Stereotaxic Radiotherapy and Radiosurgery of Mass Lesions of the Brain in Children

Trunin Yu.Yu., Golanov A.V., Gorelishev S.K., Pronin I.N., Ozerova V.I., Lubnin A.Yu., Sorokin V.S., Gorlachev G.E., Ilyalov S.R., Zotova M.V.

Burdenko Research Institute of Neurosurgery, Moscow, Russia

 

Radiotherapy is an important component of complex and combined treatment of mass lesions of the brain in children. Specialists of the Research Institute of Neurosurgery use such modern and precise methods of radiotherapy, as stereotaxic radiosurgery (SRS) and stereotaxic radiotherapy (SRT).

There were 272 children with different neurosurgical pathology, treated with the help of Novalis (BrainLab) and Primus (Siemens) linear accelerators and the Gamma-Knife apparatus in March 2005-December 2008. SRS (a considerable dose of ionizing radiation per one session) was used in 140 (51.4%) cases with a considerably small size of a target (a maximum value of 3-3.5 cm or up to 15 cm3). This group included cases with arteriovenous malformations (80) and neuroepithelial tumors (30 gliomas, 10 ependymomas). CRT was used in 132 (48.6%) cases with a pathologic focus of more than 3.5 cm3. This group consisted of cases with gliomas (70), ependymomas (12), craniopharyngiomas (12) and AVM (8). A head was fixed with the help of a stereotaxic frame under local anesthesia (SRS) or a mask (SRT). Intravenous anesthesia (ketamine, dormicum, propofol) was induced in case of necessity. Acute and subacute responses to radiation were watched in 12 cases (4.4%). Delayed complications (radiation necrosis and injuries) were revealed in 5 cases (1.8%).

The obtained results are indicative of efficacy and safety of SRS and SRT in children.