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spine radiosurgery

Nancy E Epstein
Background: Spinal meningiomas are found in patients typically between the ages of 75 and 84: some report the average age to be 50. They occur with an incidence of approximately 1000 patients per year in the US, are mostly single (90%) rather than multiple (10%), and arise from the spinal meninges (arachnoid/dura). Tumors are typically posterior/posterolateral (70%) in location, leaving the remaining 30% in the anterior/anterolateral spinal canal. They produce symptoms and signs of radiculopathy (nerve root) and/or myelopathy (cord compression) depending on their site of origin...
2018: Surgical Neurology International
Kelly C Younge, Robin B Marsh, Dawn Owen, Huaizhi Geng, Ying Xiao, Daniel E Spratt, Joseph Foy, Krithika Suresh, Q Jackie Wu, Fang-Fang Yin, Samuel Ryu, Martha M Matuszak
PURPOSE: To use knowledge-based planning (KBP) as a method of producing high-quality, consistent, protocol-compliant treatment plans in a complex setting of spine stereotactic body radiation therapy on NRG Oncology Radiation Therapy Oncology Group (RTOG) 0631. METHODS AND MATERIALS: An internally developed KBP model was applied to an external validation cohort of 22 anonymized cases submitted under NRG Oncology RTOG 0631. The original and KBP plans were compared via their protocol compliance, target conformity and gradient index, dose to critical structures, and dose to surrounding normal tissues...
March 15, 2018: International Journal of Radiation Oncology, Biology, Physics
Ori Barzilai, Charles G Fisher, Mark H Bilsky
Treatment paradigms for patients with spine metastases have evolved significantly over the past decade. Incorporating stereotactic radiosurgery into these paradigms has been particularly transformative, offering precise delivery of tumoricidal radiation doses with sparing of adjacent tissues. Evidence supports the safety and efficacy of radiosurgery as it currently offers durable local tumor control with low complication rates even for tumors previously considered radioresistant to conventional radiation. The role for surgical intervention remains consistent, but a trend has been observed toward less aggressive, often minimally invasive, techniques...
February 22, 2018: Neurosurgery
Yair Hillman, Josh Kim, Indrin Chetty, Ning Wen
PURPOSE: Mobius 3D (M3D) provides a volumetric dose verification of the treatment planning system's calculated dose using an independent beam model and a collapsed cone convolution superposition algorithm. However, there is a lack of investigation into M3D's accuracy and effectiveness for stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) quality assurance (QA). Here, we collaborated with the vendor to develop a revised M3D beam model for SRS/SBRT cases treated with a 6X Flattening Filter Free (FFF) beam and high definition multiple leaf collimator (HDMLC) on an Edge linear accelerator...
February 12, 2018: Medical Physics
Dennis T Lockney, Angela Y Jia, Eric Lis, Natalie A Lockney, Chengbao Liu, Benjamin Hopkins, Daniel S Higginson, Yoshiya Yamada, Ilya Laufer, Mark Bilsky, Adam M Schmitt
OBJECTIVE Spinal stereotactic body radiation therapy (SBRT) has emerged as an attractive method to deliver high doses of radiation to oligometastatic spinal tumors with radioresistant histology. Because SBRT is a palliative therapy, attention to potential radiation toxicities is paramount when counseling patients. The objective of this study was to report radiation-induced myositis after SBRT, a previously undescribed complication. METHODS A total of 667 patients received 891 spine SBRT treatments (either 24 Gy in 1 fraction or 27 Gy in 3 fractions) from 2011 to 2016 and underwent retrospective review...
January 26, 2018: Journal of Neurosurgery. Spine
Ehsan H Balagamwala, Jacob A Miller, Chandana A Reddy, Lilyana Angelov, John H Suh, Muhammad B Tariq, Erin S Murphy, Kailin Yang, Toufik Djemil, Anthony Magnelli, Alireza M Mohammadi, Sherry Soeder, Samuel T Chao
Spine stereotactic radiosurgery (SRS) offers excellent radiographic and pain control for patients with spine metastases. We created a prognostic index using recursive partitioning analysis (RPA) to allow better patient selection for spine SRS. Patients who underwent single-fraction spine SRS for spine metastases were included. Primary histologies were divided into favorable (breast/prostate), radioresistant (renal cell/sarcoma/melanoma) and other. Cox proportional hazards regression was done to identify factors associated with overall survival (OS)...
January 3, 2018: Journal of Neuro-oncology
Evangelia Katsoulakis, Andrew Jackson, Brett Cox, Michael Lovelock, Yoshiya Yamada
OBJECTIVE: Dose-volume tolerance of the spinal cord (SC) in spinal stereotactic radiosurgery (SRS) is difficult to define because radiation myelitis rates are low, and published reports document cases of myelopathy but do not account for the total number of patients treated at given dose-volume combinations who do not have myelitis. This study reports SC toxicity from single-fraction spinal SRS and presents a comprehensive atlas of the incidence of adverse events to examine dose-volume predictors...
November 1, 2017: International Journal of Radiation Oncology, Biology, Physics
Daniel E Spratt, Whitney H Beeler, Fabio Y de Moraes, Laurence D Rhines, Joseph J Gemmete, Neeraj Chaudhary, David B Shultz, Sean R Smith, Alejandro Berlin, Max Dahele, Ben J Slotman, Kelly C Younge, Mark Bilsky, Paul Park, Nicholas J Szerlip
Spinal metastases are becoming increasingly common because patients with metastatic disease are living longer. The close proximity of the spinal cord to the vertebral column limits many conventional therapeutic options that can otherwise be used to treat cancer. In response to this problem, an innovative multidisciplinary approach has been developed for the management of spinal metastases, leveraging the capabilities of image-guided stereotactic radiosurgery, separation surgery, vertebroplasty, and minimally invasive local ablative approaches...
December 2017: Lancet Oncology
James Pan, Rashad Jabarkheel, Yuhao Huang, Allen Ho, Steven D Chang
Hemangioblastomas are rare, benign, vascular tumors of the central nervous system (CNS), often associated with von-hippel lindau (VHL) disease. Current therapeutic options include microsurgical resection or stereotactic radiosurgery (SRS). With no randomized controlled studies and minimal data beyond single-institution reviews, the optimal management approach for patients with CNS hemangioblastomas is unclear. We completed a Pubmed/SCOPUS literature search from January 1990 to January 2017 for eligible studies on SRS for CNS hemangioblastomas...
March 2018: Journal of Neuro-oncology
Pierre Kehr
No abstract text is available yet for this article.
November 28, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Ori Barzilai, Lily McLaughlin, Mary-Kate Amato, Anne S Reiner, Shahiba Q Ogilvie, Eric Lis, Yoshiya Yamada, Mark H Bilsky, Ilya Laufer
BACKGROUND CONTEXT: Surgical decompression and stabilization followed by radiosurgery represents an effective method for local tumor control and neurologic preservation for patients with metastatic epidural spinal cord compression. We have previously demonstrated improvement in HrQOL after this combined modality treatment ("hybrid therapy"). PURPOSE: The current analysis focuses on delineation of patient-specific prognostic factors predictive of HrQOL change after combined surgery-SRS treatment of MESCC...
November 6, 2017: Spine Journal: Official Journal of the North American Spine Society
Douglas Blaty, Michael Malos, Thomas Palmrose, Stephen McGirr
BACKGROUND: The purpose of this case report is to present a rare finding of an intradural extramedullary hemangioblastoma of the cauda equina, with literature review. Spinal hemangioblastomas account for 1-5% of all spinal cord tumors. While spinal hemangioblastomas are rare, it is exceedingly rare to have a case of intradural extramedullary hemangioblastoma of the spine, especially in isolation without von-Hippel-Lindau syndrome. Only 20 previous cases have been reported. CASE DESCRIPTION: An 82-year-old male presented with MRI evidence of an intradural mass at the L4 spinal level...
October 28, 2017: World Neurosurgery
Brandon W Smith, Jacob R Joseph, Yamaan S Saadeh, Frank La Marca, Nicholas J Szerlip, Thomas C Schermerhorn, Daniel E Spratt, Kelly C Younge, Paul Park
BACKGROUND: The incidence of renal cell carcinoma (RCC) continues to rise, and the spine is the most common site for bony metastasis. Radiation therapy is one treatment for spinal RCC metastasis. Stereotactic body radiotherapy (SBRT) is a newer treatment that reportedly has benefits over conventional external beam radiotherapy (cEBRT). This study systematically reviewed the current literature on SBRT for metastatic RCC to spine. METHODS: A search of PubMed, Embase, and Scopus databases was conducted in accordance with PRISMA guidelines...
October 13, 2017: World Neurosurgery
Vincent Bernard, Andrew J Bishop, Pamela K Allen, Behrang Amini, Xin A Wang, Jing Li, Claudio E Tatsui, Laurence D Rhines, Paul D Brown, Amol J Ghia
PURPOSE: To characterize outcomes of metastatic colorectal and non-small cell lung cancer (NSCLC) histologies, compared with other radiosensitive histologies, treated with spine stereotactic radiosurgery with regard to local control, overall survival, and predictors of response. METHODS AND MATERIALS: A total of 127 patients with 148 spine stereotactic radiosurgery-treated metastatic lesions at our institution between 2003 and 2013 were reviewed. We assessed clinical endpoints in relation to histologic type, including local control (LC) and overall survival (OS), using univariate and multivariate analyses...
December 1, 2017: International Journal of Radiation Oncology, Biology, Physics
Jonathan G Thomas, Wajd N Al-Holou, Dhiego Chaves de Almeida Bastos, Amol J Ghia, Jing Li, Andrew J Bishop, Behrang Amini, Laurence D Rhines, Claudio E Tatsui
Spinal laser interstitial thermal therapy (LITT) appears to be a promising novel modality for treatment of epidural metastatic spine disease in patients who are poor candidates for larger-scale oncologic spinal surgery and can act synergetically with spinal stereotactic radiosurgery to maximize local control and palliate pain. This technique is ideally suited for the intraoperative MRI suite to monitor the extent of the ablation in the epidural space. As percutaneous navigation, imaging, and LITT technology improve, broader applicability of this minimally invasive technique in spinal oncology is foreseen...
October 2017: Neurosurgery Clinics of North America
Lijun Ma, Lei Wang, Chia-Lin Tseng, Arjun Sahgal
Stereotactic body radiation therapy (SBRT) stems from the initial developments of intra-cranial stereotactic radiosurgery (SRS). Despite similarity in their names and clinical goals of delivering a sufficiently high tumoricidal dose, maximal sparing of the surrounding normal tissues and a short treatment course, SBRT technologies have transformed from the early days of body frame-based treatments with X-ray verification to primarily image-guided procedures with cone-beam CT or stereoscopic X-ray systems and non-rigid body immo-bilization...
September 2017: Chinese Clinical Oncology
Adam M Robin, Yoshiya Yamada, Lily A McLaughlin, Adam Schmitt, Daniel Higginson, Eric Lis, Mark H Bilsky
No abstract text is available yet for this article.
September 1, 2017: Neurosurgery
Dilan A Patel, Jian L Campian
Malignant epidural spinal cord compression (MESCC) is an oncologic emergency with the potential for devastating consequences for patients if not promptly diagnosed and treated. MESCC is diagnosed by imaging. MRI is by far the most sensitive test, preferably with gadolinium. Once the diagnosis of MESCC is suspected, patients with neurologic deficits should receive prompt administration of dexamethasone with a 10-mg IV loading dose followed by 4 mg every 6 h. Quick taper is recommended once the definitive treatment is established...
August 10, 2017: Current Treatment Options in Oncology
Jacob A Miller, Ehsan H Balagamwala, Camille A Berriochoa, Lilyana Angelov, John H Suh, Edward C Benzel, Alireza M Mohammadi, Todd Emch, Anthony Magnelli, Andrew Godley, Peng Qi, Samuel T Chao
OBJECTIVE Spine stereotactic radiosurgery (SRS) is a safe and effective treatment for spinal metastases. However, it is unknown whether this highly conformal radiation technique is suitable at instrumented sites given the potential for microscopic disease seeding. The authors hypothesized that spinal decompression with instrumentation is not associated with increased local failure (LF) following SRS. METHODS A 2:1 propensity-matched retrospective cohort study of patients undergoing SRS for spinal metastasis was conducted...
October 2017: Journal of Neurosurgery. Spine
Sten Myrehaug, Arjun Sahgal, Motohiro Hayashi, Marc Levivier, Lijun Ma, Roberto Martinez, Ian Paddick, Jean Régis, Samuel Ryu, Ben Slotman, Antonio De Salles
OBJECTIVE Spinal metastases that recur after conventional palliative radiotherapy have historically been difficult to manage due to concerns of spinal cord toxicity in the retreatment setting. Spine stereotactic body radiation therapy (SBRT), also known as stereotactic radiosurgery, is emerging as an effective and safe means of delivering ablative doses to these recurrent tumors. The authors performed a systematic review of the literature to determine the clinical efficacy and safety of spine SBRT specific to previously irradiated spinal metastases...
October 2017: Journal of Neurosurgery. Spine
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