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Meningiomas are the most frequently reported neuro-oncologic condition, accounting for 12% to 30% of all primary intracranial tumors. The first case of intracranial meningioma treated with stereotactic radiosurgery was reported by Backlund E-O in 1971. Since then, more than 200,000 meningiomas have been treated with stereotactic radiosurgery worldwide to date. The large number of patients treated using this method is due to the fact that meningiomas are frequently located in critical areas and microsurgery is often associated with severe and permanent neurological complications.This book discusses the advantages, risks and limits of stereotactic radiosurgery relating to all regions of interest for a neuroradiosurgical approach for the treatment of central nervous system meningiomas. Firstly, it presents an introduction focusing on the “state of the art”. It then discusses the physics, imaging, neurological and neuro-oncological issues in multidisciplinary management. Lastly,it features a summary of results, including the most recent published papers regarding all the locations involved in the stereotactic radiosurgery treatment as well as new approaches to meningiomas, with particular reference to the hypofrationated treatments. Intended for anyone involved in the neuroradiosurgical treatment of brain diseases, the book provides an up-to-date overview of the latest stereotactic radiosurgery treatment of central nervous system meningiomas.

When I first proposed this book, one of the hopes was that it would be the stage upon which would be conducted a quiet, well­ reasoned discussion of the various techniques of stereotactic radio­ surgery. At that time, there was quite a bit of rancorous debate that tended to obscure the scientific and medical merits of each of the separate methods. At the present time, I am happy to report that the field of stereotactic radiosurgery is much less riven by such inappropriate posturing. The field has taken many steps towards maturity, both technically and medically. In the course of this mat­ uration process, there have been many grandiose plans and speeches made on behalf of stereotactic radiosurgery. Inevitably, the reality will not live up to the hype, but such is the natural course of devel­ opment in these sorts of matters. However, even though events may not match our hopes, we should keep in mind the words of Herbert Parker. Recognizing that new modalities for the treatment of cancer do not stand much chance of revolutionary success, nevertheless, he quite correctly pointed out that'... with any type of radiatiQn, the margin between success and failure is small. If the chance of success is a little greater... thi~ might well be classed as a great advance.'Mark H.

Radiosurgery performed with the'Gamma Knife'or on a linac facility is a specific radiotherapy method to treat certain lesions in the brain with a high single radiation dose. Geometric miss of a radiosurgica target is considered the most likely serious error in a stereotactic radiosurgery treatment. Therefore, the issue of quality assurance in stereotactic radiosurgery is a serious one for neurosurgeons, physicists, patients and those of us who wish to analyze the results of radiosurgery. The purpose of this book is to offer and describe a quality assurance program and procedures of the physical and technical aspects through identifying the sources of possible errors and suggesting quality assurance tests that should be performed in order for a stereotactic system to be used clinically.

Harold C. Urschel, Jr. (Editor-in-Chief) John J. Kresl · James D. Luketich Lech Papiez ·Robert D. Timmerman (Co-Editors) Raymond A. Schulz (Contributing Editor) Treating Tumors that Move with Respiration With Contributions by Numerous Experts Foreword by E. Thomson With 116 Figures in 168 Separate Illustrations, 120 in Color and 31 Tables 123 IV Foreword Editor-in-Chief: James D. Luketich, MD Sampson Family Endowed Professor of Surgery Harold C. Urschel Jr., MD Chief, The Heart, Lung and Chair of Cardiovascular and Thoracic Surgical Esophageal Surgery Institute Research, Education and Clinical Excellence University of Pittsburgh Medical Center, PUH, C-800 Baylor University Medical Center 200 Lothrop Street 1201 Barnett Tower Pittsburgh, PA 15213 3600 Gaston Avenue USA Dallas, TX 75246 USA Lech Papiez, PhD Associate Professor Department of Radiation Oncology University of Texas Southwestern Medical Center 5801 Forest Park Road Dallas, TX 75390 Co-Editors: USA John J. Kresl, MD, PhD Arizona Oncology Services at Robert D. Timmerman, MD St. Joseph's Hospital & Medical Center Professor and Vice-Chairman Department of Radiation Oncology Ef? e Marie Cain Distinguished Chair in CyberKnife Center Cancer Therapy Research Barrow Neurological Institute Department of Radiation Oncology Gamma Knife Center University of Texas Southwestern Medical Center 350 West Thomas Road 5801 Forest Park Road Phoenix, Arizona 85013 Dallas, TX 75390 USA USA Library of Congress Control Number: 2007920177 ISBN 978-3-540-69885-2 Springer Berlin Heidelberg New York This work is subject to copyright.