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Steven A. Leibel and Glenn E. Sheline

R adiation therapy is an effective adjunct to surgery in the treatment of incompletely resected primary neoplasms of the brain. Except for recent prospective studies in patients with anaplastic astrocytomas and glioblastoma multiforme, the efficacy of radiation therapy has been based on retrospective analyses of patients treated in single institutions. These patients have usually been collected over a long period of time and have been treated using a variety of techniques. These studies are limited by a lack of uniform criteria for selection of patients for

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Albert M. Petty, Larry E. Kun, and Glenn A. Meyer

M eningiomas are benign intracranial neoplasms which constitute approximately 15% of all primary brain tumors. Surgical removal is the treatment of choice for these lesions; the role of radiation therapy, either as a primary or postoperative modality, remains to be established. Several investigators have been impressed with the relative insensitivity of meningiomas to irradiation and thus have concluded that radiation therapy has little value in the management of these tumors. 4, 8, 11, 14 In contrast, recent reports, including those of Bouchard, 2 Wara, et

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Robert P. Iacono, Michael L. J. Apuzzo, Richard L. Davis, and Fong Y. Tsai

radiation as a cause of meningiomas. Case Report This 31-year-old black woman was admitted to our institution in September, 1979, with chief complaints of headache, nausea, difficulty in walking, and blurred vision. In 1952, at the age of 3 years, she had undergone a posterior fossa craniectomy for medulloblastoma and had subsequently received radiation therapy with a total of 5000 rads to the region of tumor. She had a history of primary amenorrhea. At the age of 22 years, she was diagnosed as having Turner's syndrome and subsequently received estrogen replacement

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Friedrich W. Kreth, Peter C. Warnke, Rudolf Scheremet, and Christoph B. Ostertag

) with those of surgical resection plus irradiation performed between 1986 and 1988 (resection group). Clinical Material and Methods The pathohistological diagnosis of glioblastoma was established using the criteria defined by Burger and colleagues. 4–7 The criteria for complete irradiation were: 1) beginning radiation therapy within 3 weeks after surgery; and 2) application of a conventionally fractionated radiation dose (1.7 to 2.0 Gy/day) to a total dose of 50 to 60 Gy. Therefore, in most cases whole-brain irradiation was combined with a tumor “boost.” There

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Juji Takeuchi, Kiyoshi Kikuchi, Yuta Shibamoto, and Ichiro Fujisawa

chiasm. Outcome by patient's age, tumor site, and treatment. J Neurosurg 68: 85–98, 1988 3. Borit A , Richardson EP Jr : The biological and clinical behaviour of pilocytic astrocytomas of the optic pathways. Brain 105 : 161 – 187 , 1982 Borit A, Richardson EP Jr: The biological and clinical behaviour of pilocytic astrocytomas of the optic pathways. Brain 105: 161–187, 1982 4. Brand WN , Hoover SV : Optic gliomas in children. Review of 16 cases given megavoltage radiation therapy. Childs Brain

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Antti Servo and Matti Puranen

patients had received previous radiation therapy for optic gliomas. Intracranial occlusive disease secondary to radiation has been reported. 7, 16 We report an additional case of neurofibromatosis with cerebral arterial occlusive disease after radiation therapy. Case Report This 17-year-old boy presented for neurological evaluation. At the age of 1½ years, he had received a course of irradiation, with a total of 4200 rads, postoperatively for an optic glioma. The irradiation was given over a period of 4 weeks through two opposing temporal ports and one anterior

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Leland Rogers and Minesh Mehta

— — Radiation Therapy Radiation therapy improves local control. Factors considered in the decision to use radiotherapy include the extent of resection, 24 , 85 , 128 , 133 grade, 103 , 104 and histological subtype. 76 Secondarily, one might also consider imaging findings such as edema and calcifications, 49 , 80 , 89 age, 55 , 99 and perhaps menopausal status, 55 although these remain less well defined. Data pertaining to a total of 42 studies with 4585 patients treated with radiotherapy or radiosurgery are summarized in Tables 6 and 7 . These data substantiate

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Early results of ion beam radiation therapy for sacral chordoma

A Northern California Oncology Group study

William M. Saunders, Joseph R. Castro, George T. Y. Chen, Philip H. Gutin, J. Michael Collier, Sandra R. Zink, Theodore L. Phillips, and Grant E. Gauger

C hordomas are malignant neoplasms that are thought to arise from remnants of the embryonic notochord. In almost all cases they occur along the craniospinal axis, with about 50% occurring in the sacrococcygeal region, 35% in the base of the skull, and 15% in the spine. 2, 4 Complete resection of these tumors is often difficult due to their intimate association with critical peripheral nerves or central nervous system (CNS) structures. Patients with a chordoma are therefore frequently referred for radiation therapy following a biopsy or an incomplete resection

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Thomas J. Reagan, Harry F. Bisel, Donald S. Childs Jr., Donald D. Layton, Albert L. Rhoton Jr., and William F. Taylor

permitted them to understand and to carry out the requirements of the study and if there was no evidence of other serious illness. When a patient met these criteria and consented to participate in the study, the treatment program was selected by a random procedure. Therapy was started within 2 weeks of surgery. The three treatment programs were radiation therapy alone, chemotherapy alone, and combined radiation and chemotherapy. A total of 75 patients were randomized in the study. Of the 75 patients, 12 were excluded from analysis because of major protocol violations

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Gary J. Redekop, Kost V. Elisevich, Laurie E. Gaspar, Karen P. Wiese, and Charles G. Drake

year, with a combined morbidity and mortality rate of nearly 3% annually. While surgical treatment remains the procedure of choice for many, if not most, AVM's, radiation therapy and endovascular techniques have assumed a more prominent role in recent years. 8 Radiotherapy in the treatment of AVM's has been the subject of several recent reviews 16, 33, 44 and there have been a series of reports documenting the results of focused irradiation using the gamma knife, 27, 48, 49 linear accelerator, 2, 5, 26, 45 proton beam, 23, 47 and helium ion beam. 20