Recent advances in steriotactic radiosurgery
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Transcript of Recent advances in steriotactic radiosurgery
The term “radiosurgery” has been modified to; the stereotactic application in one to five fractions of high-dose radiation to a target with ablative intent, where “high dose” means more than 2–3 Gy, fractional doses commonly used in conventional radiotherapy.
Recent advances in robotics and technology resulted in: Leksell Gamma Knife Perfexion Cyberknife and enhanced RT systems Spinal stereotactic radiosurgery
Dynamic shaping
Suboccipital targets
Extracranial targets
Multiple targets
Gamma knife with Extend program
The 2 major limitations of the gamma The 2 major limitations of the gamma knife are:knife are:
(1) stereotactic frame(2) inability to treat lesions far away from the cranium
HOWEVERHOWEVER,
Limitations of standard radiation Limitations of standard radiation techniques for treating spinal tumors:techniques for treating spinal tumors:1)treatment fields extending up to two vertebral segments above and below the target to compensate for set-up errors and patient movement during treatment
2)close proximity of the spinal cord typically makes it impossible to exclude it from the highest dose region
3)relapse within the treatment field is not uncommon BUT unacceptable to use larger and more therapeutically beneficial doses, given the risk of spinal cord injuries such as radiation-induced myelopathy
Immobilisation
CT simulation & Treatment planning
Spinal arteriovenous malformations
Benign Spinal tumors
Combined kyphoplasty and spinal radiosurgery for spinal
mets
Thank YouThank You