{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T19:49:44Z","timestamp":1785527384440,"version":"3.56.0"},"reference-count":16,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"Special_Suppl","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Gamma Knife surgery (GKS) has gained increasing relevance in the treatment of metastatic brain tumors, but many metastatic tumors contain a large cystic component and often exceed the size limit for GKS. For such lesions, the authors adopted a procedure in which stereotactic aspiration is first performed and followed immediately by GKS on the same day. In this paper, the authors describe this 1-day combined procedure and evaluate its efficacy.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Between 2005 and 2010, 25 cystic metastases in 25 patients were treated at Dokkyo Medical University. The patients first underwent MRI and stereotactic aspiration of the cyst while stationary in a Leksell stereotactic frame; immediately afterward, the patients underwent a second MR imaging session and Gamma Knife treatment. Tumor volume reduction, tumor control rate, and overall survival were examined.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Tumor volume, including the cystic component, decreased from 8.0\u201364.2 cm<jats:sup>3<\/jats:sup> (mean 20.3 cm<jats:sup>3<\/jats:sup>) to 3.0\u201336.2 cm<jats:sup>3<\/jats:sup> (mean 10.3 cm<jats:sup>3<\/jats:sup>) following aspiration, and the volume of 24 of 25 lesions decreased to less than 16.6 cm<jats:sup>3<\/jats:sup>, which is equivalent to the volume of a 3.16-cm sphere. At least 20 Gy was delivered to the entire lesion in 24 of 25 cases. Good tumor control was obtained in 16 of 21 cases that could be evaluated during a median follow-up period of 11 months (range 1\u201327 months); however, reaccumulation of cyst contents was observed in 2 patients who required Ommaya reservoir placement.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The 1-day aspiration plus GKS procedure is an effective and time-efficient treatment for large cystic brain metastases.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2012.7.gks121001","type":"journal-article","created":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T00:55:04Z","timestamp":1542329704000},"page":"17-22","source":"Crossref","is-referenced-by-count":23,"title":["Effectiveness of a 1-day aspiration plus Gamma Knife surgery procedure for metastatic brain tumor with a cystic component"],"prefix":"10.3171","volume":"117","author":[{"given":"Fumi","family":"Higuchi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Kawamoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phyo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Ueki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"},{"name":"Comprehensive Cancer Center, Dokkyo Medical University, Mibu, Tochigi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1170017","series-title":"J Natl Cancer Inst","first-page":"34","article-title":"Stereotactic radiosurgery for the definitive, noninvasive treatment of brain metastases","volume":"87","author":"Alexander","year":"1995"},{"key":"b2-1170017","series-title":"J Neurosurg","first-page":"259","article-title":"Stereotactic drainage and Gamma Knife radiosurgery of cystic brain metastasis","volume":"109","author":"Franzin","year":"2008"},{"issue":"5 Suppl","key":"b3-1170017","series-title":"J Neurosurg","first-page":"515","article-title":"Gamma knife radiosurgery for brain metastases: a primary therapeutic option","volume":"97","author":"Gerosa","year":"2002"},{"key":"b4-1170017","series-title":"Int J Radiat Oncol Biol Phys","first-page":"113","article-title":"Radiosurgery for large brain metastases","volume":"83","author":"Han","year":"2012"},{"key":"b5-1170017","series-title":"J Neurooncol","first-page":"33","article-title":"The role of surgical resection in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline","volume":"96","author":"Kalkanis","year":"2010"},{"key":"b6-1170017","series-title":"J Neurooncol","first-page":"45","article-title":"The role of stereotactic radiosurgery in the management of patients with newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline","volume":"96","author":"Linskey","year":"2010"},{"key":"b7-1170017","series-title":"Stereotact Funct Neurosurg","first-page":"36","article-title":"Factors influencing early complications following Gamma Knife radiosurgery. A prospective study","volume":"76","author":"Majhail","year":"2001"},{"key":"b8-1170017","series-title":"Neurosurg Rev","first-page":"1","article-title":"Radiosurgery in the treatment of brain metastases: critical review regarding complications","volume":"31","author":"Maldaun","year":"2008"},{"issue":"Suppl","key":"b9-1170017","series-title":"J Neurosurg","first-page":"128","article-title":"Gamma knife surgery for brain metastases from lung cancer","volume":"102","author":"Pan","year":"2005"},{"key":"b10-1170017","series-title":"J Korean Neurosurg Soc","first-page":"360","article-title":"Gamma knife radiosurgery after stereotactic aspiration for large cystic brain metastases","volume":"46","author":"Park","year":"2009"},{"issue":"5 Suppl","key":"b11-1170017","series-title":"J Neurosurg","first-page":"499","article-title":"Survival and pattern of failure in brain metastasis treated with stereotactic gamma knife radiosurgery","volume":"97","author":"Petrovich","year":"2002"},{"key":"b12-1170017","series-title":"Int J Radiat Oncol Biol Phys","first-page":"291","article-title":"Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: final report of RTOG protocol 90-05","volume":"47","author":"Shaw","year":"2000"},{"key":"b13-1170017","series-title":"Int J Radiat Oncol Biol Phys","first-page":"87","article-title":"Stereotatic radiosurgery of 468 brain metastases \u2264 2 cm: implications for SRS dose and whole brain radiation therapy","volume":"59","author":"Shehata","year":"2004"},{"key":"b14-1170017","series-title":"No Shinkei Geka","first-page":"417","article-title":"[Radiosurgery for cystic metastatic brain tumor.]","volume":"28","author":"Uchino","year":"2000"},{"key":"b15-1170017","series-title":"Int J Radiat Oncol Biol Phys","first-page":"452","article-title":"Analysis of tumor control and toxicity in patients who have survived at least one year after radiosurgery for brain metastases","volume":"57","author":"Varlotto","year":"2003"},{"issue":"Suppl","key":"b16-1170017","series-title":"J Neurosurg","first-page":"79","article-title":"Ommaya reservoir placement followed by Gamma Knife surgery for large cystic metastatic brain tumors","volume":"105","author":"Yamanaka","year":"2006"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/117\/Special_Suppl\/article-p17.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/117\/Special_Suppl\/article-p17.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/117\/Special_Suppl\/article-p17.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T23:09:07Z","timestamp":1679872147000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/117\/Special_Suppl\/article-p17.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2012,12]]},"references-count":16,"journal-issue":{"issue":"Special_Suppl"},"URL":"https:\/\/doi.org\/10.3171\/2012.7.gks121001","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,12]]}}}