       Document 0811
 DOCN  M9650811
 TI    Gamma Knife radiosurgery of primary and metastatic malignant brain
       tumors, a preliminary report.
 DT    9605
 AU    Gerosa MA; Nicolato A; Berlucchi S; Piovan E; Zampieri PG; Pasoli A;
       Foroni R; Giri MG; Marchini G; Babighian S; et al; Department of
       Neurosurgery, University Hospital, Verona, Italy.
 SO    Stereotact Funct Neurosurg. 1995;64 Suppl 1:56-66. Unique Identifier :
       AIDSLINE MED/96151256
 AB    Between February 1993 and March 1994, 75 metastases, 16 gliomas and 2
       AIDS-related malignant lymphomas were treated with Gamma Knife
       radiosurgery. Metastatic brain tumors (54% lung cancer, 14% breast
       cancer, 13.5% melanoma) were the most frequent and clinically rewarding
       cases. So-called local control was achieved in almost all patients, the
       vast majority showing neurological improvement associated with
       radiological disappearance or dramatic shrinkage of the tumor within
       9-12 weeks from treatment. According to our modified 'Pittsburgh'
       protocol, we have treated up to four distinct intracranial lesions, up
       to a total maximum volume of 20 cm3, with an average surface dose of 25
       Gy, with or without additional whole brain radiotherapy (WBR).
       Preliminary follow-up data seem to confirm increased quality of life and
       survival rates. The results were particularly striking whenever primary
       tumors were under control, and were poorly influenced by associated WBR.
       Gamma Knife treatment was also performed in a selected group of patients
       with small-to-medium-sized, well-defined, histologically proven,
       cerebral gliomas. The main indications for radiosurgery were high-risk
       surgery, multifocal disease, ventricular seeding and unresected or
       recurrent tumor. The prescription doses ranged from 18 to 30 Gy, with a
       mean of 27 Gy. Low-grade astrocytomas (9/16 cases) showed the better
       clinical and radiological response to treatment, with neurological
       recovery and significant reduction in tumor volume within 3-5 months in
       5 of the 9 patients. In 4 of 7 high-grade gliomas, there was little or
       no response. However, an impressive radiological regression with full
       clinical recovery was observed in 2 high-grade cases with small tumor
       volumes: a recurrent, anaplastic 'mixed glioma' of the pineal region and
       a double ventricular seeding of a previously operated anaplastic
       astrocytoma.
 DE    Brain Neoplasms/SECONDARY/*SURGERY  Female  Follow-Up Studies
       Glioma/*SURGERY  Human  Lymphoma, AIDS-Related/*SURGERY  Magnetic
       Resonance Imaging  Male  Middle Age  *Radiosurgery  Retrospective
       Studies  Treatment Outcome  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

