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Local interstitial radiation therapy of intrinsic and inaccessible
brain tumors is confronted with two major problems: 1. The
tolerance of normal brain tissue, which is usually involved in
local tumor irradiation, i.e. perifocal white matter edema and
demyelinating effects, is crucial. 2. Data on radiation effects of
implanted radioactive sources on neoplastic tissue, i.e. data on
the radiosensitivity and on the biology of tumors, are still widely
unavailable. In clinical practice the dose with which to achieve a
given volume of tumor necrosis is roughly estimated. This report
deals with the experimental findings of Iodine-125 and Iridium-I92
permanent implants in healthy and neoplastic brain tissue. Our own
experimental findings are correlated with experimental data on
Yttnul11-l)O irradiation from the literature. The study is directed
to collect data on the tolerance non-tumoral brain tissue and to
attempt to establish a dose-response relationship. Morphologic
Changes in the Dog Brain Following Interstitial Iodine-125
Irradiation Iodine-I25 seeds (manufactured by 3 M Company, St.
Paul, M. N.) with an activity of 3.55 mCi were permanently
implanted under stereotactic conditions into the subcortical white
matter of the gyrus coronalis of the left hemisphere in 6 beagle
dogs. One animal with a non-radioactive seed implanted under
similar operative conditions served as a control. The animals were
allowed to survive 25, 46, 71, 94, 248, 368 days, respectively,
after the implantation. The control animal survived 46 days. A
detailed description of the experimental procedure is given
elsewhere 16. 17.
Thus instead of being synonymous with specific procedures per-
formed at the level of the basal ganglia, stereotaxis is in fact a
general diagnostic and therapeutic concept, which has as its aim
the precise three-dimensional representation of the patient's brain
in its entirety. This three-dimensional representation is based on
anatomical, neuro- radiological and other localizing information,
the spatial integration Prof. Jean Talairach with friends and
coworkers at the congress dinner in the Royaumont Abbey near Paris.
(From left to right: Drs. ]. Bancaud, N. T. Zervas, B. Nashold, ].
Talairach, G. Szikla, F. Mundinger, P. Tournoux, ]. Peeker) of
which allows a more precise "anatomical" approach to the human
brain and to the surgical management of localized pathologic
proces- ses. Literally, stereotaxis means "orientation in space".
Taken in this general sense, all surgical procedures obviously
should be stereo- tactic, at least in their principle! Two of the
main themes of our meeting, namely the topic of the first day,
"Surgery of Epilepsy" and that of the second "Stereotactic Cerebral
Irradiation" of small brain tumours correspond to this evolution
toward a global "whole brain" concept of stereotaxis. The same
philosophy inspired the scientific efforts of the stereotactic
group Introduction 3 of the Sainte Anne Hospital, under the
leadership of its promoter, Professor Jean Talairach. This is the
reason why the present Meeting is dedicated in honor of his
scientific work.
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