{"id":20158,"date":"2025-06-30T00:43:58","date_gmt":"2025-06-30T00:43:58","guid":{"rendered":"https:\/\/cancercentertec100.com\/?p=20158"},"modified":"2025-06-30T00:44:36","modified_gmt":"2025-06-30T00:44:36","slug":"radiocirugia-estereotactica","status":"publish","type":"post","link":"https:\/\/cancercentertec100.com\/en\/investigacion\/radiocirugia-estereotactica\/","title":{"rendered":"RADIOCIRUG\u00cdA ESTEREOT\u00c1CTICA EN ENFERMEDADES NO TUMORALES DEL SISTEMA NERVIOSO CENTRAL"},"content":{"rendered":"
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Por: Dr. Rodrigo Uribe Pacheco
Neurocirujano con entrenamiento en Radiocirug\u00eda<\/em><\/span><\/figure>\n
La radiocirug\u00eda estereot\u00e1ctica (SRS) ha demostrado ser una herramienta eficaz y segura en el tratamiento de diversas enfermedades no tumorales del sistema nervioso central (SNC), especialmente en casos donde la cirug\u00eda convencional representa alto riesgo. En malformaciones arteriovenosas (MAV), la SRS ha mostrado tasas elevadas de obliteraci\u00f3n y baja incidencia de complicaciones tanto en adultos como en poblaci\u00f3n pedi\u00e1trica, siendo m\u00e1s efectiva sin embolizaci\u00f3n previa y con dosis elevadas [1\u20134]. En los cavernomas cerebrales, particularmente aquellos ubicados en el tallo cerebral, t\u00e1lamo o n\u00facleos de la base, la SRS ha reducido significativamente la tasa de hemorragias y mejorado el control de crisis epil\u00e9pticas, con un perfil de seguridad aceptable cuando se emplea una planificaci\u00f3n dosim\u00e9trica precisa [5\u20139].<\/p>\n

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En neuralgia del trig\u00e9mino (NT) refractaria, la SRS representa una opci\u00f3n terap\u00e9utica con buen control del dolor y bajo riesgo de complicaciones, incluso tras m\u00faltiples sesiones [10\u201312]. Aunque los procedimientos neuroablativos ofrecen mayor control inicial del dolor, se asocian a mayor morbilidad sensitiva, lo que posiciona a la SRS como alternativa favorable cuando no es viable la descompresi\u00f3n microvascular [13]. Asimismo, en trastornos del movimiento como enfermedad de Parkinson y temblor esencial, la SRS ha demostrado eficacia en el manejo del temblor, disquinesias y bradicinesia, especialmente mediante talamotom\u00eda con Gamma Knife\u00ae, siendo una intervenci\u00f3n no invasiva, precisa y con efectos cl\u00ednicos sostenidos en pacientes seleccionados [14,15].<\/p>\n

Por \u00faltimo, en epilepsia farmacorresistente, particularmente en epilepsia del l\u00f3bulo temporal mesial y hamartomas hipotal\u00e1micos, la SRS ha mostrado beneficios significativos en la reducci\u00f3n de crisis y mejor\u00eda de calidad de vida, aunque su efecto terap\u00e9utico puede tardar semanas o meses en manifestarse, a\u00fan se requieren estudios controlados para establecer recomendaciones formales [16,17]. En conjunto, la SRS se consolida como una modalidad terap\u00e9utica efectiva y segura en patolog\u00edas no tumorales del SNC, especialmente en pacientes donde las alternativas quir\u00fargicas implican riesgos mayores o no son viables.
Referencias:<\/strong><\/span><\/p>\n

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  1. Chen CJ, Kearns KN, Ding D, Kano H, Mathieu D, Kondziolka D, Feliciano C, Rodriguez-Mercado R, Grills IS, Barnett GH, Lunsford LD, Sheehan JP. Stereotactic radiosurgery for arteriovenous malformations of the basal ganglia and thalamus: an international multicenter study. J Neurosurg. 2020 Jan 1;132(1):122-131. doi: 10.3171\/2018.8.JNS182106.<\/li>\n
  2. B\u00f6rcek A\u00d6, \u00c7eltik\u00e7i E, Akso\u011fan Y, Rousseau MJ. Clinical Outcomes of Stereotactic Radiosurgery for Cerebral Arteriovenous Malformations in Pediatric Patients: Systematic Review and Meta-Analysis. Neurosurgery. 2019 Oct 1;85(4):E629-E640. doi: 10.1093\/neuros\/nyz146.<\/li>\n
  3. Essibayi MA, Tos SM, Vadset T, Behbahani M, Lasala PA, Altschul DJ, Sheehan JP. Stereotactic Radiosurgery Outcomes in Arteriovenous Malformations: A Pediatric-Adult Comparative Meta-Analysis. World Neurosurg. 2024 Oct;190:e956-e982. doi: 10.1016\/j.wneu.2024.08.045.<\/li>\n
  4. Ding D, Yen CP, Starke RM, Xu Z, Sun X, Sheehan JP. Outcomes following single-session radiosurgery for high-grade intracranial arteriovenous malformations. Br J Neurosurg. 2014 Oct;28(5):666-74. doi: 10.3109\/02688697.2013.872227.<\/li>\n
  5. Tos SM, Shaaban A, Mantziaris G, Dumot C, Kotecha R, Fariselli L, Gorgulho A, Levivier M, Ma L, Paddick I, Pollock BE, Regis J, Suh JH, Yomo S, Sahgal A, Sheehan JP. Stereotactic Radiosurgery for Intracranial Cavernous Malformations: International Stereotactic Radiosurgery Society, Systematic Review, Meta-Analysis, and Practice Guidelines. World Neurosurg. 2024 Dec;192:e366-e401. doi: 10.1016\/j.wneu.2024.09.106.<\/li>\n
  6. Park K, Kim JW, Chung H-T, Paek SH, Kim DG. Long-term outcome of Gamma knife radiosurgery for symptomatic brainstem cavernous malformation. World Neurosurg. 2018;116:e1054-e1059.<\/li>\n
  7. Nagy G, Burkitt W, Stokes SS, et al. Contemporary radiosurgery of cerebral cavernous malformations: Part 1. Treatment outcome for critically located hemorrhagic lesions. J Neurosurg. 2018;130: 1817-1825.<\/li>\n
  8. Dumot C, Mantziaris G, Pikis S, et al. Epilepsy associated with cerebral cavernous malformations managed with stereotactic radiosurgery: an international, multicenter study. J Neurol. 2023;270: 5048-5056.<\/li>\n
  9. Dulamea, A.O., Ene, A.M. A Review of Current Advances in the Treatment of Cerebral Cavernous Malformations. Curr Treat Options Neurol 27, 30 (2025). https:\/\/doi.org\/10.1007\/s11940-025-00842-w<\/li>\n
  10. De Nigris Vasconcellos F, Alzate JD, Mashiach E, Meng Y, Santhumayor B, Bernstein K, Pichardo-Rojas P, Dono A, Damron EP, Blanco AI, Esquenazi Y, Urgosik D, May J, Lee CC, Yang HC, Kawalec P, Kaufmann AM, Mathieu D, Iorio-Morin C, Picozzi P, Franzini A, Tripathi M, Peker S, Samanci Y, Almeida T, Benjamin C, Kondziolka D, Sheehan J. Efficacy and safety of a third stereotactic radiosurgery for recurrent trigeminal neuralgia: an international, multicenter study. Acta Neurochir (Wien). 2024 Oct 23;166(1):422. doi: 10.1007\/s00701-024-06317-2.<\/li>\n
  11. Richards GM, Bradley KA, Tom\u00e9 WA, Bentzen SM, Resnick DK, Mehta MP. Linear accelerator radiosurgery for trigeminal neuralgia. Neurosurgery. 2005 Dec;57(6):1193-200; discussion 1193-200. doi: 10.1227\/01.neu.0000186015.01179.70.<\/li>\n
  12. Kienzler JC, Tenn S, Chivukula S, Chu FI, Sparks HD, Agazaryan N, Kim W, Salles A, Selch M, Gorgulho A, Kaprealian T, Pouratian N. Linear accelerator-based radiosurgery for trigeminal neuralgia: comparative outcomes of frame-based and mask-based techniques. J Neurosurg. 2021 Nov 26;137(1):217-226. doi: 10.3171\/2021.8.JNS21658.<\/li>\n
  13. Akkara Y, Singh JM, Thorne L, Hill CS. Stereotactic Radiosurgery versus Neuroablative Techniques for Medically Refractory Trigeminal Neuralgia: A Systematic Review and Meta-Analysis of Outcomes. Stereotact Funct Neurosurg. 2025 Feb 3:1-12. doi: 10.1159\/000543859.<\/li>\n
  14. Pereira GM, Soares NM, Rieder CRM, Alva TAP. Stereotatic radiosurgery for the treatment of motor symptoms in Parkinson’s disease: A systematic review. J Med Imaging Radiat Sci. 2024 Mar;55(1):146-157. doi: 10.1016\/j.jmir.2024.01.001.<\/li>\n
  15. Bilski M, Szklener K, Szklener S, Rudzi\u0144ska A, Kluz N, Klas J, Rodzajewska A, Kury\u0142o W, Korga M, Baranowska I, Ma\u0144dziuk S. Stereotactic radiosurgery in the treatment of essential tremor – a systematic review. Front Neurol. 2024 Apr 3;15:1370091. doi: 10.3389\/fneur.2024.1370091.<\/li>\n
  16. Romanelli P, Anschel DJ. Radiosurgery for epilepsy. Lancet Neurol. 2006 Jul;5(7):613-20. doi: 10.1016\/S1474-4422(06)70496-3.<\/li>\n
  17. McGonigal A, Sahgal A, De Salles A, Hayashi M, Levivier M, Ma L, Martinez R, Paddick I, Ryu S, Slotman BJ, R\u00e9gis J. Radiosurgery for epilepsy: Systematic review and International Stereotactic Radiosurgery Society (ISRS) practice guideline. Epilepsy Res. 2017 Nov;137:123-131. doi: 10.1016\/j.eplepsyres.2017.08.016.<\/li>\n<\/ol>\n<\/figure>\n<\/div>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

    La radiocirug\u00eda estereot\u00e1ctica (SRS) ha demostrado ser una herramienta eficaz y segura en el tratamiento de diversas enfermedades no tumorales del sistema nervioso central (SNC), especialmente en casos donde la cirug\u00eda convencional representa alto riesgo. En malformaciones arteriovenosas (MAV), la SRS ha mostrado tasas elevadas de obliteraci\u00f3n y baja incidencia de complicaciones tanto en adultos como en poblaci\u00f3n pedi\u00e1trica, siendo m\u00e1s efectiva sin embolizaci\u00f3n previa y con dosis elevadas<\/p>","protected":false},"author":1,"featured_media":20160,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[23,357,394,24],"tags":[391],"class_list":["post-20158","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-informacion-sobre-el-cancer","category-investigacion","category-radiocirugia","category-tratamiento","tag-radiocirugia"],"yoast_head":"\nRADIOCIRUG\u00cdA ESTEREOT\u00c1CTICA EN ENFERMEDADES NO TUMORALES DEL SISTEMA NERVIOSO CENTRAL<\/title>\n<meta name=\"description\" content=\"La radiocirug\u00eda estereot\u00e1ctica (SRS) ha demostrado ser una herramienta eficaz y segura en el tratamiento de diversas enfermedades no tumorales del sistema nervioso central (SNC), especialmente en casos donde la cirug\u00eda convencional representa alto riesgo. 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