Stereotactic radiosurgery for intracranial lesions using a linear accelerator

Experiences in 47 cases of stereotactic radiosurgery were reported. The surgery was carried out using stereotactic radiosurgery system of Fisher STP system (Leibinger Co.). The accelerator was Clinac 2100c (Varian Co., 10 mV X ray) or EXL-15 SP (Mitsubishi Co., 6 mV) equipped with collimator. CT and MRI imaging data were firstly transported to the working station to determine the target volume, target coordinates and radiation dose. Irradiation from 90deg to -90deg directions from isocenter of the linac was done within an error of 1 mm after the actual measurement of the target on the port film. The treatment was necessary for 6-8 hr and and irradiation was essentially complete for it. The dose was 20 Gy for metastatic brain tumors (31 patients), 14-16 Gy for acoustic neuroma (1) and 16 Gy for arteriovenous malformation (1). The local control rate of the brain tumors was as high as 90%. The complication was cerebral necrosis (1 case) and exacerbation of neurological symptoms (1), which exhibited remission with steroid treatment. Thus stereotactic radiosurgery with linac made it possible to treat intracranial lesions without invasion effectively and safely. (K.H.)