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2005, Número 5

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Gac Med Mex 2005; 141 (5)


Radiocirugía estereotáxica con acelerador lineal (LINAC). Informe de la experiencia técnica en el manejo de 100 casos en el Hospital General de México

Lujan-Castilla PJ, Duran-Cruz M, Enríquez-Barrera M, García-Muñóz L, Hernández-Oviedo JO, Barragán-Pérez JA

Idioma: Español
Referencias bibliográficas: 49
Paginas: 367-382
Archivo PDF: 90.34 Kb.


RESUMEN

La radiocirugía estereotáxica consiste en la liberación de una dosis única y grande de radiación a una lesión intracraneal, pequeña, bien definida y localizada estereotáxicamente. Objetivo: El objetivo de este estudio es detallar las consideraciones técnicas y correlacionarlas con los resultados clínicos, así como reportar los márgenes de dosis utilizados. Métodos: Fueron tratados 100 pacientes mediante radiocirugía estereotáxica con LINAC. Treinta y cuatro casos de malformaciones arteriovenosas, 22 meningiomas, 18 astrocitomas, 11 adenomas hipofisiarios, 5 angiomas cavernosos, 3 neurinomas del acústico, 3 craneofaringiomas, 2 casos de epilepsia, una metástasis cerebral y un ependimoma. Las dosis de radiación utilizadas variaron en cada caso. Variables estudiadas: respuesta de la lesión, toxicidad, dosis al volumen blanco, número de isocentros, número de arcos de tratamiento, número de colimadores, dosis a órganos riesgo, homogeneidad volumen blanco, margen de error, volumen blanco, diámetro de colimadores y localización del volumen blanco. Se realizó la prueba χ2 con significancia estadística p ‹ 0.05. La media seguimiento fue de 17.7 meses. Resultados: Se presentaron tres casos de toxicidad menor. Se confirmó que a mayor volumen blanco tratado será necesario mayor número de arcos de tratamiento, con amplio margen de error y mayor número de isocentros. Conclusión: La radiocirugía es un método seguro y confiable para el manejo de entidades patológicas benignas y malignas intracraneales.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Zernoff DN. L’encephalomethre. Rev Gen Clin Ther 1890;4:302-305.

  2. Phillips MH, Stelzer KJ, Griffin TW, et al. Stereotactic radiosurgery: a review and comparison of methods. J Clin Oncol 1994;12:1085-1099.

  3. Leksell L. The stereotactic method and radiosurgery of the brain. Acta Chir Scand 1951;102:316-319.

  4. Lunsford LD, Flickinger J, Lindner G, et al. Stereotactic radiosurgery of the brain using the first United States 201 cobalt-60 source gamma knife. Neurosurgery 1989;24:151-159.

  5. Gunderson LL, Tepper JE, et al. Clinical radiation oncology. Churchill-Livingstone 2000:218.

  6. Friedman WA, Bova FJ, Spiegelmann R. Linear accelerator radiosurgery at the University of Florida. Neurosurgery Clinics of North America 1992;3:140-166.

  7. Betti OO, Derechinsky VE. Hyperselective encephalic irradiation with linear accelerator. Acta Neurochir Suppl (Wien) 1984;33:385-390.

  8. Tsai JS, Buck BA, Svensson GK. Quality assurance in stereotactic radiosurgery using a standard linear accelerator. Int J Radiat Oncol Biol Phys 1991;21:737-748.

  9. Germano IM et al. Linac and Gamma Knife radiosurgery. The American Association of Neurological Surgeons 2000:20-26.

  10. Lutz W, Winston KR, Maleki N. A system for stereotactic radiosurgery with a linear accelerator. Int J Radiat Oncol Biol Phys 1988;14:373-381.

  11. Steiner L, Forster D, Leksell L, et al. Gammathalamotomy in intractable pain. Acta Neurochir (Wien) 1980;52:173-184.

  12. Ramírez-Castañeda V. Radiocirugía con acelerador lineal. Gac Med Mex 2003;139:572-578

  13. Mendez I, Namihira D, Moreno L y cols. El protocolo de investigación.2000,México,Trillas.2ª.ed.

  14. Tsai JS, Buck BA, Svensson GK, et al. Quality assurance in stereotactic radiosurgery using a standard linear accelerator. Int J Radiat Oncol Biol Phys 1991;21:737-748.

  15. 44th Annual meeting of the American Society for Therapeutic Radiology and Oncology. 2002.

  16. Betti OO, Munari C,Rosler R. Stereotactic radiosurgery with the linear accelerator: treatment of arteriovenous malformations. Neurosurgery 1989;24:311-321.

  17. Colombo F, Benedetti A, Pozza F, et al. Linear accelerator radiosurgery of cerebral arteriovenous malformations. Neurosurgery 1989;24:833-840.

  18. Souhami L, Olivier A, Podgorsak EB, et al. Radiosurgery of cerebral arteriovenous malformations with the dynamic stereotactic irradiation. Int J Radiat Oncol Biol Phys 1990;19:775-782.

  19. Loeffler JS, Alexander E III, Siddon RL, et al. Stereotactic radiosurgery for intracranial arteriovenous malformations using a standard linear accelerator. Int J Radiat Oncol Biol Phys 1989;17:673-677.

  20. Hakim R, Alexander E III, Loeffler JS, et al. results of linear accelerator-based radiosurgery for intracranial meningiomas. Neurosurgery 1998;42:446-454.

  21. Mitsumori M, Shrieve DC, Alexander E III, et al. Initial clinical results of LINAC-based stereotactic radiosurgery and stereotactic radiotherapy for pituitary adenomas. Int J Radiat Oncol Biol Phys 1998;42:573-580.

  22. Barcia JA, Barcia-Salorio JL, Lopez-Gomez L, et al. Stereotactic radiosurgery may be effective in the treatment of idiopathic epilepsy: report on the methods and results in a series of eleven cases. Stereotact Funct Neurosurg 1994;63:271-279.

  23. Shaw E, Scott C, Souhami L, et al. Radiosurgery for the treatment of previously irradiated recurrent primary brain tumors and brain metastases: initial report of Radiation Therapy Oncology Group protocol 90-05. Int J Radiat Oncol Biol Phys 1996;34:647-654.

  24. Friedman WA, Blatt DL, Bova FJ, et al. The risk of hemorrhage after radiosurgery for arteriovenous malformations. J Neurosurg 1996;84:912-919.

  25. American Association of Neurological Surgeons Task Force, American Society of Therapeutic Radiology and Oncology Task Force: Consensus statement on stereotactic radiosurgery: quality improvement. Neurosurgery 1994;34:193-195.

  26. Colombo F, Benedetti A, Pozza F, et al. External stereotactic irradiation by linear accelerator. Neurosurgery 1985;16:154-160.

  27. Hartmann GH, Schlegel W, Sturm V, et al. Cerebral radiation surgery using moving field irradiation at a linear accelerator facility. Int J Radiat Oncol Biol Phys 1985;11:1185-1192.

  28. Nedzi LA, Kooy H, Alexander E III, et al. Variables associated with the development of complications from radiosurgery of intercranial tumors. Int J Radiat Oncol Biol Phys 1991;21:591-599.

  29. Lyman JT, Phillips MH, Frankel KA, et al. Stereotactic frame for neuroradiology and charged particle Bragg peak radiosurgery of intracranial disorders. Int J Radiat Oncol Biol Phys 1989;16:1615-1621.

  30. Larson DA, Loeffler JS, Flickinger J. Radiobiology of radiosurgery. Int J Radiat Oncol Biol Phys 1993;25:557.

  31. Hall EJ, Brenner DJ. The radiobiology of radiosurgery: rationale for different treatment regimens for AVMs and malignancies. Int J Radiat Oncol Biol Phys 1993;25:381-385.

  32. Larson DA. Radiosurgery dose and corresponding total radiotherapy dose. Int J Radiat Oncol Biol Phys 1993;12:557-561.

  33. Loeffler JS, Siddon RL, Wen PY, et al. Stereotactic radiosurgery of the brain using a standard linear accelerator: a study of early and late effects. Radiother Oncol 1990;17:311-321.

  34. Sheline GE, Wara WM, Smith V. Therapeutic irradiation and brain injury. Int J Radiat Oncol Biol Phys 1980;6:1215-1228.

  35. Alexander E, moriarty TM, Davis RB, et al. Stereotactic radiosurgery for the definitive, noninvasive treatment of brain metastases. J Natl Cancer Inst 1995;87:34-40

  36. Breneman JC, Warnick RE, Albright RE, et al. Stereotactic radiosurgery for the treatment of brain metastases; results of a single institution series. Cancer 1996;79:551-557

  37. Joseph J, Adler JR, Cox RS, et al. Linear accelerator based stereotactic radiosurgery for brain metastases: the influence of number of lesions on survival. J Clin Oncol 1996;14:1085-1092.

  38. Flickinger JC, Kondziolka D, Lunsford LD, et al. A multi-institutional experience with stereotactic radiosurgery for solitary brain metastasis. Int J Radiat Oncol Biol Phys 1994;28:797-802.

  39. Schultheiss TE, Stephens LC, Maor MH. Analysis of the histopathology of radiation myelopathy. Int J Radiat Oncol Biol Phys 1988;14:27-32.

  40. Boyd TS, Mehta MP. A comprehensive review of the role of radiosurgery in patients with intracranial metastases. Radiosurgery 1997;2:31-50

  41. Loeffler JS, Alexander E. Radiosurgery for the treatment of intracranial metastases. Stereotactic Radiosurgery,McGraw-Hill,NY, 1993.

  42. Flickinger JC, Kondziolka D, Lunsford. Principles of dose prescription and risk minimization for radiosurgery. Porg Neural Surg 1998;13:39-50.

  43. Danoff BF, Cowchock FS, Marquette C, et al. Statement of the long term effects of primary irradiation therapy for brain tumors in children. Cancer 1982;4:1580-1586.

  44. Kondziolka D, Dempsey PK, Lunsford LD, et al. A comparison between magnetic resonance imaging and computed tomography for stereotactic coordinate determinatior. Neurosurgery 1992;30(3):402-406.

  45. Landi A, Marina R, DeGrandi C, et al. Accuracy of stereotactic localization with magnetic resonance compared to CT scan: experimental findings. Acta Neurochir 2001;143(6):593-601.

  46. Holtzheimer PE, Roberts DW, Darcey TM. Magnetic resonance imaging versus computed tomography for target localization in functional stereotactic neurosurgery. Neurosurgery 1999;45(2):290-297.

  47. Yu C, Apuzzo ML, Zee CS, et al. A phantom study of the geometric accuracy of computed tomographic and magnetic resonance imaging stereotactic localization with the Leksell stereotactic system. Neurosurgery 2001;48(5):1092-1098.

  48. Choi DR, Ahn YC, Kim DY, et al. Accuracy in target localization in stereotactic radiosurgery. Med Dosis 1997;22(1):53-58.

  49. Karger CP, Hipp P, Henze M, et al. Stereotactic imaging for radiotherapy: accuracy of CT, MRI, PET and SPECT. Physics in Medicine and Biology 2003;48(2):211-221.




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