The role of gamma knife radiosurgery in the treatment of primary and metastatic brain tumors

Current Opinion in Oncology

Volumn 15, Issue 3, 2003, Pages 188-196

  Gerosa, Massimo ^a   Nicolato, Antonio ^a   Foroni, Roberto ^a  

^a UNIVERSITY HOSPITAL OF VERONA   (Italy)

Author keywords

[No Author keywords available]

Indexed keywords

ASTROCYTOMA; BRAIN; BRAIN METASTASIS; BRAIN SCINTISCANNING; BRAIN TUMOR; CANCER CHEMOTHERAPY; CANCER GRADING; DOCUMENTATION; GAMMA KNIFE RADIOSURGERY; GLIOBLASTOMA; HUMAN; NEUROBIOLOGY; NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY; PRIORITY JOURNAL; RADIOBIOLOGY; RADIOSENSITIVITY; REVIEW; TUMOR RECURRENCE;

BRAIN NEOPLASMS; CARCINOMA, RENAL CELL; CLINICAL TRIALS; FEMALE; GLIOMA; HUMANS; KIDNEY NEOPLASMS; MALE; MELANOMA; PROGNOSIS; RADIOSURGERY; RISK ASSESSMENT; SURVIVAL ANALYSIS; TREATMENT OUTCOME;

EID: 0038348537     PISSN: 10408746     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001622-200305000-00002     Document Type: Review

References (120)

1. Leksell L: Stereotaxis and Radiosurgery. An Operative System. Springfield, III.: Charles C. Thomas; 1971:1-66.
2. Bhatnagar A, Heron DE, Kondziolka D, et al.: Analysis of repeat stereotactic radiosurgery for progressive primary and metastatic CNS tumors. Int J Radiat Oncol Biol Phys 2002, 53:527-532. Among the first reports analyzing the problems of GKR re-irradiation. Documented bibliography on radiobiologic questions for radiation necrosis.
3. Laws ER Jr, Thapar K: Brain tumors. CA Cancer J Clin 1993, 43:263-271.
4. Nwokedi EC, Di Biase SJ, Jabbour S, et al.: Gamma knife stereotactic radiosurgery for patients with glioblastoma multiforme. Neurosurgery 2002, 50:41-47. Analysis of the potential role of GKR as a boost in HGG treatment. Excellent compendium of basic references.
5. Cancer statistics, 1988. CA-A 1988, 38:5-22.
6. Stylopous LA, George AE, De Leon MJ, et al.: Longitudinal CT study of parenchymal brain changes in glioma survivors. AJNR 1988, 9:517-522.
7. Choucair AK, Scott C, Urtasun R, et al.: Quality of life and neuropsychological evaluation for patients with malignant astrocytomas: RTOG 91-14. Int J Radiat Oncol Biol Phys 1997, 38:9-20.
8. Lantos PL, Vandernberg SR, Kleihues P: Tumors of the nervous system: epidemiology and etiology. In Greenfield's Neuropathology. Edited by Graham DI, Lantos PL. London: G. Arnold; 1997, 2:583-588.
9. Kida Y, Kobayashi T, Mori Y: Gamma knife radiosurgery of lowgrade astrocytomas: results of long-term follow-up. J Neurosurg 2000, 93(suppl 3):42-46.
10. Velema JP, Percy CL: Age curves of central nervous system tumor incidence in adults. Variations of shape by histologic type. J Natl Cancer Inst 1987, 79:623-629.
11. Kleihues P, Burger PC, Scheithauer BW: Histological Typing of Tumors of the Central Nervous System. Berlin: Springer Verlag; 1993.
12. Salcman M: Surgical resection of malignant brain tumors: who benefits? Oncology 1988, 2:47-63.
13. Simpson JR, Horton J, Scott C: Influence of location and extent of surgical resection on survival of patients with glioblastoma multiforme: results of three consecutive Radiation Therapy Oncology Group (RTOG) clinical trials. Int J Radiat Oncol Biol Phys 1993 26:239-244.
14. Walker MD, Green SB, Byar DP: Randomized comparison of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. N Engl J Med 1980, 303:1323-1329.
15. Walker MD, Strike TA, Sheline GE: An analysis of dose-effect relation in the radiotherapy of malignant gliomas. Int J Radiat Oncol Biol Phys 1979, 5:1725-1731.
16. Tatter SB: Recurrent malignant glioma in adults. Curr Treat Options Oncol 2002, 3:509-524. Exhaustive survey of treatment options in HGG.
17. Fuchs I, Kreil W, Sutter B, et al.: Gamma knife radiosurgery for brainstem gliomas. Acta Neurochir Suppl 2002, 84:85-90. One of the largest published series on Gkr for brainstem gliomas.
18. Jawahar A, Kondziolka D, Flickinger JC, et al.: Adjuvant stereotactic radiosurgery for anaplastic ependymomas. Stereotact Funct Neurosurg 1999, 73:23-30.
19. Larson DA, Gutin PH, McDermott M, et al.: Gamma knife for glioma: selection factors and survival. Int J Radiat Oncol Biol Phys 1996, 36:1045-1053.
20. Croteau D, Mikkelsen T, Rempel SA, et al.: New innovations and developments for glioma treatment. Clin Neurosurg 2001, 48:60-81. Interesting review of multimodality updated treatment options for gliomas.
21. Reddy AT: Advances in biology and treatment of childhood brain tumors. Curr Neurol Neurosci Rep 2001, 1:137-143.
22. Regine WF, Patchell RA, Strottmann JM, et al.: Combined stereotactic split-course fractionated gamma knife radiosurgery and conventional radiation therapy for unfavorable gliomas: a phase 1 study. J Neurosurg 2000, 93(suppl 3):37-41.
23. Gutin PH, Prados MD, Phillips TL, et al.: External irradiation followed by an interstitial high activity iodine-125 implant "boost" in the initial treatment of malignant gliomas. Int J Radiat Oncol Biol Phys 1991, 21:601-606.
24. Souhami L, Olivier A, Podgorsak E, et al.: Fractionated stereotactic radiation therapy for intracranial tumors. Cancer 1991, 68:2101-2108.
25. Hall EJ, Brenner DJ: Radiobiology for radiosurgery: rationale for different treatment regimens for AVMS and malignancies. Int J Radiat Oncol Biol Phys 1993, 25:381-385.
26. Wara WM, Bauman GS, Sneed PK, et al.: Brain, brainstem and cerebellum. In Principles and Practice of Radiation Oncology, edn 3. Edited by Perez CA, Brady LW. Philadelphia: Lippincott-Raven; 1998:777-828.
27. Silbergeld DL, Chicoine MR: Isolation and characterization of human malignant glioma from histologically normal brain. J Neurosurg 1997, 86:525-531.
28. Bleehen NM, Stenning SP: A Medical Research Council trial of two radiotherapy doses in the treatment of grade 3 and 4 astrocytoma. The Medical Research Council Brain Tumor Working Party. Br J Cancer 1991, 64:769-774.
29. Marks JE, Baglan RJ, Prassad SC, et al.: Cerebral radionecrosis: incidence and risk in relation to dose, time, fractionation, and volume. Int J Radiat Oncol Biol Phys 1981, 7:243-252.
30. Laperriere NJ, Leung PMK, McKenzie S, et al.: Randomized study of brachytherapy in the initial management of patient with malignant astrocytoma. Int J Radiat Oncol Biol Phys 1998, 41:1005-1011.
31. Videtic GM, Gaspar LE, Zamorano L, et al.: Use of the RTOG recursive partitioning analysis to validate the benefit of iodine-125 implants in the primary treatment of malignant gliomas. Int J Radiat Oncol Biol Phys 1999, 45:687-692.
32. Cho KH, Hall WA, Gerbi BJ, et al.: Single dose versus fractionated stereotactic radiotherapy for recurrent high grade gliomas. Int J Radiat Oncol Biol Phys 1999, 45:1133-1141
33. Foote KD, Friedman WA, Buatti JM, et al.: Linear accelerator radiosurgery in brain tumor management. Neurosurg Clin N Am 1999, 10:203-242.
34. Graves EE, Nelson SJ, Vigneron DB, et al.: Serial proton MR spectroscopic imaging of recurrent malignant gliomas after gamma knife radiosurgery. AJNR 2001, 22:598-601. Basic contribution to functional neuroimaging of GKR in HGG.
35. Levivier M, Wikler D, Goldman S, et al.: Integration of the metabolic data of positron emission tomography in the dosimetry planning of radiosurgery with the gamma knife: early experience with brain tumors-Technical note. J Neurosurg 2000, 3(suppl 3):233-238.
36. Graves EE, Nelson SJ, Vigneron DB, et al.: A preliminary study of the prognostic value of proton magnetic resonance spectroscopic imaging in gamma knife radiosurgery of recurrent malignant gliomas. Neurosurgery 2000, 46:319-326.
37. Eder HG, Leber KA, Eustacchio S, et al.: The role of gamma knife radiosurgery in children. Childs Nerv Syst 2001, 17:341-346.
38. Flickinger JC, Kondziolka D, Lunsford LD: Clinical applications of stereotactic radiosurgery. Cancer Treat Res 1998, 93:283-297.
39. Kondziolka D, Flickinger JC, Bissonette DJ, et al.: Survival benefit of stereotactic radiosurgery for patients with malignant glial neoplasms. Neurosurgery 1997, 41:776-785.
40. Park YG, Kim EY, Chang JW, et al.: Volume changes following gamma knife radiosurgery of intracranial tumors. Surg Neurol 1997, 48:488-493.
41. Curran WJ, Scott C, Horton J, et al.: Recursive partitioning analysis of prognostic factors in three radiation therapy oncology group malignant glioma trials. J Natl Cancer Inst 1993, 85:704-710.
42. Niranjian A, Witham T, Kondziolka D, et al.: The role of stereotactic cyst aspiration for glial and metastatic brain tumors. Can J Neurol Sci 2000, 27:229-235.
43. MacDonald DR, Cascino TL, Schold SC, et al.: Response criteria for phase II studies of supratentorial malignant glioma. J Clin Oncol 1990, 8:1277-1280.
44. Ross DA, Sandler HM, Balter JM, et al.: Imaging changes after stereotactic radiosurgery of primary and secondary malignant brain tumors. J Neurooncol 2002, 56:175-181. Critical re-appraisal of the role of MRF-spectroscopy and FDG-PET in evaluating GKR tumor response versus tumor recurrence.
45. Hoffman HJ, Soloniuk US, Humphreys RP, et al.: Management and outcome of lowgrade astrocytomas of the midline in children: a retrospective review. Neurosurgery 1993, 33:964-971.
46. Fiepmeier J, Christopher S, Spencer D: Variation in the natural history and survival of patients with supratentorial low-grade astrocytomas. Neurosurgery 1996, 38:872-879.
47. Bouffet E, Perilongo G, Canete A, et al.: Intracranial ependymomas in children. A critical review of prognostic factors and a plea for cooperation. Med Pediatr Oncol 1998, 30:319-331.
48. Hadjipanayis CG, Kondziolka D, Gardner R, et al.: Stereotactic radiosurgery for pilocytic astrocytomas when multimodality therapy is necessary. J Neurosurg 2002, 97:56-64. Excellent presentation of GKR in the multimodality treatment of pilocytic astrocytomas.
49. Sutton LN, Molloy PT, Sernyak H, et al.: Long-term outcome of hypothalamic/chiasmatic astrocytomas in children treated with conservative surgery. J Neurosurg 1995, 83:583-589.
50. Stieber VW: Low-grade gliomas. Curr Treat Options Oncol 2001, 2:495-506. Reliable critical review of the main surgical, radiation, chemotherapy options of LGG.
51. Freeman CR, Farmer JP, Montes J: Low-grade astrocytomas in children: evolving management strategies. Int J Radiat Oncol Biol Phys 1998, 41:979-987.
52. Hayostek CJ, Shaw EG, Scheithauer B, et al.: Astrocytomas of the cerebellum. A comparative clinico-pathologic study of pilocytic and diffuse astrocytomas. Cancer 1993, 72:856-869.
53. Constine LS, Woolf PD, Cann D, et al.: Hypothalamic-pituitary dysfunction after radiation for brain tumors. N Engl J Med 1993, 328:87-94.
54. Duffner PK, Cohen ME, Thomas PR, et al.: The long-term effects of cranial irradiation of the central nervous system. Cancer 1985, 56(suppl 7):1841-1946.
55. Glauser TT, Packer RJ: Cognitive deficits in long-term survivors of childhood brain tumors. Childs Nerv Syst 1991, 7:2-12.
56. Lim YJ, Leem W: Two cases of gamma knife radiosurgery for low-grade optic chiasm glioma. Stereotact Funct Neurosurg 1996, 66(suppl 1):174-183.
57. Hirato M, Nakamura M, Inoue HK, et al.: Gamma Knife radiosurgery for the treatment of brainstem tumors. Stereotact Funct Neurosurg 1995, 64(suppl 1):32-41.
58. Regis J, Bartolomei F, Rey M, et al.: Rôle de la radiochirurgie gamma knife dans le traitement des epilepsies severes. Rev Neurol (Paris) 2002, 158:405-411. GKR to treat severe temporomesial epilepsies of different origin, including LGG.
59. Shamisa A, Bance M, Nag S, et al.: Glioblastoma multiforme occurring in a patient treated with gamma knife surgery. Case report and review of the literature. J Neurosurg 2001, 94:816-821. Important radiobiologic and oncological contribution, to better define any potential alarm concerning late sequelae of this technique.
60. Posner JB: Management of brain metastases. Rev Neurol (Paris) 1992, 148:477-487.
61. Sano K: Intracranial metastatic tumors. An overview. In Neuro-Oncology. Edited by Paoletti P, Takakura K, Walker MD, et al.: Dordrecht: Kluwer. 1991:309-319.
62. Larson DA, Gutin PH, Leibel SA, et al.: Stereotactic irradiation of brain tumors. Cancer 1990, 65:792-799.
63. Black P, Alexander E III, Loeffler JS: New treatments for metastatic brain tumors. In Current Techniques in Neurosurgery. Current Medicine Publ., 2nd edn. Edited by Salcman M. Philadelphia: 1996:151-156.
64. Patchell RA, Tibbs PA, Walsh JW, et al.: A randomized trial of surgery in the treatment of single brain metastases to the brain. N Engl J Med 1990, 322:494-500.
65. Smith KA: Metastatic brain tumors: gamma knife radiosurgery or microsurgical resection? BNI Q 1997, 13:22-29.
66. Loeffler JS, Kooy HM, Wen PY, et al.: The treatment of recurrent brain metastases with stereotactic radiosurgery. J Clin Oncol 1990, 8:576-582.
67. Peretti-Viton P, Margain D, Murayama N, et al.: Les métastases cérébrales. J Neuroradiol 1991, 18:161-172.
68. Coia LR: The role of radiation therapy in the treatment of brain metastases. Int J Radiat Oncol Biol Phys 1992, 23:229-238.
69. Delarive J, De Tribolet N: Métastases cérébrales. Etude d'un collectif chirurgical de 81 cas. Neurochirurgie 1992, 38:89-97.
70. Smalley SR, Laws ER, O'Fallon JR, et al.: Resection for solitary brain metastases. J Neurosurg 1992, 77:531-540.
71. Penar PL, Wilson JT: Cost and survival analysis of metastatic cerebral tumors treated by resection and radiation. Neurosurgery 1994, 34:388-394.
72. Arbit E, Wronski M: The treatment of brain metastases. Neurosurgery Q 1995, 5:1-17.
73. Hoskin PJ, Crow J, Ford HT: The influence of extent and local management on the outcome of radiotherapy for brain metastases. Int J Radiat Oncol Biol Phys 1990, 19:111-115.
74. Loeffler JS, Alexander E III, Wen PY, et al.: Radiosurgery for brain metastases: five-year experience of the Brigham and Women's Hospital. In Stereotactic Radiosurgery Update. Edited by Lunsford LD. Amsterdam: Elsevier; 1992:383-392.
75. Arnold SM, Patchell RA: Diagnosis and management of brain metastases. Hematol Oncol Clin North Am 2001, 15:1085-1107.
76. Van De Bent MJ: The diagnosis and management of brain metastases. Curr Opin Neurol 2001, 14:717-723.
77. Becker G, Jeremic B, Engel C, et al.: Radiosurgery for brain metastases: the Tuebingen experience. Radiother Oncol 2002, 62:233-237.
78. Di Biase SJ, Chin LS, Ma L: Influence of gamma knife radiosurgery on the quality of life in patients with brain metastases. Am J Clin Oncol 2002, 25:131-134. Excellent analysis, using Spitzer QOL survey of quality of life in patients treated with GKR for brain metastases. Results of the specifically applied test seem to be substantially predictive of tumor response to treatment.
79. Flickinger JC: Radiotherapy and radiosurgical management of brain metastases. Curr Oncol Rep 2001, 3:484-489.
80. Gerosa M, Nicolato A, Severi F, et al.: Gamma knife radiosurgery for intracranial metastases: from local tumor control to increased survival. Stereotact Funct Neurosurg 1996, 66(suppl 1):184-192.
81. Kim DG, Chung HT, Gwak HS, et al.: Gamma knife radiosurgery for brain metastases. Prognostic factors for survival and local control. J Neurosurg 2000, 93(suppl 3):23-29.
82. Kondziolka D, Lunsford LD, Flickinger JC: Controversies in the management of multiple brain metastases: the roles of radiosurgery and radiation therapy. Forum (Genova) 2001, 11:47-58.
83. Marcou Y, Lindquist C, Adams C, et al.: What is the optimal therapy of brain metastases? Clin Oncol (R Coll Radiol) 2001, 13:105-111.
84. Muacevic A, Kreth FW, Horstmann GA, et al.: Surgery and radiotherapy compared with gamma knife radiosurgery in the treatment of solitary cerebral metastases of small diameter. J Neurosurg 1999, 91:35-43.
85. Nakagawa K, Tago M, Terahara A, et al.: A single-institutional outcome analysis of gamma knife radiosurgery for single or multiple brain metastases. Clin Neurol Neurosurg 2000, 102:227-232.
86. Sansur CA, Chin LS, Ames JW, et al.: Gamma knife radiosurgery for the treatment of brain metastases. Stereotact Funct Neurosurg 2000, 74:37-51.
87. Koehler M, Merlo A: Treatment of brain metastases. Ther Umsch 2001, 58:732-733.
88. Mehta M, Noyes W, Craig B, et al.: A cost-effectiveness and cost-utility analysis of radiosurgery vs. resection for single brain metastases. Int J Radiat Oncol Biol Phys 1997, 39:445-454.
89. Rutigliano MJ, Lunsford LD, Kondziolka D, et al.: The cost effectiveness of stereotactic radiosurgery versus surgical resection in the treatment of solitary metastatic brain tumors. Neurosurgery 1995, 37:445-455.
90. Amendola BE, Wolf AL, Coy SR, et al.: Brain metastases in renal cell carcinoma: management with gamma knife radiosurgery. Cancer J 2000, 6:372-376.
91. Goyal LK, Suh JH, Reddy CA, et al.: The role of whole brain radiotherapy and stereotactic radiosurgery on brain metastases from renal cell carcinoma. Int J Radiat Oncol Biol Phys 2000, 47:1007-1012.
92. Mori Y, Kondziolka D, Flickinger JC, et al.: Stereotactic radiosurgery for brain metastases from renal cell carcinoma. Cancer 1998, 83:344-353.
93. Payne BR, Prasad D, Szeifert G, et al.: Gamma surgery for intracranial metastases from renal cell carcinoma. J Neurosurg 2000, 92:760-765
94. Schoggl A, Kitz K, Ertl A, et al.: Gamma knife radiosurgery for brain metastases of renal cell carcinoma: results in 23 patients. Acta Neurochir (Wien) 1998, 140:549-555
95. Wowra B, Siebels M, Muacevic A, et al.: Repeated gamma knife surgery for multiple brain metastases from renal cell carcinoma. J Neurosurg 2002, 97:785-793. One of the largest published studies on GKR for renal cancer BMs (350 treated lesions) including analysis of predictive factors.
96. Lavine SD, Petrovich Z, Cohen-Gadol AA, et al.: Gamma knife radiosurgery for metastatic melanoma: an analysis of survival, outcome and complications. Neurosurgery 1999, 44:59-66.
97. Mingione V, Oliveira M, Prasad D, et al.: Gamma surgery for melanoma metastases in the brain. J Neurosurg 2002, 96:544-551. Results of GKR in melanoma BMs are reviewed and parametrized according to the most used predictive indexes: KPS, primary tumor control, etc., with interesting remarks.
98. Mori Y, Kondziolka D, Flickinger JC, et al.: Stereotactic radiosurgery for cerebral metastatic melanoma: factors affecting local disease, control and survival. Int Radiat Oncol Biol Phys 1998, 42:581-589.
99. Seung SK, Sneed PK, McDermott MW, et al.: Gamma knife radiosurgery for malignant melanoma brain metastases. Cancer J Sci Am 1998, 4:80-83.
100. 3, and inactive systemic disease (P = 0.0065)
101. Ohta Y, Oda M, Tsunezuka Y, et al.: Results of recent therapy for non-small-cell lung cancer with brain metastases as the initial relapse. Am J Clin Oncol 2002, 25:476-479. A rare study on a small group of patients with NSCLC and brain metastases as the initial relapse, treated by GKR.
102. Yamanaka K, Iwai Y, Nakajima H, et al.: Treatment for brain metastases from lung cancer in the era of radiosurgery. No Shinkei Geka 2001, 29:617-623.
103. Firlik KS, Kondziolka D, Flickinger JC, et al.: Stereotactic radiosurgery for brain metastases from breast cancer. Ann Surg Oncol 2000, 7:333-338.
104. Mandell L, Hilaris B, Sullivan M, et al.: The treatment of single brain metastases from non-oat-cell lung carcinoma. Surgery and radiation vs. radiation alone. Cancer 1986, 58:641-649.
105. Gaspar L, Scott C, Rotmann M, et al.: Recursive-Partitioning-Analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 1997, 37:745-751.
106. Buchsbaum JC, Suh JH, Lee SY, et al.: Survival by radiation therapy oncology group recursive-partitioning-analysis class and treatment modality in patients with brain metastases from malignant melanoma. Cancer 2002, 94:2265-2272.
107. Vecht CJ, Haaxima-Reiche H, Noordijk EM, et al.: Treatment of single brain metastases: radiotherapy alone or combined with neurosurgery? Ann Neurol 1993, 33:583-590.
108. Schackert G, Steinmetz A, Meier U, et al.: Surgical management of single and multiple brain metastases: results of a retrospective study. Onkologie 2001, 24:246-255.
109. Schiff D: Single brain metastases. Curr Treat Options Neurol 2001, 3:89-99.
110. Sanghavi SN, Miranpuri SS, Chappel R, et al.: Radiosurgery for patients with brain metastases: a multi-institutional analysis, stratified by the RTOG recursive-partitioning analysis method. Int J Radiat Oncol 2001, 51:426-434.
111. Brown PD, Brown CA, Pollock BE, et al.: Stereotactic radiosurgery for patients with "radioresistant" brain metastases. Neurosurgery 51:665-667. An extensive investigation on GKR treatment of radioresistant BMs: melanoma, renal cell carcinoma, sarcoma. Results of the three oncotypes are parametrized according to RPA, analyzing the different rates of local recurrence and of distant brain failure.
112. Yamamoto M, Ide M, Nishio S, et al.: Gamma knife radiosurgery for numerous brain metastases. Is this a safe treatment? Int J Radiat. Oncol Biol Phys 2002, 53:1279-1283. This is one of the very few published investigations on GKR treatment of an extremely high (10 and more) number of BMs. Brain tolerance to radiation exposure seems higher than expected, at least in short-term follow-up.
113. Wronski M, Maor MH, Davis BJ, et al.: External radiation of brain metastases from renal carcinoma: a retrospective study of 119 patients from the M.D., Anderson Cancer Center. Int J Radiat Oncol Biol Phys 1997, 37:753-759.
114. Ikushima H, Tokuuye K, Sumi M, et al.: Fractionated stereotactic radiotherapy for brain metastases from renal cell carcinoma. Int J Radiat Oncol Biol Phys 2000, 48:1389-1393.
115. Douglas JG, Margolin K: The treatment of brain metastases from malignant melanoma. Semin Oncol 2002, 29:518-524.
116. Huang CF, Kondziolka D, Flickinger JC, et al.: Stereotactic radiosurgery for brainstem metastases. J Neurosurg 1999, 91:563-568.
117. Nicolato A, Ferraresi P, Bontempini L, et al.: Multiple brain metastases from "lymphoepithelioma-like" thyroid carcinoma: a combined stereotactic-radiosurgical approach. Surg Neurol 2001, 55:232-234.
118. Uchino M, Nagao T, Seiki Y, et al.: Radiosurgery for cystic metastatic brain tumor. No Shinkei Geka 2000, 28:417-421.
119. Niranjan A, Moriuchi S, Lunsford LD, et al.: Effective treatment of experimental glioblastoma by HSV vector-mediated TNF alpha and HSV-tk gene transfer in combination with radiosurgery and ganciclovir administration. Mol Ther 2000, 2:114-120.
120. Minami H, Kanagawa K, Watanabe Y, et al.: Combination of stereotactic radiosurgery and cytokine gene-transduced tumor cell vaccination: a new strategy against metastatic brain tumors. J Neurosurg 2001, 95:984-989.