Stereotactic Radiosurgery Techniques and Quality Assurance for Brain Metastases | Chapter 12 | Highlights on Medicine and Medical Research Vol. 2

The most common intracranial tumors that form in up to 40 percent of all adult cancers over the course of the disease are brain metastases (BMs), a significant cause of cancer-related morbidity and mortality. Stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT) was assured of global acceptance by radiation oncologists for the victorious treatment of BMs, noting the weak prognosis of these patients with other therapies, including whole-brain radiotherapy (WBRT). Furthermore, the rapid introduction of the SRS/FSRT to the routine radiation oncology procedure was incited by other skepticisms on cognitive decline and comparably lower tumor control rates provided by the traditional WBRT. However, the extraordinary differences between the treatment algorithms and the gamma knife, linear accelerator (LINAC), tomotherapy, robotic cyberknife, or proton therapy-based SRS treatment planning systems allow the administration of SRS/FSRT severely stressful. On that basis, the present chapter intended to provide an intensive layout of the requisite standards of the SRS/FSRT procedures from the initial patient fixation to the final quality assurance steps of guaranteeing the system quality and effective delivery of the prescribed dose.

Author (s) Details

Erkan Topkan
Department of Radiation Oncology, Baskent University Medical Faculty, Adana, Turkey.

Ahmet Kucuk
Mersin City Education and Research Hospital, Radiation Oncology Clinics, Mersin, Turkey.

Sukran Senyurek
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.

Duygu Sezen
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.

Nulifer Kilic Durankus
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.

Eyub Yasar Akdemir
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.

Yucel Saglam
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.

Yasemin Bolukbasi
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.

Berrin Pehlivan
Department of Radiation Oncology, Bahcesehir University, Istanbul, Turkey.

Ugur Selek
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.

View Book :- https://stm.bookpi.org/HMMR-V2/issue/view/20

Management of Brain Metastases with Preoperative Radiosurgery | Chapter 11 | Highlights on Medicine and Medical Research Vol. 2

Nearly 30 percent to 54 percent of all patients are diagnosed with the most common intracranial tumor brain metastases (BMs) during or after their solid cancer treatment courses. Although the prognosis is extremely poor for BM patients, the estimated median OS is usually less than 7 months. However, nowadays, after the implementation of effective systemic and local therapies, such as surgery and radiotherapy, some patient groups can experience significantly longer survival periods (RT). Neurosurgery, whole-brain RT (WBRT), definitive SRS, postoperative SRS, systemic chemotherapy, targeted therapies, immunotherapy and their various mixtures are currently noteworthy alternatives for the management of BMs. Regarding the local treatment maneuvers, the well-recognized severe neurotoxicity of WBRT and the augmented risk for radionecrosis and leptomeningeal dissemination after postoperative SRS and the ineligibility of certain patients during the postoperative period mandated the search for safer and potentially more effective treatment alternatives for such patients' group. In this regard, it was proposed that the novel preoperative SRS (PO-SRS) should provide at least comparable local control rates with a lower risk of radionecrosis and leptomeningeal spread. This chapter describes the conceivable rationale and available evidence for the new PO-SRS in the management armamentarium for cancer patients who have BMs.

Author (s) Details

Erkan Topkan
Department of Radiation Oncology, Baskent University Medical Faculty, Adana, Turkey.

Ahmet Kucuk
Mersin City Education and Research Hospital, Radiation Oncology Clinics, Mersin, Turkey.

Sukran Senyurek
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.

Duygu Sezen
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.

Nulifer Kilic Durankus
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.

Eyub Yasar Akdemir
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.

Esma Didem Ikiz
Department of Radiation Oncology, Kahramanmaras Necip Fazil City Hospital, Kahramanmaras, Turkey.

Yasemin Bolukbasi
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.

Berrin Pehlivan
Department of Radiation Oncology, Bahcesehir University, Istanbul, Turkey.

Ugur Selek
Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.

View Book :- https://stm.bookpi.org/HMMR-V2/issue/view/20