Biological Insights and Radiation-Immuno-Oncology Developments in Primary and Secondary Brain Tumors.

Malignant central nervous system (CNS) cancers include a group of heterogeneous dis-eases characterized by a relative resistance to treatments and distinguished as either primary tumors arising in the CNS or secondary tumors that spread from other organs into the brain. Despite therapeutic efforts, they often cause significant mortality and morbidity across all ages. Radiotherapy (RT) remains the main treatment for brain cancers, improving associated symptoms, improving tumor control, and inducing a cure in some.

Sequential administration of carbon nanotubes and near-infrared radiation for the treatment of gliomas.

The objective was to use carbon nanotubes (CNT) coupled with near-infrared radiation (NIR) to induce hyperthermia as a novel non-ionizing radiation treatment for primary brain tumors, glioblastoma multiforme (GBM). In this study, we report the therapeutic potential of hyperthermia-induced thermal ablation using the sequential administration of carbon nanotubes (CNT) and NIR. In vitro studies were performed using glioma tumor cell lines (U251, U87, LN229, T98G).

Cerebral arteriovenous malformations: issues of the interplay between stereotactic radiosurgery and endovascular surgical therapy.

Intracranial arteriovenous malformations (AVMs) are congenital lesions frequently diagnosed as a result of hemorrhage or other neurological symptoms. Prevention of such devastating neurological injury has promoted a variety of treatment strategies. The rich history of multimodal therapy in the treatment of AVMs includes microsurgery, endovascular embolization, and stereotactic radiosurgery (SRS).

HIV- positive anal cancer: an update for the clinician.

Anal cancer used to be a rare cancer traditionally associated with elderly women. There are approximately 5260 cases per year in the U.S.

Long-term outcomes and patterns of tumor progression after gamma knife radiosurgery for benign meningiomas.

Object: To characterize the timing and patterns of long-term treatment failure after Gamma Knife radiosurgery (GKRS) for benign meningiomas.

Methods: Data were retrospectively reviewed in 116 patients who underwent 136 GKRS treatments for benign intracranial meningiomas from 1996 to 2004. Patients with atypical or malignant meningiomas were excluded.

Early decreased tumor volume following fractionated Gamma Knife Radiosurgery for metastatic melanoma and the role of "adaptive radiosurgery": case report.

Objective: We report a case in which fractionated gamma knife radiosurgery was used to treat a metastatic melanoma lesion. The tumor demonstrated a rapid response to radiosurgery with an observable reduction in tumor volume between the second and third treatments, requiring a favorable modification in the third fractionated treatment.

Clinical Presentation: A 61-year-old woman presented with a frontal floor metastatic melanoma lesion that was located adjacent to the optic apparatus.

Delayed toxicity from gamma knife radiosurgery to lesions in and adjacent to the brainstem.

The aims of this study were to assess the incidence of, and risk factors for, delayed toxicity following gamma knife stereotactic radiosurgery (GKRS) to lesions in and adjacent to the brainstem. We retrospectively evaluated the delayed toxicity of GKRS following the treatment of 114 lesions in and adjacent to the brainstem in 107 patients. The median tumor volume was 6.

Chained lightning: part III--Emerging technology, novel therapeutic strategies, and new energy modalities for radiosurgery.

Radiosurgery is fundamentally the harnessing of energy and delivering it to a focal target for a therapeutic effect. The evolution of radiosurgical technology and practice has served toward refining methodologies for better conformal energy delivery. In the past, this has resulted in developing strategies for improved beam generation and delivery.

Postoperative Gamma Knife surgery for benign meningiomas of the cranial base.

Object: The standard treatment for meningiomas is complete resection, but the proximity of skull base meningiomas to important neurovascular structures makes complete excision of the lesion difficult or impossible. The authors analyzed the mid- and long-term results obtained in patients treated with postresection Gamma Knife surgery (GKS) for residual or recurrent benign meningiomas of the cranial base.

Methods: Thirty-six patients with residual or recurrent benign meningiomas of the skull base following one or more surgical procedures underwent GKS.

Chained lightning, part II: neurosurgical principles, radiosurgical technology, and the manipulation of energy beam delivery.

The fundamental principle in the radiosurgical treatment of neurological conditions is the delivery of energy to a lesion with minimal injury to surrounding structures. The development of radiosurgical techniques from Leksell's original design has focused on the refinement of various methodologies to achieve energy containment within a target. This article is the second in a series reviewing the evolution of radiosurgical instruments with respect to issues of energy beam generation and delivery for improved conformal therapy.

Chained lightning, part I: Exploitation of energy and radiobiological principles for therapeutic purposes.

The fundamental principle of radiosurgery is the focusing of energy within a restricted target volume. In examining the history of radiosurgery, various strategies for addressing this issue of energy containment become apparent. This is the first in a series of articles that reviews the evolution of radiosurgery through the development of instruments for beam generation and delivery for improved conformal therapy.

Stereotactic radiosurgery: adjacent tissue injury and response after high-dose single fraction radiation. Part II: Strategies for therapeutic enhancement, brain injury mitigation, and brain injury repair.

In the first part of this series, we reviewed the histological, radiographic, and molecular data gathered regarding the brain parenchymal response to radiosurgery and suggested future studies that could enhance our understanding of the topic. With this article, we begin by addressing methods of potentiating the effect of radiosurgery on target lesions of the central nervous system. Much of the work on potentiating the effects of cranial radiation has been performed in the field of whole-brain radiotherapy.

Stereotactic radiosurgery: adjacent tissue injury and response after high-dose single fraction radiation: Part I--Histology, imaging, and molecular events.

Radiosurgery is now the preferred treatment modality for many intracranial disease processes. Although almost 50 years have passed since it was introduced as a tool to treat neurological disease, investigations into its effects on normal tissues of the central nervous system are still ongoing. The need for these continuing studies must be underscored.