Gil Lederman on Prostate Cancer Seeds Plus Radiosurgery

Gil Lederman Discusses Brain Radiosurgery
A primary difference between standard radiation and fractionated stereotactic radiosurgery is that standard radiation must - because of less precision - radiate large amounts of normal healthy brain - compared to radiosurgery, which focuses on the tumor. Radiation of healthy brain usually cannot be construed as always optimal and may, in fact, lead to complications. Radiosurgery represents the opposite end of the spectrum from standard radiation - focused directed radiation with prescribed doses of treatment.

Think of a plum in a breadbox and imagine the plum is the tumor while the brain is the breadbox. Standard radiation treats the larger breadbox while we isolate the plum for treatment. That means we can escalate the dose to the tumor and diminish much of the unnecessary dose to normal brain tissue. That should mean less chance of late adverse effects. Stereotactic radiosurgery has a greater degree of accuracy than just conformal radiation. There are issues concerning risks, benefits and alternatives that must be discussed. While IMRT (Intensity Modulated Radiation Therapy) helps shape the radiation, it is only one part of our innovative program.

How does Fractionation of Radiosurgery Help the Patient?
Radiation oncologists believe that higher doses of radiation are more beneficial in curing cancer, in general, than lower doses. However, higher doses cannot be given innocuously. Essentially, all tumors are surrounded by normal tissue. It is the presence of the normal tissue that limits the amount of radiation that can be safely administered. It’s our physicians’ large experience that helps to know when to increase or decrease doses! For benign conditions – such as acoustic neuromas – we are famous for using the lowest biologic effective dose in order to effectively treat the tumor and minimize harm to the surrounding fifth, seventh, eighth cranial nerves and brain stem. It’s for the patients’ benefit.

Fractionation allows healthy, surrounding tissues to potentially repair radiation effects in a way that single fraction radiosurgery cannot. Our system permits us the ability to fractionate - or divide - the dose, which is based upon biologic principles to make treatment safer. This is true for benign tumors such as acoustic neuromas, meningiomas and pituitary tumors, as well as malignancies.
We have the largest experience worldwide using fractionated stereotactic radiosurgery for acoustic neuromas. Fractionation exploits the difference between normal tissues and tumors thus resulting in a safer and superior outcome. This is why fractionated stereotactic radiosurgery is so important. Scientists have known for decades the potential benefits of fractionation; that’s why we are the leaders in fractionated stereotactic radiosurgery.

Another major difference between single shot radiosurgery and fractionated stereotactic radiosurgery is that our system is non-invasive avoiding pins in the skull, which causes discomfort and limits usefulness of the technique. Unlike single shot radiosurgery, we have an unlimited array of beam sizes – custom-made - for tumor treatment ranging from the very small to the very large. But today, there’s much more! We have custom-shaped fields and multi-leaf collimation and IMRT. IMRT, a small part of our overall program, is intensity modulated radiation therapy. Also, our planning systems are new and state-of-the-art.

The desired treatment is one that produces the most appropriate and beneficial doses of radiation delivered to the tumor while minimizing effects to the normal healthy brain.
Fractionated stereotactic radiosurgery helps us achieve this goal most elegantly. This article discusses the benefits in brief.

By: Dr. Gil096 Lederman096

Article Source: http://www.directorys.uniquearticles.info

Please visit our before and after visual Body Radiosurgery gallery. For more information about Stereotactic Body Radiosurgery, please visit www.rsny.org/ or email Dr. Gil Lederman at Gil.Lederman@RSNY.ORG

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