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 aspire this portal to be a gateway to scientific facts and information, for patients and healthcare professionals.
We remain available for any further information you may need.
Christos Boskos
Radiation Oncologist / Radiosurgeon
Diplome Universitaire in Stereotactic Radiosurgery, Curie University, (Paris VI)
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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 (VESTIBULAR SCHWANNOMA)
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).
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.
Digital Exhibition Hall
Source: Brainlab
https://www.youtube.com/channel/UCKdufRzbyuhkQoGlg3ISpKw
Congresses Regarding SRS
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