Stereotactic Radiosurgery

Morbidity and mortality rates

Stereotactic radiosurgery has a low reported rate of serious complications with minimal mortality. One German study reported a 4.8% rate of temporary morbidity in patients under treatment for brain tumors, with no permanent morbidity and no mortality. An American group of researchers found that less than 2% of patients who had eye tumors treated with radiosurgery suffered damage to the optic nerve from the dose of radiation.

Mild side effects following gamma knife radiosurgery are not uncommon, however. One group of British researchers found that 47 out of a group of 65 patients treated with gamma knife surgery had mild or moderate side effects within two weeks of treatment. Of these patients, more than half suffered headaches and a fifth reported unusual tiredness or nausea and vomiting.

Alternatives

With certain types of brain tumors, whole-brain radiation treatment (WBRT) is an option; however, it has a number of severe side effects. Surgical removal of the tumor is another option, but it carries a higher risk of tumor recurrence. For other tumors, gamma knife radiosurgery is the only treatment available as of 2003.

BOOKS

"Acoustic Neuroma." Section 7, Chapter 85 in The Merck Manual of Diagnosis and Therapy, edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 1999.

"Radiation Injury of the Nervous System." Section 14, Chapter 177 in The Merck Manual of Diagnosis and Therapy, edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 1999.

PERIODICALS

Chua, D. T., J. S. Sham, P. W. Kwong, et al. "Linear Accelerator-Based Stereotactic Radiosurgery for Limited, Locally Persistent, and Recurrent Nasopharyngeal Carcinoma; Efficacy and Complications." International Journal of Radiation Oncology, Biology, Physics 56 (May 1, 2003): 177-183.

Ganz, J. C. "Gamma Knife Radiosurgery and Its Possible Relationship to Malignancy: A Review." Journal of Neurosurgery 97 (December 2002) (5 Suppl): 644-652.

Muacevic, A., and F. W. Kreth. "Significance of Stereotactic Biopsy for the Management of WHO Grade II Supratentorial Glioma." [in German] Der Nervenarzt 74 (April 2003): 350-354.

O'Neill, B. P., N. J. Iturria, M. J. Link, et al. "A Comparison of Surgical Resection and Stereotactic Radiosurgery in the Treatment of Solitary Brain Metastases." International Journal of Radiation Oncology, Biology, Physics 55 (April 1, 2003): 1169-1176.

St. George, E. J., J. Kudhail, J. Perks, and P. N. Plowman. "Acute Symptoms After Gamma Knife Radiosurgery." Journal of Neurosurgery 97 (December 2002) (5 Suppl): 631-634.

Sheehan, J. P., M. H. Sun, D. Kondziolka, et al. "Radiosurgery in Patients with Renal Cell Carcinoma Metastasis to the Brain: Long-Term Outcomes and Prognostic Factors Influencing Survival and Local Tumor Control." Journal of Neurosurgery 98 (February 2003): 342-349.

Stafford, S. L., B. E. Pollock, J. A. Leavitt, et al. "A Study on the Radiation Tolerance of the Optic Nerve and Chiasm After Stereotactic Radiosurgery." International Journal of Radiation Oncology, Biology, Physics 55 (April 1, 2003): 1177-1181.

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Author Info: Richard Robinson, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Surgery, 2004

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