ムラガキ　ヨシヒロ   MURAGAKI Yoshihiro   村垣　善浩    所属   医学部 医学科（東京女子医科大学病院）    職種   客員教授
言語種別	英語
種別	部分執筆
表題	Concept of Robotic Gamma Knife Microradiosurgery and Results of Its Clinical Application in Benign Skull Base Tumors
書名	Gamma Knife Neurosurgery in the Management of Intracranial Disorders
ISBNコード	9783709113752
編者名	Mikhail Chernov,Motohiro Hayashi,Jeremy Ganz,Kintomo Takakura
版・巻・頁	116,pp.5-15
出版社	Springer-Verlag Wien
出版地 （都市, 国名）	Wien,Austria
著者・共著者	HAYASHI Motohiro, CHERNOV Mikhail, TAMURA Noriko, IZAWA Masahiro, MURAGAKI Yoshihiro, ISEKI Hiroshi, OKADA Yoshikazu, Pavel Ivanov, Jean Regis, TAKAKURA Kintomo
発行年月	2013/03
概要	Abstract The availability of advanced computer-aided robotized devices for the Gamma Knife (i.e., an automatic positioning system and PerfeXion) resulted in significant changes in radiosurgical treatment strategy. The possibility of applying irradiation precisely and the significantly improved software for treatment planning led to the development of the original concept of robotic Gamma Knife microradiosurgery, which is comprised of the following: (1) precise irradiation of the lesion with regard to conformity and selectivity; (2) intentional avoidance of excessive irradiation of functionally important anatomical structures, particularly cranial nerves, located both within the target and in its vicinity; (3) delivery of sufficient radiation energy to the tumor with a goal of shrinking it while keeping the dose at the margins low enough to prevent complications. Realization of such treatment principles requires detailed evaluation of the microanatomy of the target area, which is achieved with an advanced neuroimaging protocol. From 2003, we applied the described microradiosurgical concept in our clinic for patients with benign skull base tumors. Overall, 75 % of neoplasms demonstrated shrinkage, and 47 % showed ≥50 % and more volume reduction. Treatment-related complications were encountered in only 6 % of patients and were mainly related to transient cranial nerve palsy. Just 2 % of neoplasms showed regrowth after irradiation. In conclusion, applying the microradiosurgical principles based on advanced neuroimaging and highly precise treatment planning is beneficial for patients, providing a high rate of tumor shrinkage and a low morbidity rate.