Alain C. J. de Lotbinière, M.D.
Mission
The Yale Radiosurgery Program is a multidisciplinary effort designed to meet the needs of patients suffering from a variety of intracranial disorders, which are either unsuitable for more traditional treatments with "open" surgery or radiation therapy. Initiated in 1991, the program has been recently expanded with the addition of the Gamma Knife to include treatment of trigeminal neuralgia, movement disorders and other types of intractable pain..
Clinical Care
Given the rapidly changing environment affecting the accessibility and delivery of health care, stereotactic radiosurgery is being increasingly recognized as a cost effective alternative to open surgery, avoiding many of the potential complications of the latter. This is most clearly demonstrated in the treatment of patients with brain metastases, the most common intracranial tumor to afflict mankind. Avoiding prolonged hospitalization with a limited survival, patients can return within 24 hours to their former activities at a substantially reduced cost when compared to the alternative, craniotomy for removal of their tumor(s).
In order to ensure that the appropriate patient is selected for this form of treatment, the case is reviewed by a multidisciplinary team within the context of a neuro-oncology or neuro-vascular conference. This is designed to ensure that all potential options are carefully considered prior to recommending a radiosurgical treatment. This is in keeping with the goal of the program, namely to provide a tertiary consultation and treatment service at both a local and a national level.
Research
Research concerning the biology of the radiosurgical lesion, its time to maturity and the histology affecting the target areas and surrounding brain have been studied in collaboration with Dr. Patricia Goldman-Rakic in neuro-biology. The results of these studies have been presented at international meetings and are in the process of being prepared for publication. Clinical research analyzing retrospectively the results of the radiosurgery together with collaborative projects with other centers using radiosurgery are ongoing in an effort to answer fundamental questions concerning the clinical role of radiosurgery to treat a variety of intracranial lesions. The close follow-up of patients who have undergone this form of treatment by a multidisciplinary staff is felt to be an integral part of the clinical research effort, without which outcome measures would be impossible.
Education
A multidisciplinary approach which lies at the base of the radiosurgery program provides a context in which the education of students, residents and clinicians will continue on an ongoing basis. As the indications for radiosurgery undergo modifications by virtue of the experience gained in the field, the multidisciplinary setting ensures that all aspects, including follow-up, are discussed. This enables the participant to view how an emerging technology can effect the practice of medicine at multiple levels.
The Stereotactic Radiosurgery Program can be reached at 203-785-2808
or email to alain.delotbiniere@yale.edu
Neurosurgery Faculty/Program Menu
Department of Neurosurgery address and phone number
http://info.yale.med.edu/surgery/neurosur/neuroonco.html
credits
