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https://www.readbyqxmd.com/read/30105233/stereotactic-body-radiation-therapy-for-lung-spine-and-oligometastatic-disease-current-evidence-and-future-directions
#1
REVIEW
Emma Maria Dunne, Ian Mark Fraser, Mitchell Liu
Stereotactic body radiation therapy (SBRT) also referred to as stereotactic ablative radiotherapy (SABR), is a technique which has emerged over the past two decades due to improvements in radiation technology. Unlike conventional external beam radiotherapy (cEBRT) which traditionally delivers radiation in small doses [approximately 2 Gray (Gy) per fraction] over several weeks, SBRT, typically delivered in one to eight fractions, is a technique whereby potentially ablative doses of radiotherapy (usually 7.5-20 Gy per fraction) can be delivered with steeper dose gradients and sub millimetre precision, minimising risk to surrounding normal tissues...
July 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/30003994/imaging-based-outcomes-for-24-gy-in-2-daily-fractions-for-patients-with-de-novo-spinal-metastases-treated-with-spine-stereotactic-body-radiotherapy-sbrt
#2
Chia-Lin Tseng, Hany Soliman, Sten Myrehaug, Young K Lee, Mark Ruschin, Eshetu G Atenafu, Mikki Campbell, Pejman Maralani, Victor Yang, Albert Yee, Arjun Sahgal
OBJECTIVES: We report mature outcomes for a cohort of patients with no prior radiation (de novo) to the spine treated with 24 Gy in 2 daily fractions for metastases, which represents the SBRT regimen under evaluation on the current SC-24 phase 3 randomized trial (NCT02512965). METHODS: The cohort consisted of 279 de novo spinal metastases in 145 consecutive patients treated with 24 Gy in 2 SBRT fractions, identified from a prospective single-institution database...
July 9, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29988301/correlation-between-small-volume-spinal-cord-doses-for-spine-stereotactic-body-radiotherapy-sbrt
#3
Lijun Ma, Lei Wang, Young Lee, Chia-Lin Tseng, Scott Soltys, Steve Braunstein, Arjun Sahgal
Purpose: Doses to small spinal cord isodose volume (such as those ranging from Dmax 0.0 cc to 0.5 cc) as well as to large volumes (such as those ranging from 0.5 cc to 3.0 cc) are critical parameters to guide safe practice of spine SBRT. We here report a mathematical formula that links the most probable dose volume limits together for common spine SBRT cases.Methods and materials: A dose ripple formula parameterized with equivalent dose radius (EDR) was derived to model spinal cord small-volume doses for a spine SBRT treatment...
2018: Journal of Radiosurgery and SBRT
https://www.readbyqxmd.com/read/29983032/positional-uncertainties-of-cervical-and-upper-thoracic-spine-in-stereotactic-body-radiotherapy-with-thermoplastic-mask-immobilization
#4
Seung Hyuck Jeon, Jin Ho Kim
PURPOSE: To investigate positional uncertainty and its correlation with clinical parameters in spine stereotactic body radiotherapy (SBRT) using thermoplastic mask (TM) immobilization. Materials and. METHODS: A total of 21 patients who underwent spine SBRT for cervical or upper thoracic spinal lesions were retrospectively analyzed. All patients were treated with image guidance using cone beam computed tomography (CBCT) and 4 degrees-of-freedom (DoF) positional correction...
June 2018: Radiation Oncology Journal
https://www.readbyqxmd.com/read/29943895/improving-accuracy-for-stereotactic-body-radiotherapy-treatments-of-spinal-metastases
#5
James Rijken, Barry Jordan, Scott Crowe, Tanya Kairn, Jamie Trapp
PURPOSE: Use of SBRT techniques is now a relatively common recourse for spinal metastases due to good local control rates and durable pain control. However, the technique has not yet reached maturity for gantry-based systems, so work is still required in finding planning approaches that produce optimum conformity as well as delivery for the slew of treatment planning systems and treatment machines. METHODS: A set of 32 SBRT spine treatment plans based on four vertebral sites, varying in modality and number of control points, were created in Pinnacle...
June 26, 2018: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/29940802/the-evolution-and-rise-of-stereotactic-body-radiotherapy-sbrt-for-spinal-metastases
#6
Balamurugan A Vellayappan, Samuel T Chao, Matthew Foote, Matthias Guckenberger, Kristin J Redmond, Eric L Chang, Nina A Mayr, Arjun Sahgal, Simon S Lo
Owing to improvements in clinical care and systemic therapy, more patients are being diagnosed with, and living longer with, spinal metastases (SM). In parallel, tremendous technological progress has been made in the field of radiation oncology. Advances in both software and hardware are able to integrate three- (and four-) dimensional body imaging with spatially accurate treatment delivery methods. This leads to improved efficacy, shortened treatment schedule, and potentially reduced treatment-related toxicity...
July 3, 2018: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/29908789/first-experience-with-markerless-online-3d-spine-position-monitoring-during-sbrt-delivery-using-a-conventional-linac
#7
Colien Hazelaar, Wilko F A R Verbakel, Hassan Mostafavi, Lineke van der Weide, Ben J Slotman, Max Dahele
PURPOSE: The purpose was to report our initial experience with online markerless 3-dimensional (3D) spine position monitoring. We used template matching plus triangulation of fluoroscopic kilovoltage images acquired with the gantry-mounted imager during flattening filter-free volumetric modulated arc spine stereotactic body radiation therapy delivery on a conventional linear accelerator. METHODS AND MATERIALS: Kilovoltage images were acquired at 7 frames per second and streamed to a stand-alone computer...
August 1, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29905524/postoperative-re-irradiation-using-stereotactic-body-radiotherapy-for-metastatic-epidural-spinal-cord-compression
#8
Kei Ito, Keiji Nihei, Takuya Shimizuguchi, Hiroaki Ogawa, Tomohisa Furuya, Shurei Sugita, Takahiro Hozumi, Keisuke Sasai, Katsuyuki Karasawa
OBJECTIVE This study aimed to clarify the outcomes of postoperative re-irradiation using stereotactic body radiotherapy (SBRT) for metastatic epidural spinal cord compression (MESCC) in the authors' institution and to identify factors correlated with local control. METHODS Cases in which patients with previously irradiated MESCC underwent decompression surgery followed by spine SBRT as re-irradiation between April 2013 and May 2017 were retrospectively reviewed. The surgical procedures were mainly performed by the posterior approach and included decompression and fixation...
June 15, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29799334/stereotactic-body-radiation-therapy-for-benign-spine-tumors-is-dose-de-escalation-appropriate
#9
Ronny Kalash, Scott M Glaser, John C Flickinger, Steven Burton, Dwight E Heron, Peter C Gerszten, Johnathan A Engh, Nduka M Amankulor, John A Vargo
OBJECTIVE Akin to the nonoperative management of benign intracranial tumors, stereotactic body radiation therapy (SBRT) has emerged as a nonoperative treatment option for noninfiltrative primary spine tumors such as meningioma and schwannoma. The majority of initial series used higher doses of 16-24 Gy in 1-3 fractions. The authors hypothesized that lower doses (such as 12-13 Gy in 1 fraction) might provide an efficacy similar to that found with the dose de-escalation commonly used for intracranial radiosurgery to treat acoustic neuroma or meningioma and with a lower risk of toxicity...
August 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29796646/surgical-resection-with-radiation-treatment-planning-of-spinal-tumors
#10
Raphael Jakubovic, Mark Ruschin, Chia-Lin Tseng, Ana Pejovic-Milic, Arjun Sahgal, Victor X D Yang
BACKGROUND: The clinical paradigm for spinal tumors with epidural involvement is challenging considering the rigid dose tolerance of the spinal cord. One effective approach involves open surgery for tumor resection, followed by stereotactic body radiotherapy (SBRT). Resection extent is often determined by the neurosurgeon's clinical expertise, without considering optimal subsequent post-operative SBRT treatment. OBJECTIVE: To quantify the effect of incremental epidural disease resection on tumor coverage for spine SBRT in an effort to working towards integrating radiotherapy planning within the operating room...
May 15, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29748100/impact-of-magnetic-resonance-imaging-on-gross-tumor-volume-delineation-in-non-spine-bony-metastasis-treated-with-stereotactic-body-radiation-therapy
#11
Srinivas Raman, Lee Chin, Darby Erler, Eshetu G Atenafu, Patrick Cheung, William Chu, Hans Chung, Andrew Loblaw, Ian Poon, Joel Rubenstein, Hany Soliman, Arjun Sahgal, Chia-Lin Tseng
PURPOSE: This study investigates the inter-observer variability of contouring non-spine bone metastases using the planning CT alone vs. the addition of MRI T1 and T2 imaging sequences. METHODS AND MATERIALS: 10 cases of non-spine bone metastases treated with SBRT at our institution were selected. The gross tumor volume (GTV) for each case was delineated by six SBRT radiation oncologists (RO) and one diagnostic radiologist (DR) on the treatment planning CT. After a minimum of three months, each case was re-contoured on the CT fused with a MRI T1 sequence followed by a MRI T2 sequence...
March 17, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29706460/local-control-and-fracture-risk-following-stereotactic-body-radiation-therapy-for-non-spine-bone-metastases
#12
Darby Erler, Drew Brotherston, Arjun Sahgal, Patrick Cheung, Andrew Loblaw, William Chu, Hany Soliman, Hans Chung, Alex Kiss, Edward Chow, Ian Poon
AIMS: To report local control and toxicity rates for patients treated with stereotactic body radiotherapy (SBRT) for non-spine bone metastases. METHODS AND MATERIALS: Eighty-one patients with 106 non-spine bone metastases were treated between 2011 and 2014 and retrospectively reviewed. Indications included: oligometastases (63%), oligoprogression (17.3%), retreatment (2.4%) or other (17.3%). Cumulative incidence function was used to assess local recurrence and fracture probability...
May 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29590465/population-description-and-clinical-response-assessment-for-spinal-metastases-part-2-of-the-spine-response-assessment-in-neuro-oncology-spino-group-report
#13
Ilya Laufer, Simon S Lo, Eric L Chang, Jason Sheehan, Matthias Guckenberger, Moon-Jun Sohn, Samuel Ryu, Matthew Foote, Alexander Muacevic, Scott G Soltys, Samuel Chao, Sten Myrehaug, Peter C Gerszten, Eric Lis, Pejman Maralani, Mark Bilsky, Charles Fisher, Laurence Rhines, Jorrit-Jan Verlaan, David Schiff, Michael G Fehlings, Lijun Ma, Susan Chang, Wendy R Parelukar, Michael A Vogelbaum, Arjun Sahgal
Background: Approximately 40% of metastatic cancer patients will develop spinal metastases. The current report provides recommendations for standardization of metrics used for spinal oncology patient population description and outcome assessment beyond local control endpoints on behalf of the SPIne response assessment in Neuro-Oncology (SPINO) group. Methods: SPINO group survey was conducted in order to determine the preferences for utilization of clinician-based and patient-reported outcome measures for description of patients with spinal metastases...
March 24, 2018: Neuro-oncology
https://www.readbyqxmd.com/read/29550605/application-of-morphometrics-as-a-predictor-for-survival-in-female-patients-with-breast-cancer-spinal-metastasis-a-retrospective-cohort-study
#14
Hesham Mostafa Zakaria, Lara Massie, Azam Basheer, David Boyce-Fappiano, Erinma Elibe, Lonni Schultz, Ian Lee, Brent Griffith, Farzan Siddiqui, Victor Chang
BACKGROUND CONTEXT: The current standard of care for prediction of survival of cancer staging is based on TNM staging. However, for patients with spinal metastasis, who all have identical stage IV disease, identifying accurate prognostic markers of survival would allow better treatment stratification between more aggressive treatment strategies or palliation. Analytical morphometrics enables physicians to quantify patient frailty by measuring lean muscle mass. Morphometrics also predicts survival in patients with lung cancer metastases to the spine...
March 14, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29547929/histopathological-findings-after-reirradiation-compared-to-first-irradiation-of-spinal-bone-metastases-with-stereotactic-body-radiotherapy-a-cohort-study
#15
Robert Foerster, B C John Cho, Daniel K Fahim, Peter C Gerszten, John C Flickinger, Inga S Grills, Maha S Jawad, C Ronald Kersh, Daniel Létourneau, Frederick Mantel, Arjun Sahgal, John H Shin, Brian A Winey, Matthias Guckenberger
BACKGROUND: Stereotactic body radiotherapy (SBRT) of the spine provides superior tumor control, but vertebral compression fractures are increased and the pathophysiological process underneath is not well understood. Data on histopathological changes, particularly after salvage SBRT (sSBRT) following conventional irradiation, are scarce. OBJECTIVE: To investigate surgical specimens after sSBRT and primary SBRT (pSBRT) regarding histopathological changes. METHODS: We assessed 704 patients treated with spine SBRT 2006 to 2012...
March 14, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29431865/refinement-of-mlc-modeling-improves-commercial-qa-dosimetry-system-for-srs-and-sbrt-patient-specific-qa
#16
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...
April 2018: Medical Physics
https://www.readbyqxmd.com/read/29429794/treatment-plan-quality-and-delivery-accuracy-assessments-on-3-imrt-delivery-methods-of-stereotactic-body-radiotherapy-for-spine-tumors
#17
Long Huang, Toufik Djemil, Tingliang Zhuang, Martin Andrews, Samuel T Chao, John H Suh, Ping Xia
Stereotactic body radiotherapy (SBRT) for spine tumors has demonstrated clinical effectiveness. The treatment planning and delivery techniques have evolved from dynamic conformal arc therapy, to fixed gantry angle intensity modulated radiotherapy (IMRT), and most recently to volumetric modulated arc therapy (VMAT). A hybrid-arc (HARC) planning and delivery method combining dynamic conformal arc therapy delivery with a number of equally spaced IMRT beams is proposed. In this study we investigated plan quality, delivery accuracy, and efficiency of 3 delivery techniques: IMRT, HARC, and VMAT...
February 8, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/29417728/comparison-of-four-techniques-for-spine-stereotactic-body-radiotherapy-dosimetric-and-efficiency-analysis
#18
Saif Aljabab, Balamurugan Vellayappan, Eric Vandervoort, Jamie Bahm, Robert Zohr, John Sinclair, Jean-Michel Caudrelier, Janos Szanto, Shawn Malone
PURPOSE: The aim of this study is to compare the dosimetric differences between four techniques for spine stereotactic body radiotherapy (SBRT): CyberKnife (CK), volumetric modulated arc therapy (VMAT), and helical tomotherapy (HT) with dynamic jaws (HT-D) and fixed jaws (HT-F). MATERIALS/METHODS: Data from 10 patients were utilized. All patients were planned for 24 Gy in two fractions, with the primary objectives being: (a) restricting the maximum dose to the cord to ≤ 17 Gy and/or cauda equina to ≤ 20 Gy, and (b) to maximize the clinical target volume (CTV) to receive the prescribed dose...
March 2018: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/29372858/myositis-following-spine-radiosurgery-for-metastatic-disease-a-case-series
#19
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...
April 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29357902/intensity-modulated-radiotherapy-with-integrated-boost-in-patients-with-bone-metastasis-of-the-spine-study-protocol-for-a-randomized-controlled-trial
#20
Tanja Sprave, Stefan Ezechiel Welte, Thomas Bruckner, Robert Förster, Tilman Bostel, Ingmar Schlampp, Nils Henrik Nicolay, Jürgen Debus, Harald Rief
BACKGROUND: Stereotactic body radiation therapy (SBRT) using intensity-modulated radiotherapy (IMRT) with dose escalation by simultaneous integrated boost (SIB) can be a safe modality for treating spinal bone metastases with enhanced targeting accuracy and improve local tumor control. METHODS/DESIGN: This is a single-center, prospective, randomized, controlled trial. One hundred and twenty patients with spinal bone metastases will receive palliative radiation therapy at the Heidelberg University Hospital...
January 22, 2018: Trials
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