Recent Advances In Surgery 34 Pdf Free !!BETTER!! Download

srs has also been investigated for the treatment of skull-base tumors including chordomas, chondrosarcomas, meningiomas, and craniopharyngiomas [ 80, 81, 82, 83 ]. in a retrospective study, arma et al. [ 83 ] reported that local control of skull-base chordomas was achieved in 44% of the patients treated with srs and in none of the patients treated with surgery alone. the median duration of local control was 31months. in a more recent study, fonseca et al. [ 80 ] reported that local control was achieved in 47% of patients treated with srs and in 50% of patients treated with surgery alone. the median duration of local control was 36months, and the median duration of local control was not reached.

recent advances in surgery 34 pdf free download

at least two studies have suggested that srs is an effective treatment for recurrent gbm [ 77, 78 ]. in a single-institution retrospective analysis of 41 patients with recurrent gbm, srs was delivered using a median dose of 18gy in three fractions (range: 16-24gy) at a median interval of 4.1months post-initial srs (range: 1.7-28.9months) [ 77 ]. the median os was 17.5months, and 2-year os, pfs, and local progression-free survival (lpfs) rates were 69.2%, 53.7%, and 75.7%, respectively. in a recent retrospective study of 19 patients with recurrent gbm, 16 patients were treated with srs, and median os and 2-year os rate were 20.9months and 31.2%, respectively [ 78 ]. median survival was not reached in the group treated with srs alone, whereas the median survival in the group treated with srs plus chemotherapy was 20.3months. in both studies, patients with kps scores of less than 80% and multiple recurrent tumors were included in the srs treatment group. the role of srs in the management of recurrent gbm is still evolving. additional studies are needed to better define the role of srs in the treatment of recurrent gbm. optimal dose fractionation, timing of srs, role of concurrent and/or sequential systemic therapy, and the number of treatment sessions should be defined. in addition, srs should be considered as a potential adjunct to hypofractionated or fractionated srt or wbrt for patients with an o6-methylguanine dna methyltransferase (mgmt) promoter-methylated tumor to avoid unnecessary radiation to normal tissue.

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