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https://www.readbyqxmd.com/read/30326310/oligometastatic-disease-state-is-associated-with-improved-local-control-in-patients-undergoing-3-or-5-fraction-spine-stereotactic-body-radiotherapy
#1
Scott R Silva, Adam Gliniewicz, Brendan Martin, Vikram C Prabhu, Anand V Germanwala, Edward Melian, G Alex Jones, Abhishek A Solanki
BACKGROUND: The objective of our study was to describe the local control (LC) outcomes with 3 or 5 fraction stereotactic body radiotherapy (SBRT) to the spine in patients with oligometastatic (≤ 5 systemic metastases) versus polymetastatic disease (> 5 metastases). METHODS: We retrospectively reviewed outcomes of patients treated with SBRT for spinal metastases. No patients had prior surgical intervention or spinal cord compression. All patients were treated with 3 (median dose 27 Gy; range 24-30 Gy) or 5 fraction (median dose 35 Gy, range 25-40 Gy) SBRT...
October 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30308345/stereotactic-body-radiation-therapy-in-non-surgical-patients-with-metastatic-spinal-disease-and-epidural-compression-a-retrospective-review
#2
Ahmed Meleis, Sachin R Jhawar, Joseph P Weiner, Neil Majmundar, Aria Mahtabfar, Yong Lin, Salma Jabbour, Shabbar Danish, Sharad Goyal
In the setting of spinal metastases with epidural cord compression, radiosurgery is often only considered when there is sufficient separation between the epidural disease and the spinal cord. However, in patients who are non-surgical candidates or those who prefer non-operative management, there may be a benefit from stereotactic body radiation therapy (SBRT) even when the epidural target is closer than the traditionally referenced 3 mm distance from the spinal cord. The purpose of this retrospective study is to evaluate our institution's experience in treating twenty such patients...
October 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30233872/cyberknife-%C3%A2-stereotactic-radiation-therapy-for-stage-i-lung-cancer-and-pulmonary-metastases-evaluation-of-local-control-at-24-months
#3
Myriam Khadige, Julia Salleron, Vincent Marchesi, Guillaume Oldrini, Didier Peiffert, Véronique Beckendorf
Background: CyberKnife® stereotactic radiotherapy allows for minimally invasive treatment with satisfactory results in patients with inoperable primary or metastatic lung cancer. The objective of this study was to identify factors influencing the probability of local control. Methods: Ninety-five patients (100 lung tumors) treated between January and December 2013 at our department by SBRT (stereotactic body radiation therapy) using CyberKnife® were included in the study...
August 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/30169694/stereotactic-body-radiotherapy-for-spinal-metastases-at-the-extreme-ends-of-the-spine-imaging-based-outcomes-for-cervical-and-sacral-metastases
#4
K Liang Zeng, Sten Myrehaug, Hany Soliman, Chia-Lin Tseng, Eshetu G Atenafu, Mikki Campbell, Salman Faruqi, Young K Lee, Mark Ruschin, Leodante da Costa, Victor Yang, Julian Spears, Chris Heyn, Pejman Jabehdar Maralani, Cari Whyne, Albert Yee, Arjun Sahgal
Background: The unique anatomy and biomechanical features of the cervical spine and sacrum may impact treatment outcomes following spine stereotactic body radiotherapy (SBRT). Current data for spine metastases are not specific for these locations. Objective: To report imaging-based SBRT outcomes to cervical and sacral metastases. Methods: We retrospectively reviewed our prospective spine SBRT database for cervical and sacral metastases. Patients were followed at 2- to 3-mo intervals with a clinical visit and full spine magnetic resonance imaging (MRI) and we report overall survival (OS), vertebral compression fracture (VCF), and MR imaging-based local control (LC) rates...
August 29, 2018: Neurosurgery
https://www.readbyqxmd.com/read/30114379/dose-fall-off-during-the-treatment-of-thoracic-spine-metastasis-with-cyberknife-stereotactic-body-radiation-therapy-sbrt
#5
Zhongjian Ju, Jingyuan Wang, Huaiwen Zhang, Lei Du, Wei Xu, Xiaoshen Wang, Ruigang Ge, Jiwei Li, Qingzeng Zheng, Jianxiong Li
CyberKnife stereotactic body radiation therapy (SBRT) is becoming increasingly used for cancer treatment and, to maximize its clinical application, it is important to define the dosimetric characteristics, optimal dose and fractionation regimens. The aim of this study was to evaluate the dose fall-off in two fractionated regimens of CyberKnife SBRT during the treatment of thoracic spinal metastasis. Patients with spinal metastasis involving a vertebra and pedicle were treated with 40 Gy in 5 fractions (n = 4), and patients with spinal metastasis involving only a vertebra received 33 Gy in 3 fractions (n = 4)...
August 2, 2018: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/30105233/stereotactic-body-radiation-therapy-for-lung-spine-and-oligometastatic-disease-current-evidence-and-future-directions
#6
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
#7
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
#8
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
#9
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
#10
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...
September 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
#11
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...
September 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
#12
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
#13
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...
September 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29799334/stereotactic-body-radiation-therapy-for-benign-spine-tumors-is-dose-de-escalation-appropriate
#14
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
#15
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
#16
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
#17
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
#18
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 Parulekar, 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: The 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...
August 2, 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
#19
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
#20
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
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