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Stereotactic ablative

Elisabeth Steiner, Chun-Chien Shieh, Vincent Caillet, Jeremy Booth, Nicholas Hardcastle, Adam Briggs, Dasantha Jayamanne, Carol Haddad, Thomas Eade, Paul Keall
PURPOSE: Four-dimensional cone beam computed tomography (4DCBCT) facilitates verification of lung tumor motion before each treatment fraction and enables accurate patient setup in lung stereotactic ablative body radiation therapy. This work aims to quantify the real-time motion represented in 4DCBCT, depending on the reconstruction algorithm and the respiratory signal utilized for reconstruction. METHODS AND MATERIALS: Eight lung cancer patients were implanted with electromagnetic Calypso beacons in airways close to the tumor, enabling real-time motion measurements...
April 27, 2018: International Journal of Radiation Oncology, Biology, Physics
M A Palacios, O Bohoudi, A M E Bruynzeel, J R van Sörnsen-de Koste, P Cobussen, B J Slotman, F J Lagerwaard, S Senan
PURPOSE: To study inter-fractional organ changes during MR-guided stereotactic ablative radiotherapy (SABR) for adrenal metastases and to evaluate the dosimetric advantages of online plan adaptation. METHODS AND MATERIALS: Seventeen patients underwent a total of 84 fractions of video-assisted, respiration-gated MR-guided adaptive radiotherapy to deliver either 50 Gy (5 fractions), 60 Gy (8 fractions) or 24 Gy (3 fractions). An MR scan was repeated prior to each fraction, followed by rigid co-registration to the GTV on the pre-treatment MR scan...
June 11, 2018: International Journal of Radiation Oncology, Biology, Physics
Kiri A Sandler, Fereidoun Abtin, Robert Suh, Ryan R Cook, Carol Felix, Jay M Lee, Edward B Garon, Jeffrey Wu, Elaine M Luterstein, Nzhde Agazaryan, Stephen E Tenn, Chul Lee, Michael L Steinberg, Percy Lee
PURPOSE: Stereotactic body radiation therapy (SBRT) and heat-based ablation (HBA) are both potentially safe and effective treatments for primary and metastatic lung tumors. Both are suboptimal for centrally located tumors, with SBRT having a higher risk of significant toxicity and HBA having lower efficacy. This study evaluates the safety and efficacy of combination SBRT-HBA to determine whether combined treatment can result in superior outcomes to each treatment alone. METHODS AND MATERIALS: Patients with 1 or 2 primary or metastatic lung tumors ≤ 5 cm in size were enrolled in a prospective phase 2 trial and treated with SBRT in 3 fractions followed by HBA...
July 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Heather M McGee, Megan E Daly, Sohelia Azghadi, Susan L Stewart, Leslie Oesterich, Jeffrey Schlom, Renee Donahue, Jonathan D Schoenfeld, Qian Chen, Shyam Rao, Ruben C Fragoso, Richard K Valicenti, Robert J Canter, Emmanual M Maverakis, William J Murphy, Karen Kelly, Arta M Monjazeb
PURPOSE: Despite the strong interest in combining stereotactic ablative radiation therapy (SAR) with immunotherapy, limited data characterizing the systemic immune response after SAR are available. We hypothesized that the systemic immune response to SAR would differ by irradiated site owing to inherent differences in the microenvironment of various organs. METHODS AND MATERIALS: Patients receiving SAR to any organ underwent prospective blood banking before and 1 to 2 weeks after SAR...
April 22, 2018: International Journal of Radiation Oncology, Biology, Physics
Narges Kazemzadeh, Arezoo Modiri, Santanu Samanta, Yulong Yan, Ross Bland, Timothy Rozario, Henky Wibowo, Puneeth Iyengar, Chul Ahn, Robert Timmerman, Amit Sawant
PURPOSE: Radiation injury to the bronchial tree is an important yet poorly understood potential side effect in lung stereotactic ablative radiation therapy (SAbR). We investigate the integration of virtual bronchoscopy in radiation therapy planning to quantify dosage to individual airways. We develop a risk model of airway collapse and develop treatment plans that reduce the risk of radiation-induced airway injury. METHODS AND MATERIALS: Pre- and post-SAbR diagnostic-quality computerized tomography (CT) scans were retrospectively collected from 26 lung cancer patients...
May 2, 2018: International Journal of Radiation Oncology, Biology, Physics
Neehar D Parikh, Vincent D Marshall, Michael Green, Theodore S Lawrence, Nataliya Razumilava, Dawn Owen, Amit G Singal, Mary Feng
INTRODUCTION: For early-stage hepatocellular carcinoma (HCC) patients, ablative strategies are potentially curative treatment options. Stereotactic body radiotherapy (SBRT) has emerged as a promising ablative therapy, although its comparison with radiofrequency ablation (RFA) remains confined to a single institution retrospective review. We sought to characterize the comparative outcomes and cost between the two treatment strategies. METHODS: We conducted a secondary analysis of the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database (2004-2011) and identified adult patients with stage I or II HCC and treated with RFA or SBRT as the initial treatment within 6 months of diagnosis...
June 7, 2018: Journal of Medical Imaging and Radiation Oncology
Daniel R Gomez, Heng Li, Joe Y Chang
In the setting of early-stage non-small cell lung cancer (NSCLC), defining the optimal clinical context for proton beam therapy (PBT) is challenging due to the increasing evidence demonstrating high rates of local control and good tolerance of stereotactic ablative body radiation (SABR). Given the relatively small percentage of lung and other critical structures treated with SABR, dosimetric studies comparing the two techniques have typically concluded that there are modest advantages to PBT, typically by reducing the low dose volumes, such as volume of lung receiving 5 Gy...
April 2018: Translational Lung Cancer Research
D Putzer, P Schullian, E Braunwarth, M Fodor, F Primavesi, B Cardini, T Resch, R Oberhuber, M Maglione, C Margreiter, S Schneeberger, S Stättner, D Öfner-Velano, W Jaschke, R J Bale
Background: Percutaneous ablation techniques offer a vast armamentarium for local, minimally invasive treatment of liver tumors, nowadays representing an established therapeutic option, which is integrated in treatment algorithms, especially for non-resectable liver tumors. The results of ablative treatment compare very well to surgical treatment in liver lesions, and confirm that these techniques are a valuable option for bridging for transplantation. Different techniques have been established to perform tumor ablation, and the feasibility varies according to the procedure and technical skills of the operator, depending on the size and location of the liver lesion...
2018: European Surgery: ACA: Acta Chirurgica Austriaca
Ashish H Shah, Joshua D Burks, Simon S Buttrick, Luca Debs, Michael E Ivan, Ricardo J Komotar
BACKGROUND: Treatment strategies for deep intracranial gliomas remain limited to stereotactic biopsy in many cases due to the morbidity of aggressive surgical resection. Since no cytoreductive therapy is offered, outcomes have been demonstrably poor compared to patients who are able to undergo primary surgical resection. OBJECTIVE: To present our practice, in an effort to reduce morbidity and still offer cytoreductive treatment, of offering the possibility of laser interstitial thermal therapy (LITT) for the primary treatment of intracranial deep gliomas that would be otherwise unamenable for resection...
June 5, 2018: Neurosurgery
Dianne Hartgerink, Britt van der Heijden, Dirk De Ruysscher, Alida Postma, Linda Ackermans, Ann Hoeben, Monique Anten, Philippe Lambin, Karin Terhaag, Arthur Jochems, Andre Dekker, Janna Schoenmaekers, Lizza Hendriks, Jaap Zindler
Brain metastases (BM) frequently occur in non-small cell lung cancer (NSCLC) patients. Most patients with BM have a limited life expectancy, measured in months. Selected patients may experience a very long progression-free survival, for example, patients with a targetable driver mutation. Traditionally, whole-brain radiotherapy (WBRT) has been the cornerstone of the treatment, but its indication is a matter of debate. A randomized trial has shown that for patients with a poor prognosis, WBRT does not add quality of life (QoL) nor survival over the best supportive care...
2018: Frontiers in Oncology
Takayuki Kanai, Noriyuki Kadoya, Yujiro Nakajima, Yuya Miyasaka, Yoshiro Ieko, Tomohiro Kajikawa, Kengo Ito, Takaya Yamamoto, Suguru Dobashi, Ken Takeda, Kenji Nemoto, Keiichi Jingu
For the purpose of reducing radiation pneumontisis (RP), four-dimensional CT (4DCT)-based ventilation can be used to reduce functionally weighted lung dose. This study aimed to evaluate the functionally weighted dose-volume parameters and to investigate an optimal weighting method to realize effective planning optimization in thoracic stereotactic ablative radiotherapy (SABR). Forty patients treated with SABR were analyzed. Ventilation images were obtained from 4DCT using deformable registration and Hounsfield unit-based calculation...
May 2018: Physica Medica: PM
Yushen Qian, Rie Von Eyben, Yufei Liu, Frederick T Chin, Zheng Miao, Sandeep Apte, Justin N Carter, Michael S Binkley, Erqi L Pollom, Jeremy P Harris, Nicolas D Prionas, Madelyn Kissel, Amanda Simmons, Maximilian Diehn, David B Shultz, J Martin Brown, Peter G Maxim, Albert C Koong, Edward E Graves, Billy W Loo
PURPOSE: Tumor hypoxia contributes to radiation resistance. A noninvasive assessment of tumor hypoxia would be valuable for prognostication and possibly selection for hypoxia-targeted therapies. 18 F-pentafluorinated etanidazole (18 F-EF5) is a nitroimidazole derivative that has demonstrated promise as a positron emission tomography (PET) hypoxia imaging agent in preclinical and clinical studies. However, correlation of imageable hypoxia by 18 F-EF5 PET with clinical outcomes after radiation therapy remains limited...
April 18, 2018: International Journal of Radiation Oncology, Biology, Physics
Sabine Gerum, Christian Heinz, Claus Belka, Franziska Walter, Philipp Paprottka, Enrico N De Toni, Falk Roeder
BACKGROUND: To report our experience with SBRT in primary and secondary liver tumors. METHODS: We retrospectively analysed 55 patients (70 lesions) with a median follow-up of 10 months (range 1-57) treated from 2011 to 2016. All patients had not been eligible for other local treatment options. Median age was 64 years and 64% were male. 27 patients (36 lesions) suffered from hepatocellular carcinoma (HCC, Child A:78%, Child B:18%, Child C:4%), 28 patients (34 lesions) had oligometastatic liver disease (MD)...
May 29, 2018: Radiation Oncology
Adam D Lindsay, Edward E Haupt, Chung M Chan, Andre R Spiguel, Mark T Scarborough, Robert A Zlotecki, Parker C Gibbs
Background: The most common site of sarcoma metastasis is the lung. Surgical resection of pulmonary metastases and chemotherapy are treatment options that have been employed, but many patients are poor candidates for these treatments for multiple host or tumor-related reasons. In this group of patients, radiation might provide a less morbid treatment alternative. We sought to evaluate the efficacy of radiotherapy in the treatment of metastatic sarcoma to the lung. Methods: Stereotactic body radiotherapy (SBRT) was used to treat 117 pulmonary metastases in 44 patients...
2018: Sarcoma
Wei-Jun Wang, Jeng-Fong Chiou, Yaoru Huang
The prognosis of patients with metastatic cancers has improved in the past decades due to effective chemotherapy and oligometastatic surgery. For inoperable patients, local ablation therapies, such as stereotactic body radiotherapy (SBRT), can provide effective local tumor control with minimal toxicity. Because of its high precision and accuracy, SBRT delivers a higher radiation dose per fraction, is more effective, and targets smaller irradiation volumes than does conventional radiotherapy. In addition, steep dose gradients from target lesions to surrounding normal tissues are achieved using SBRT; thus, SBRT provides more effective tumor control and exhibits fewer side effects than conventional radiotherapy...
May 8, 2018: Journal of Visualized Experiments: JoVE
Arthur Carminucci, Nitesh V Patel, Sri Sundararajan, Irwin Keller, Shabbar Danish
OBJECTIVE: Magnetic resonance (MR)-guided stereotactic laser amygdalohippocampectomy is a minimally invasive procedure for the treatment of refractory epilepsy in patients with mesial temporal sclerosis. Limited data exist on post-ablation volumetric trends associated with the procedure. METHODS: 10 patients with mesial temporal sclerosis underwent MR-guided stereotactic laser amygdalohippocampectomy. Three independent raters computed ablation volumes at the following time points: pre-ablation (PreA), immediate post-ablation (IPA), 24 hours post-ablation (24PA), first follow-up post-ablation (FPA), and greater than three months follow-up post-ablation (>3MPA), using OsiriX DICOM Viewer (Pixmeo, Bernex, Switzerland)...
March 27, 2018: Curēus
Marguerite Tyran, Minsong Cao, Ann C Raldow, Audrey Dang, James Lamb, Daniel A Low, Michael L Steinberg, Percy Lee
We present a case of durable local control achieved in a patient treated with stereotactic magnetic resonance-guided adaptive radiation therapy (SMART) for an abdominal lymph node in the setting of oligometastatic breast cancer. A 50-year-old woman with a history of triple positive metastatic invasive ductal carcinoma of the left breast, stage IV (T3N2M1), underwent neoadjuvant chemotherapy, mastectomy, adjuvant radiotherapy and maintenance hormonal treatment with HER2 targeted therapies. At 20 months after definitive treatment of her primary, imaging showed an isolated progressive enlargement of lymph nodes between hepatic segment V/IVB and the neck of the pancreas...
March 26, 2018: Curēus
J J Wendler, R Damm, U-B Liehr, T Brunner, M Pech, M Schostak
The incidence of renal cell carcinoma has been rising for years. At the same time there is an increasing prevalence of chronic renal failure with subsequent higher morbidity and shorter life expectancy in those affected. In the last decades the gold standard has thus shifted from radical to partial nephrectomy or tumor enucleation. A treatment alternative can be advantageous for selected patients with high morbidity and an increased risk of complications in anesthesia or surgery. Active surveillance represents a controlled delay in the initiation of treatment with a curative intention...
May 23, 2018: Der Urologe. Ausg. A
Ines B Menjak, Teresa M Petrella, Justin W Lee
No abstract text is available yet for this article.
May 23, 2018: Journal of Oncology Practice
Thibault Vieira, Jean-Baptiste Stern, Philippe Girard, Raffaelle Caliandro
The expanded possibilities to explore the lung deeper with new tools such as electromagnetic navigation bronchoscopy (ENB) or radial probe endobronchial ultrasonography (radial EBUS), combined with miniaturization of traditional local therapies such as radiofrequency ablation (RFA), radiotherapy, cryotherapy or photodynamic therapy, let the bronchoscopists hope for new ways of endoscopic treatments. This challenge could change the practice in the upcoming decades but raise some physical and technical issues...
April 2018: Journal of Thoracic Disease
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