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Radiosurgery for Tumors in the Body: Clinical Experience Using a New Method
Henric Blomgren, M.D., Ph.D., Ingmar Lax, Ph.D., Hákan Góranson, M.D.,
Thomas Kraepelien, B.Sc., Bo Nilsson, B.SC., Ingemar Náslund, M.D., Ph.D.,Ruth Svanstróm, M.D., and Aris Tilikidis, Ph.D.
A stereotactic body frame for exact tumor localization, reproducible
fixation, and high-dose fraction irradiation with an accelerator
(radiosurgery) has been developed. With the aid of this body frame,
tumors are usually treated with five to nine static coplanar or
noncoplanar beams yielding a planned inhomogeneous dose distribution
with a 50% higher dose in the center of the tumor compared to the
periphery of the planning target volume. Due to the steep dose
gradient, the surrounding normal tissue is exposed to relatively low
doses. Seventy-five evaluable tumors in 50 patients in whom
conventional treatment modalities had been exhausted or considered
inapplicable have been treated with doses of between 15 and 45 Gy
(mean, 28 Gy) at the periphery of the planning target volume delivered
in one to five fractions (mean, 2.5). The tumors, which had volumes
ranging from 2732 cm (mean, 73 cm'), were mainly metastases, from a
variety of primaries, in the liver, lungs, and retroperitoneal space.
Some primáries such as lung cancer and primary liver cancer were also
treated. During an evaluation period of 1.5-38 months (mean, I 1 months)
22 tumors showed growth arrest (29.3%), 29 were reduced in size (38.7%),
and 24 děsappeared (32%) as judged by computed tomography examinations,
which were usually performed at 2- to 3-month intervals afier radiosurgery.
Four of the tumors were classifica as local failures (5.3%).
This treatment, which is noninvasive, painless, and rapid and does not
require hospitalization, does not impair the quality of life of the
patients when used properly. Treatment has been given regardless of
age and medical status of the patients
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