals and basic features of SRS treatment remain the same.

Back then, treatment targets were limited to malignant or benign neoplasms and anatomical malformations of the brain. Stereo tactic precision of these targets was achieved by using an immobilizing metallic head frame. This method is applied until today, ensuring maximal accuracy of SRS treatment.

What are the Principles of SRS?

All methods of SRS share common principles.

Using specialized hardware and software, multiple small beams of radiation are focused on a target that has been pre-selected by the treating physicians. Targets often vary, from tumors (benign or malignant) to other anatomical and/or functional ones.

Each beam has very little effect on the normal tissue it passes through until it reaches the target. Then, a biologically significant targeted dose of radiation bombs the area where all the beams are precisely focused.

SRS Indications

Indications for treatment with Stereotactic Radiosurgery (SRS) include intracranial and extracranial tumors, benign or malignant, primary or metastatic. Indications also include the so-called “functional” and “anatomical malformations”.

In summary, the main indications for Stereotactic Radiosurgery (SRS) are:

➦ Brain metastasis, both solitary (one) and multiple.

➦ Meningiomas

➦ Acoustic Neuroma

➦Pituitary tumors (secreting and non-secreting)

➦ Arteriovenous malformations (AVM)

➦ “Low-Grade” Gliomas

➦ Trigeminal Neuralgia

➦ Primary or Metastatic tumors of the Spinal Cord

➦ Chordomas and Chondrosarcomas scull base

➦ Paragangliomas (Glomus Jugulare)

➦ Hemangioblastomas

➦ Craniopharyngiomas

➦ Spasticity treatment, neurological disorders such as Parkinson’s disease and essential tremor

➦ Re-irradiation of primary and secondary tumors

Patients with the conditions listed above are not all eligible for Stereotactic Radiosurgery.

Only by examining their medical record by specialized doctors will they know if their condition needs treatment with Stereotactic Radiosurgery.

SRS Applications

Acoustic Neuroma

Acoustic neuroma (Vestibular schwannoma) is a benign tumor of the vestibular nerve (VIII cranial nerve). These benign lesions represent 5-10% of all intracranial tumors and occur in a ratio of about 1 per 100,000 population.

Most common symptoms include hearing loss (hearing loss to deafness), tinnitus, dizziness and vertigo.

Local disease control rates for patients treated with Stereotactic Radiosurgery (SRS) ranged from 90-99% with far fewer complications than surgical resection (maintaining hearing, facial nerve functions and sensory function of the trigeminal nerve).

Meningioma

Meningioma is the most common primary intracranial tumor among adults,
accounting for approximately 30% of all the cases.

Meningiomas are mostly benign lesions. The tumors are most common in older patients, with the highest rate in people in their 70s and 80s.

Meningioma is about three times more common in women than in men. Some of the risk factors associated with meningiomas are previous treatment with intracranial radiation therapy and neurofibromatosis type 2, while there seems to be a colleration between meningiomas and elevated estrogen and progesterone levels, that has not been scientifically proven yet.

Brain metastases

Brain metastases occur when cancer cells spread from their original site to the brain.
Any cancer can spread to the brain, but the types most likely to cause brain metastases are lung, breast, colon, kidney and melanoma.

Trigeminal Neuralgia

Trigeminal neuralgia (TN), referred to as “tic doloureux” by the French neurosurgeon
André, is a severe, unilateral, lancinating, and electric-like facial pain. It remains the
most common neuralgia but with a low global incidence of 4–5 cases per 100,000
persons.

Frequently Asked Questions regarding SRS

• What will the effect of SRS will be on the tumor ?

SRS manages the necrosis of the tumor and cessation of its growth, followed by its reduction. The success rates of the treatment (response) in many cases even exceed 95%. Malignant tumors are presented with a faster response and a higher risk of local recurrence when compared with benign ones.

• How soon will my symptoms go away after SRS treatment ?

Response to SRS treatment with remission of symptoms can occur in a few days or even longer. It depends on the histological type and grade, the size and extent of the lesion, the tumor location and other factors.

• Can SRS be combined with other forms of treatment ?

SRS can, for sure, be combined successively with Surgical resection, Radiotherapy, Chemotherapy and Immunotherapy. In fact, in cases of lung cancer, concomitant administration of Immunotherapy is proved to be the most efficient in achieving local control of the disease.

Introduction Note