Publications by authors named "Roberto Martinez-Alvarez"

Background And Objectives: Single-session stereotactic radiosurgery (SRS) has limited role for large arteriovenous malformations (AVM). Volume-staged SRS (VS-SRS) is used to optimize outcomes, but studies reporting results are limited.

Methods: This multicenter retrospective cohort of 378 patients from 21 centers reports results of VS-SRS for the entire AVM nidus.

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Background And Objectives: Papillary tumors of the pineal region (PTPR) are rare neuroepithelial tumors that are at high risk of local recurrence even after gross total resection. Their optimal management, including the potential role of stereotactic radiosurgery (SRS), remains a matter of debate. Only a few retrospective outcome studies have been reported.

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Background And Objectives: Hemangioblastomas (HGBs) are rare, benign, World Health Organization grade 1 vascular tumors, which are most commonly located in the cerebellum, and may occur sporadically or in association with von Hippel-Lindau (VHL) disease, a hereditary VHL-mutated tumor syndrome. Limited data are available regarding factors affecting outcomes after stereotactic radiosurgery (SRS). We aim to provide a contemporary evaluation of SRS for HGBs through an international, multicenter study.

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Background: Whether the number or cumulative volume of brain metastases affects survival in patients with metastatic non-small cell lung cancer (NSCLC) remains controversial. We conducted a volume matched multi-center study to determine whether patients with a single metastasis had better outcomes than patients with > 20 brain metastases.

Methods: Between 2014 and 2022, 317 NSCLC patients (21.

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Introduction: Management for elderly patients (> 65yo) with incidental meningiomas remains unclear. This study aims to characterize the functional and tumor outcomes of expectant and stereotactic radiosurgery (SRS) management of asymptomatic meningioma elderly patients.

Methods: Using retrospectively collected data from 14 centers, SRS outcomes were compared to radiographic and clinical observation of asymptomatic meningiomas in elderly patients following propensity score matching.

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Objective: We present our experience in using Gamma knife surgery (GKS) on the posterior part of the central lateral nucleus (CLp) for refractory neuropathic pain, examining its long-term efficacy and safety in patients with one of the longest pretreatment pain duration in the literature. Furthermore, we examined certain factors that might influence the outcome of this technique.

Methods: We conducted a prospective study involving 9 patients who underwent GKS between 2020 and 2023.

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Background And Objectives: Pineocytomas are grade 1 tumors arising from the pineal parenchyma. Gross total resection can potentially cure these benign lesions but can be associated with morbidity. This study was designed to provide multi-institutional data to evaluate the results of stereotactic radiosurgery (SRS) for pineocytomas.

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Brainstem cerebral cavernous malformations (CCM) are clinically more aggressive compared to superficial CCMs. Due to their location, resection can be challenging, making stereotactic radiosurgery (SRS) an attractive alternative for symptomatic patient. Brainstem CCM patients (n = 170) were treated with Gamma Knife SRS at 11 radiosurgical centers.

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Article Synopsis
  • A study was conducted to compare the neurological and radiographic outcomes between patients treated with initial stereotactic radiosurgery (SRS) and those who underwent a second SRS for intracranial arteriovenous malformations (AVMs).
  • Data from 21 medical centers spanning from 1987 to 2022 included a matched comparison of 328 patients in each group, focusing on factors like AVM volume and location.
  • Results indicated similar rates of obliteration and radiation-induced changes between the two groups, suggesting that repeat SRS is as effective as the initial treatment and may not require dose reduction.
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Background: A higher risk of secondary brain tumor, carotid stenosis, and stroke has been reported after conventional sella irradiation for pituitary neuroendocrine tumors (PitNET). Stereotactic radiosurgery (SRS), which is a more focused approach, is now increasingly used instead. The aim was to assess the risk of secondary brain tumor, carotid stenosis/occlusion, and stroke after SRS.

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Background And Objectives: Pleomorphic xanthoastrocytoma (PXA) is a rare low-grade glial tumor primarily affecting young individuals. Surgery is the primary treatment option; however, managing residual/recurrent tumors remains uncertain. This international multi-institutional study retrospectively assessed the use of stereotactic radiosurgery (SRS) for PXA.

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Article Synopsis
  • - Vestibular schwannoma (VS), the most common tumor in the cerebellopontine angle, often leads to challenging treatment decisions among observation, surgery, or radiotherapy based on patient-specific factors including age and symptoms.
  • - A comprehensive literature review was conducted to create a clinical guide addressing frequently asked questions by clinicians regarding VS, with input from a panel of experts from the SEORL-CCC.
  • - The resulting clinical practice guideline summarizes the 13 most debated topics related to VS management, presenting answers to 50 key questions, though it notes that the levels of evidence are mostly medium or low due to a lack of sufficient prospective studies.
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Objective: The purpose of this study was to describe the long-term outcomes and associated risks related to repeat stereotactic radiosurgery (SRS) for persistent arteriovenous malformations (AVMs) in pediatric patients.

Methods: Under the auspices of the International Radiosurgery Research Foundation, this retrospective multicenter study analyzed pediatric patients who underwent repeat, single-session SRS between 1987 and 2022. The primary outcome variable was a favorable outcome, defined as nidus obliteration without hemorrhage or neurological deterioration.

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Objective: Cerebral cavernous malformations (CCMs) are the second most common vascular anomaly affecting the CNS in children. Although stereotactic radiosurgery (SRS) has been proposed as an alternative to microsurgery in the management of selected cases in adults, there is a paucity of studies focusing on pediatric patients. The aim of this study was to present the outcomes and associated risks of SRS in this subgroup of patients.

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Objective: Patients with deep-seated arteriovenous malformations (AVMs) have a higher rate of unfavorable outcome and lower rate of nidus obliteration after primary stereotactic radiosurgery (SRS). The aim of this study was to evaluate and quantify the effect of AVM location on repeat SRS outcomes.

Methods: This retrospective, multicenter study involved 505 AVM patients managed with repeat, single-session SRS.

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Background And Objectives: There are no studies evaluating the efficacy and safety of more than 2 stereotactic radiosurgery (SRS) procedures for cerebral arteriovenous malformations (AVM). The aim of this study was to provide evidence on the role of third single-session SRS for AVM residual.

Methods: This multicenter, retrospective study included patients managed with a third single-session SRS procedure for an AVM residual.

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Objective: There are few reports of outcomes following stereotactic radiosurgery (SRS) for the management of cerebral cavernous malformations (CCMs) of the basal ganglia or thalamus. Therefore, the authors aimed to clarify these outcomes.

Methods: Centers participating in the International Radiosurgery Research Foundation were queried for CCM cases managed with SRS from October 2001 to February 2021.

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Background And Objectives: Trigeminal neuralgia affects approximately 2% of patients with multiple sclerosis (MS) and often shows higher rates of pain recurrence after treatment. Previous studies on the effectiveness of stereotactic radiosurgery (SRS) for trigeminal neuralgia did not consider the different MS subtypes, including remitting relapsing (RRMS), primary progressive (PPMS), and secondary progressive (SPMS). Our objective was to investigate how MS subtypes are related to pain control (PC) rates after SRS.

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Background: Cerebral cavernous malformations (CCMs) frequently manifest with haemorrhages. Stereotactic radiosurgery (SRS) has been employed for CCM not suitable for resection. Its effect on reducing haemorrhage risk is still controversial.

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Background And Objectives: An international, multicenter, retrospective study was conducted to evaluate the long-term clinical outcomes and tumor control rates after stereotactic radiosurgery (SRS) for trigeminal schwannoma.

Methods: Patient data (N = 309) were collected from 14 international radiosurgery centers. The median patient age was 50 years (range 11-87 years).

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Objective: Stereotactic radiosurgery (SRS) has been proposed as an alternative to resection for epilepsy control in patients with cerebral cavernous malformations (CCM) located in critical areas.

Methods: This multicentric, retrospective study evaluated seizure control in patients with a solitary CCM and a history of at least one seizure prior to SRS.

Results: 109 patients (median age at diagnosis 28.

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Background: Repeat stereotactic radiosurgery (SRS) for persistent cerebral arteriovenous malformation (AVM) has generally favorable patient outcomes. However, reporting studies are limited by small patient numbers and single-institution biases. The purpose of this study was to provide the combined experience of multiple centers, in an effort to fully define the role of repeat SRS for patients with arteriovenous malformation.

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Article Synopsis
  • Meningiomas in children are rare and have different characteristics compared to adults, with limited existing research on stereotactic radiosurgery (SRS) for this group.
  • A study was conducted on 57 pediatric patients treated with single-fraction SRS, evaluating tumor control, complications, and neurological outcomes over a median follow-up of 69 months.
  • Results showed high tumor control rates (85.9%) with minimal new neurological deficits (3.5%) and some adverse radiation effects, indicating that SRS is a promising treatment option for difficult-to-treat pediatric meningiomas.
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Background: Vestibular schwannomas (VSs) related to neurofibromatosis type 2 (NF2) are challenging tumors. The increasing use of stereotactic radiosurgery (SRS) necessitates further investigations of its role and safety.

Objective: To evaluate tumor control, freedom from additional treatment (FFAT), serviceable hearing preservation, and radiation-related risks of patients with NF2 after SRS for VS.

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