Radiosurgery within Neurosurgery : As Primary Surgery or as Part of a Multi-Modality Approach(<SPECIAL ISSUES>Stereotactic Radiosurgery Past, Present and Future)

概要

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The incorporation of stereotactic radiosurgery into neurosurgery represents a fundamental paradigm shift in our specialty. Intracranial radiosurgery has been the most developed model for a minimal access procedure that seeks to treat disease on a biologic rather than mechanical basis. Over the last 20 years at our center, over 8,000 patients had radiosurgery for disorders that included cerebrovascular malformations, benign and malignant intracranial tumors, and selected functional disorders. Approximately 600 to 700 procedures are performed annually. Metastatic tumors represent the fastest growing indication for radiosurgery. Neurosurgeons should be exposed to formal training in stereotactic radiosurgery, either within residency or practice if a new program is instituted. At our center, residents complete a four month educational experience, and for practicing physicians, we conduct six one-week immersion courses each year. Radiosurgery should be incorporated into residency training and general neurosurgical practice because it has important roles in the majority of intracranial disorders managed by neurosurgeons. We discuss the indications, techniques, and expectations of stereotactic radiosurgery for brain disorders, either as primary or adjuvant management.
日本脳神経外科コングレスの論文
2008-06-20