Gamma knife surgery for cancer pain—pituitary gland—stalk ablation: a multicenter prospective protocol since 2002

• DOI: 10.3171/jns.2002.97.supplement_5.0433
• Publication Date: 2018-11-16T05:38:28Z
• Authors: Motohiro Hayashi; Takaomi Taira; Mikhail Chernov; Seiji Fukuoka; Roman Liscak; Chung Ping Yu; Robert T. K. Ho; Jean Regis; Yoko Katayama; Yoriko Kawakami; Tomokatsu Hori
• Keywords: Lung Neoplasms; Polymers; Antigens, CD34; Stereotaxic Techniques; brain metastasis; brainstem tumor; gamma knife; melanoma; radiosurgery; renal cell carcinoma; Activities of Daily Living; Factor VIII -- analysis; Cooperative Behavior; Melanoma; Oral Ulcer; Cells, Cultured; Bone Marrow Transplantation; Cysts; brainstem tumor; Sciences bio-médicales et agricoles; Prognosis; Survival Rate; Dystonia; Evaluation Studies as Topic; Child, Preschool; Cerebrovascular Circulation; Pituitary Gland; Acute Disease; Cell Division; Rotation; Oligodendroglioma; Neurosurgery; Vision Disorders; 610; Gamma knife; Radiation Dosage; 03 medical and health sciences; Neurologie; melanoma; Endothelium; RNA, Messenger; Neoplasms, Squamous Cell; Retrospective Studies; Aged; Vascular -- pathology; Astrocytoma -- radionuclide imaging; Cranial Nerve Diseases; Ki-67 Antigen; Cranial Fossa, Posterior; Brain Neoplasms -- chemistry; Neuritis/complications; Uveal Neoplasms; Cranial Sinuses; Weight-Bearing; Astrocytoma -- metabolism; Postoperative Complications; Hearing; Thalamus; Risk Factors; Carcinoma, Non-Small-Cell Lung; Carcinoma, Small Cell; Brain Neoplasms -- radionuclide imaging; Nuclear Proteins; Neuroma, Acoustic; Treatment Outcome; Intracranial Hemorrhages; Malignant astrocytoma; Intracranial Arteriovenous Malformations; Adult; gamma knife; Adolescent; Pain; Skull Base Neoplasms; Imaging, Three-Dimensional; Antigens; CD34 -- analysis; Prostatic Neoplasms; Radiosurgery*; Telephone; Quality of Life; Gels; Male; Microsurgery; Neoplasms, Radiation-Induced; Skin Neoplasms; Trigeminal Neuralgia/surgery*; Visual Acuity; Craniopharyngioma; Cognition; 0302 clinical medicine; Surveys and Questionnaires; Pons; Meningeal Neoplasms; Prospective Studies; Child; Tomography; Aged, 80 and over; Phantoms, Imaging; Brain Neoplasms; Incidence; Palliative Care; Headache; Proto-Oncogene Proteins c-mdm2; Sarcoma; Kidney Neoplasms; 3. Good health; Dry Eye Syndromes; Artifacts; Meningioma; Neurilemmoma; Tomography, Emission-Computed; Cyclin-Dependent Kinase Inhibitor p21; Adenoma; Quality Control; renal cell carcinoma; Multiple Sclerosis; Trigeminal Neuralgia/etiology*; Astrocytoma -- surgery; Movement; Essential Tremor; Hypothalamus; Bone Neoplasms; Adenocarcinoma; Radiosurgery; Hypopituitarism; Disease-Free Survival; Subthalamic Nucleus; Cyclins; Vimentin; Humans; Sella Turcica; Pituitary Neoplasms; Sweden; Factor VIII; Dose-Response Relationship, Radiation; Recovery of Function; Fibroblasts; Survival Analysis; Gamma Rays; Emission-Computed; Endothelium, Vascular; Software; Antimetabolites; Cohort Studies; Recurrence; brain metastasis; Treatment Failure; Skull Base; radiosurgery; Angiography; Parkinson Disease; Cell Differentiation; Glioma; Middle Aged; Trigeminal Neuralgia/pathology; Combined Modality Therapy; Magnetic Resonance Imaging; Vascular Neoplasms; Neuritis/virology; Sensation Disorders; Colonic Neoplasms; Cavernous Sinus; Female; Reoperation; Brain Neoplasms -- metabolism; Rest; Histopathology; Breast Neoplasms; Astrocytoma; Brain Neoplasms -- pathology; Immobilization; Neuritis; Proto-Oncogene Proteins; Meningitis; Brain Neoplasms -- surgery; Radiometry; Carcinoma, Renal Cell; Neuronavigation; Proportional Hazards Models; Hypophysectomy; Central Nervous System Vascular Malformations; Salvage Therapy; Reproducibility of Results; Endoscopy; Trigeminal Neuralgia; Actins; Stomatitis, Herpetic; Hemangioma, Cavernous; Bromodeoxyuridine; Tumor Suppressor Protein p53; Neoplasm Recurrence, Local; Tomography, X-Ray Computed; Head; Follow-Up Studies

Object. The authors have treated intractable pain, particularly cancer pain related to bone metastasis, with various protocols. Cancer has been by gamma knife radiosurgery (GKS), targeted the pituitary gland—stalk, as an alternative new control method. purpose of this study was investigate a prospective multicenter protocol prove efficacy and safety treatment. Methods. Indications for patient inclusion in treatment were: 1) metastasis; 2) no other effective options; 3) general condition rated greater than 40 on Karnofsky Performance Scale; 4) morphine control; 5) previous radiation (GKS or conventional radiotherapy) brain metastasis. at one institution two patients, who suffered from severe using GKS. target gland. maximum dose 160 Gy isocenter 8-mm collimator, keeping optic nerve less 8 Gy. At another patients were same way; additional five similarly targeting gland isocenters 4-mm collimator. In all nine cases, resolved without significant complication. Pain relief observed within several days, effect prolonged until day that they died. follow up 1 24 months, recurrences hormonal dysfunction observed. Conclusions. Despite insufficient experience, GKS demonstrated patients. This potential ameliorate cancer-related will play more important role pain. More experience refined protocols are needed evaluate which parameters important, determine what strategy is best, clarify safest option