Report of whole-brain radiation therapy in a patient with an implanted deep brain stimulator: important neurosurgical considerations and radiotherapy practice principles

Journal of Neurosurgery
Rupesh KotechaKevin L Stephans

Abstract

Patients with implanted neuromodulation devices present potential challenges for radiation therapy treatment planning and delivery. Although guidelines exist regarding the irradiation of cardiac pacemakers and defibrillators, fewer data and less clinical experience exist regarding the effects of radiation therapy on less frequently used devices, such as deep brain stimulators. A 79-year-old woman with a history of coarse tremors effectively managed with deep brain stimulation presented with multiple intracranial metastases from a newly diagnosed lung cancer and was referred for whole-brain radiation therapy. She was treated with a German helmet technique to a total dose of 30 Gy in 10 fractions using 6 MV photons via opposed lateral fields with the neurostimulator turned off prior to delivery of each fraction. The patient tolerated the treatment well with no acute complications and no apparent change in the functionality of her neurostimulator device or effect on her underlying neuromuscular disorder. This represents the first reported case of the safe delivery of whole-brain radiation therapy in a patient with an implanted neurostimulator device. In cases such as this, neurosurgeons and radiation oncologists should have discus...Continue Reading

References

May 29, 2001·Neurology·J G NuttK J Burchiel
Sep 22, 2001·The New England Journal of Medicine·E D Louis
Jul 17, 2004·Journal of Neurosurgery·Puneet PlahaSteven S Gill
Jul 15, 2005·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·T KlenznerJ Lutterbach
Feb 16, 2006·Clinical Oncology : a Journal of the Royal College of Radiologists·G MazdaiA R Hounsell
Jul 1, 2006·Movement Disorders : Official Journal of the Movement Disorder Society·Andre MachadoAlim-Louis Benabid
Jul 14, 2010·Movement Disorders : Official Journal of the Movement Disorder Society·Eliana Della FloraGuy J Maddern
Dec 12, 2012·Magnetic Resonance Imaging·Krzysztof R GornyMatt A Bernstein
May 23, 2013·British Journal of Neurosurgery·Jean-Baptiste GuyNicolas Magné
Jun 19, 2013·Journal of Cancer Research and Therapeutics·Anusheel MunshiKailash Chander Pandey
Sep 7, 2014·Practical Radiation Oncology·Jenna F BorkenhagenLauren Q Shapiro
Jan 1, 2011·Journal of X-ray Science and Technology·Michael S GossmanJames S Powell

❮ Previous
Next ❯

Methods Mentioned

BETA
cochlear implants

Software Mentioned

Activa

Related Concepts

Related Feeds

Brain-Computer Interface

A brain-computer interface, also known as a brain-machine interface, is a bi-directional communication pathway between an external device and a wired brain. Here is the latest research on this topic.

Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.