Abstract
Non-invasive frameless stereotactic radiosurgical systems have recently been developed.
We report our experience of frameless stereotactic radiosurgery (SRS) with a bite-plate
for brain metastases. Between February 2002 and December 2005, 147 patients with brain
metastases were treated with C-arm linear accelerator-based SRS and 122 patients were
followed up by our institute. An optic tracking system with infrared light-emitting
diodes was used for real-time monitoring. A bite-plate with fiducial markers was applied
as a first-line method for frameless SRS. Head-ring fixation was used in patients
lacking teeth. Lung carcinomas (63%) were the most common primary tumors, followed
by breast carcinomas (13%). Ninety patients underwent radiosurgery with a bite-plate
and 32 patients underwent fixation of a head ring. Males were significantly more predominant
in the head-ring group (26 men and 6 women), compared with the bite-plate group (47
men and 43 women, p<0.01). The average age (62 years) in the bite-plate group was
significantly younger than that (68 years) in the head-ring group (p<0.01). The median
survival time was 12.0 months in the bite-plate group and 8.0 months in the head-ring
group (p=0.0621). Nine patients who had brain metastases in or close to the brain
stem were treated with fractionated stereotactic radiotherapy. The frameless stereotactic
radiosurgical system with a bite-plate is safe and effective for the treatment of
brain metastasis. Elderly male patients sometimes are edentulous and require placement
of a head ring for radiosurgery.
Key words
brain metastases - frameless - radiosurgery - stereotactic techniques
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Correspondence
M. FuruseMD, PhD
Department of Neurosurgery
Kitano Hospital
The Tazuke Kofukai Medical Research Institute
2-4-20 Ohgimachi
Kita-ku
Osaka 530-8480
Japan
Phone: 81/6/6312 88 31
Fax: +81/6/6312 88 67
Email: MFuruse@aol.com
