title: Chained lightning, part I: Exploitation of energy and radiobiological principles for therapeutic purposes.
abstract: The fundamental principle of radiosurgery is the focusing of energy within a restricted target volume. In examining the history of radiosurgery, various strategies for addressing this issue of energy containment become apparent. This is the first in a series of articles that reviews the evolution of radiosurgery through the development of instruments for beam generation and delivery for improved conformal therapy. In this first part of the series, we focus specifically on beam generation and the development of particle beams as the initial approach in radiosurgery for focused radiation treatment. We examine the physical characteristics and biological effects of particles and the unique advantage they confer for radiosurgery. We consider clinical studies and treatment of neurological diseases with particles and also assess boron neutron capture therapy as a strategy for selectively targeting neutron beams. Later in this series, we explore methods of beam delivery with the development of stereotactic radiosurgery. Finally, we introduce new concepts and applications in radiosurgery such as nanotechnology, radiation enhancement, ultrasound, near infrared, and free electron lasers. The elaboration of these efforts sets the stage for neurosurgeons to further explore new ideas, develop innovative technology, and advance the practice of radiosurgery.
authors.affiliation: Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA. dj_hoh@yahoo.com
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Hoh
authors.forename: Charles Y
authors.initials: CY
authors.lastname: Liu
authors.forename: Paul G
authors.initials: PG
authors.lastname: Pagnini
authors.forename: Cheng
authors.initials: C
authors.lastname: Yu
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Wang
authors.forename: Michael L J
authors.initials: ML
authors.lastname: Apuzzo
mesh_terms: D001921:Brain / Q000503:physiopathology* / Q000528:radiation effects*; D001927:Brain Diseases / Q000503:physiopathology* / Q000601:surgery*; D004735:Energy Transfer; D005544:Forecasting; D006801:Humans; D011853:Radiobiology / Q000379:methods; D016634:Radiosurgery / Q000295:instrumentation / Q000379:methods* / Q000639:trends*