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https://www.readbyqxmd.com/read/28096104/recent-developments-in-the-surgical-management-of-paediatric-epilepsy
#1
REVIEW
Vijay M Ravindra, Matthew T Sweney, Robert J Bollo
Among the 1% of children affected by epilepsy, failure of pharmacological therapy and early age of seizure onset can lead to worse long-term cognitive outcomes, mental health disorders and impaired functional status. Surgical management often improves functional and cognitive outcomes in children with medically refractory epilepsy, especially when seizure remission is achieved. However, surgery remains underused in children with drug-resistant epilepsy, creating a large treatment gap. Several recent innovations have led to considerable improvement in surgical technique, including the recent development of minimally invasive diagnostic and therapeutic techniques such as stereotactic EEG, transcranial magnetic stimulation, MRI-guided laser ablation, as well as novel paradigms of neurostimulation...
January 17, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28078405/-radiosurgery-and-fractionated-stereotactic-radiotherapy-of-vestibular-schwannoma
#2
K Hamm, H-U Herold, G Surber, S Rosahl
Management of vestibular schwannoma (VS) should always be interdisciplinary and results better than the natural course. Particularly in small VS, either microsurgical resection or radiosurgery (RS) can be employed. RS is a special method (initially only possible stereotactically) for delivering high-precision radiation from many directions to the target point (the isocenter) in a single high dose. With the development of three different systems-Gamma Knife (Elekta, Stockholm, Sweden), special linear accelerators, and CyberKnife (Accuray, Sunnyvale, CA, USA)-the options were extended to 1-5 fractions for RS and multisession RS (msRS), and to up to 6 weeks of conventional fractionation as stereotactic radiotherapy (SRT)...
January 11, 2017: HNO
https://www.readbyqxmd.com/read/28074327/when-should-negative-endobronchial-ultrasonography-findings-be-confirmed-by-a-more-invasive-procedure
#3
Basil S Nasir, Kazuhiro Yasufuku, Moishe Liberman
The treatment of non-small cell lung cancer is largely dependent on accurate staging in order to determine appropriate therapy. Despite advances in imaging, such as computed tomography and positron emission tomography, invasive mediastinal staging is frequently needed to rule out mediastinal involvement prior to curative-intent stereotactic ablative radiotherapy or surgical resection. Surgical mediastinal staging with mediastinoscopy, or anterior mediastinotomy, were traditionally considered the gold standard for invasive mediastinal staging...
January 10, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28058710/stereotactic-ablative-radiotherapy-for-patients-with-unresectable-or-medically-inoperable-cholangiocarcinoma
#4
Ming-Yueh Liu, Cheng-Hsiang Lo, Chun-Shu Lin, Hsing-Lung Chao, Jen-Fu Yang, Kuen-Tze Lin, Chao-Yueh Fan, Yu-Fu Su, Wen-Yen Huang
PURPOSE: The role of stereotactic ablative radiotherapy (SABR) in patients with unresectable or medically inoperable cholangiocarcinoma remains unclear. We examined the efficacy and safety of SABR in this group of patients. METHODS: From January 2008 to December 2014, 15 patients with 17 lesions were included in this study. The lesions included 14 intrahepatic, 1 hilar, and 2 distal bile duct tumors. Three patients were classified as medically inoperable because of old age or multiple comorbidities...
January 5, 2017: Tumori
https://www.readbyqxmd.com/read/28056412/toxicity-of-concurrent-stereotactic-radiotherapy-and-targeted-therapy-or-immunotherapy-a-systematic-review
#5
REVIEW
Stephanie G C Kroeze, Corinna Fritz, Morten Hoyer, Simon S Lo, Umberto Ricardi, Arjun Sahgal, Rolf Stahel, Roger Stupp, Matthias Guckenberger
BACKGROUND AND PURPOSE: Both stereotactic radiotherapy (SRT) and immune- or targeted therapy play an increasingly important role in personalized treatment of metastatic disease. Concurrent application of both therapies is rapidly expanding in daily clinical practice. In this systematic review we summarize severe toxicity observed after concurrent treatment. MATERIAL AND METHODS: PubMed and EMBASE databases were searched for English literature published up to April 2016 using keywords "radiosurgery", "local ablative therapy", "gamma knife" and "stereotactic", combined with "bevacizumab", "cetuximab", "crizotinib", "erlotinib", "gefitinib", "ipilimumab", "lapatinib", "sorafenib", "sunitinib", "trastuzumab", "vemurafenib", "PLX4032", "panitumumab", "nivolumab", "pembrolizumab", "alectinib", "ceritinib", "dabrafenib", "trametinib", "BRAF", "TKI", "MEK", "PD1", "EGFR", "CTLA-4" or "ALK"...
December 19, 2016: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28054139/-local-ablative-radiotherapy-of-oligometastatic-colorectal-cancer
#6
C Petersen, T Gauer
BACKGROUND: Colorectal cancer (CRC) often presents as oligometastatic disease. Currently available intensive systemic treatment regimens, including combination chemotherapy and molecular targeted agents, result in tumor response and transient to long-term disease control in a high percentage of patients, thus raising the question of further management. Secondary resection and ablation, e.g. by surgery or radiofrequency may contribute to long-term survival and even be curative or at least allow a relevant chemotherapy-free interval...
January 4, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28054137/-local-treatment-of-solitary-intrapulmonary-malignant-nodules
#7
J Op den Winkel, F Eichhorn, S Rieken, H Dienemann
DEFINITION: Intrapulmonary nodules generally represent an incidental finding in the roentgenogram or computed tomography (CT) scan of the chest. They are defined as single, well-circumscribed, radiographic opaque lesions that measures up to 3 cm in diameter and are surrounded completely by aerated lung. The probability of malignancy directly correlates with increasing diameter. Lesions that have a diameter of 1 cm or larger require direct evaluation. THERAPY: Surgery is the first option for patients with a malignant lesion, given an acceptable perioperative risk; for high-risk patients either radiofrequency ablation (RFA) or stereotactic body radiation therapy (SBRT) should be offered...
January 4, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28048479/we-ab-207b-01-dose-tolerance-for-sbrt-sabr
#8
J Grimm
PURPOSE: Stereotactic body radiation therapy (SBRT) / stereotactic ablative body radiotherapy (SABR) is gaining popularity, but quantitative dose tolerance has still been lacking. To improve this, the April 2016 issue of Seminars in Radiation Oncology will have normal tissue complication probability (NTCP) models for 10 critical structures: optic pathway, cochlea, oral mucosa, esophagus, chestwall, aorta, bronchi, duodenum, small bowel, and spinal cord. METHODS: The project included more than 1500 treatments in 1-5 fractions using CyberKnife, Gamma Knife, or LINAC, with 60 authors from 15 institutions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048369/su-f-t-558-arccheck-for-patient-specific-qa-in-stereotactic-ablativeradiotherapy
#9
P Ramachandran, A Tajaldeen, D Taylor, D Wanigaratne, K Roozen, N Esen, M Geso, T Kron
PURPOSE: Stereotactic Ablative Radiotherapy (SABR) is one of the most preferred treatment techniques for early stage lung cancer. This technique has been extended to other treatment sites like Spine, Liver, Scapula, Sternum etc., This has resulted in increased physics QA time on machine. In this study, we've tested the feasibility of using ArcCheck as an alternative method to replace film dosimetry. METHODS: Twelve patients with varied diagnosis of Lung, Liver, scapula, sternum and Spine undergoing SABR were selected for this study...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048360/mo-b-201-03-mri-guided-tracking-and-gating
#10
O Green
: The motion management in stereotactic body radiation therapy (SBRT) is a key to success for a SBRT program, and still an on-going challenging task. A major factor is that moving structures behave differently than standing structures when examined by imaging modalities, and thus require special considerations and employments. Understanding the motion effects to these different imaging processes is a prerequisite for a decent motion management program. The commonly used motion control techniques to physically restrict tumor motion, if adopted correctly, effectively increase the conformity and accuracy of hypofractionated treatment...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048243/mo-b-201-00-motion-management-in-current-stereotactic-body-radiation-therapy-sbrt-practice
#11
Charles Shang
: The motion management in stereotactic body radiation therapy (SBRT) is a key to success for a SBRT program, and still an on-going challenging task. A major factor is that moving structures behave differently than standing structures when examined by imaging modalities, and thus require special considerations and employments. Understanding the motion effects to these different imaging processes is a prerequisite for a decent motion management program. The commonly used motion control techniques to physically restrict tumor motion, if adopted correctly, effectively increase the conformity and accuracy of hypofractionated treatment...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048221/su-f-t-617-remotely-pre-planned-stereotactic-ablative-radiation-therapy-validation-of-treatment-plan-quality
#12
T Juang, K Bush, B Loo, M Gensheimer
PURPOSE: We propose a workflow to improve access to stereotactic ablative radiation therapy (SABR) for rural patients. When implemented, a separate trip to the central facility for simulation can be eliminated. Two elements are required: (1) Fabrication of custom immobilization devices to match positioning on prior diagnostic CT (dxCT). (2) Remote radiation pre-planning on dxCT, with transfer of contours/plan to simulation CT (simCT) and initiation of treatment same-day or next day. In this retrospective study, we validated part 2 of the workflow using patients already treated with SABR for upper lobe lung tumors...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047754/su-f-t-644-reproducibility-of-target-position-using-moderate-voluntary-breath-hold-during-liver-stereotactic-ablative-radiotherapy
#13
G Cui, N Trakul, E Chang, A Shiu
PURPOSE: To evaluate the reproducibility of target position using moderate voluntary breath-hold during liver stereotactic ablative radiotherapy (SABR). METHODS: Two patients who underwent liver SABR on a Varian TrueBeam STx linac were used for this study. Fiducial markers were placed in and around the target in the liver as surrogates for the target position and motion. GTVs were contoured by assessing tumor extent on contrast enhanced CT. The PTV was created from the GTV by adding 2 mm margins to account for the residual motion during breath-holds...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047597/mo-b-201-01-overcoming-the-challenges-of-motion-management-in-current-lung-sbrt-practice
#14
C Shang
: The motion management in stereotactic body radiation therapy (SBRT) is a key to success for a SBRT program, and still an on-going challenging task. A major factor is that moving structures behave differently than standing structures when examined by imaging modalities, and thus require special considerations and employments. Understanding the motion effects to these different imaging processes is a prerequisite for a decent motion management program. The commonly used motion control techniques to physically restrict tumor motion, if adopted correctly, effectively increase the conformity and accuracy of hypofractionated treatment...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047581/su-g-jep2-01-a-new-approach-for-mr-only-treatment-planning-tissue-segmentation-based-pseudo-ct-generation-using-t1-weighted-mri
#15
H Yu, Y Lee, B Chugh, C Tseng, M Campbell, K Leszczynski, A Sahgal
PURPOSE: To evaluate MR-only treatment planning for brain Stereotactic Ablative Radiotherapy (SABR) based on pseudo-CT (pCT) generation using one set of T1-weighted MRI. METHODS: T1-weighted MR and CT images from 12 patients who were eligible for brain SABR were retrospectively acquired for this study. MR-based pCT was generated by using a newly in-house developed algorithm based on MR tissue segmentation and voxel-based electron density (ED) assignment (pCTv). pCTs using bulk density assignment (pCTb where bone and soft tissue were assigned 800HU and 0HU,respectively), and water density assignment (pCTw where all tissues were assigned 0HU) were generated for comparison of ED assignment techniques...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047448/su-f-t-59-the-effect-of-radiotherapy-dose-on-immunoadjuvants
#16
M Moreau, S Yasmin-Karim, Y Hao, W Ngwa
PURPOSE: Combining radiotherapy with immunotherapy is a promising approach to enhance treatment outcomes for cancer patients. This in-vitro study investigated which radiotherapy doses could adversely affect the function of anti-CD40 mAb, which is one of the key immunoadjuvants under investigations for priming such combination therapy. METHODS: Human monocyte derived THP-1 cells were treated with 100ng/mL of PMA in chamber slides to differentiate into macrophage...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047237/tu-h-campus-tep1-01-variable-beam-fractionation-for-sabr
#17
A Modiri, A Sawant
PURPOSE: In current conventionally-fractionated as well as hypofractionated 3D conformal radiotherapy (CRT), the same beam arrangement is employed from fraction to fraction. We challenge this notion and postulate that by varying the beam arrangement between fractions we can achieve greater sparing of organs at risk (OARs) while maintaining PTV coverage. We use an inverse planning strategy using a swarm intelligence-based global optimization algorithm to exploit the additional degree of freedom represented by inter-fractional variation in beam angles...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046946/mo-b-201-02-motion-management-for-proton-lung-sbr
#18
S Flampouri
: The motion management in stereotactic body radiation therapy (SBRT) is a key to success for a SBRT program, and still an on-going challenging task. A major factor is that moving structures behave differently than standing structures when examined by imaging modalities, and thus require special considerations and employments. Understanding the motion effects to these different imaging processes is a prerequisite for a decent motion management program. The commonly used motion control techniques to physically restrict tumor motion, if adopted correctly, effectively increase the conformity and accuracy of hypofractionated treatment...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046812/su-g-brb-07-developing-a-qa-procedure-for-gated-vmat-sabr-treatments-using-10-mv-beam-in-flattening-filter-free-mode
#19
S Chitsazzadeh, D Wells, A Mestrovic
PURPOSE: To develop a QA procedure for gated VMAT stereotactic ablative radiotherapy (SABR) treatments. METHODS: An interface was constructed to attach the translational stage of a Quasar respiratory motion phantom to a pinpoint ion chamber insert and move the ion chamber inside an ArcCheck diode array. The Quasar phantom controller used a patient specific breathing pattern to translate the ion chamber in a superior-inferior direction inside the ArcCheck. An amplitude-based RPM tracking system was specified to turn the beam on during the exhale phase of the breathing pattern...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045603/cost-effectiveness-of-stereotactic-body-radiation-therapy-versus-radiofrequency-ablation-for-hepatocellular-carcinoma-a-markov-modeling-study
#20
Erqi L Pollom, Kyueun Lee, Ben Y Durkee, Madeline Grade, Daniel A Mokhtari, Daniel R Wahl, Mary Feng, Nishita Kothary, Albert C Koong, Douglas K Owens, Jeremy Goldhaber-Fiebert, Daniel T Chang
Purpose To assess the cost-effectiveness of stereotactic body radiation therapy (SBRT) versus radiofrequency ablation (RFA) for patients with inoperable localized hepatocellular carcinoma (HCC) who are eligible for both SBRT and RFA. Materials and Methods A decision-analytic Markov model was developed for patients with inoperable, localized HCC who were eligible for both RFA and SBRT to evaluate the cost-effectiveness of the following treatment strategies: (a) SBRT as initial treatment followed by SBRT for local progression (SBRT-SBRT), (b) RFA followed by RFA for local progression (RFA-RFA), (c) SBRT followed by RFA for local progression (SBRT-RFA), and (d) RFA followed by SBRT for local progression (RFA-SBRT)...
January 3, 2017: Radiology
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