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Brain srs

Michael C LeCompte, Emory R McTyre, Roy E Strowd, Claire Lanier, Michael H Soike, Ryan T Hughes, Adrianna H Masters, Christina K Cramer, Michael Farris, Jimmy Ruiz, Kounosuke Watabe, Adrian W Laxton, Stephen B Tatter, Karen M Winkfield, Michael D Chan
Purpose: To determine the influence of diabetes mellitus (DM) on outcomes in patients with brain metastasis treated with stereotactic radiosurgery (SRS). Methods: We retrospectively reviewed 498 patients with brain metastasis treated at our institution with SRS between January 2012 and March 2017. Results: Eight-four patients (16.9%) held a diagnosis of DM prior to SRS treatment. Diabetics compared to nondiabetics had worse overall survival (OS)...
2018: Journal of Radiosurgery and SBRT
Rachel F Shenker, Ryan T Hughes, Emory R McTyre, Claire Lanier, Hui-Wen Lo, Linda Metheny-Barlow, Jing Su, Alexandra Thomas, Doris R Brown, Tiffany Avery, Boris Pasche, Christina K Cramer, Adrian W Laxton, Stephen B Tatter, Kounosuke Watabe, Michael D Chan
Purpose/Objectives: Stereotactic radiosurgery (SRS) is used as a treatment option for breast cancer brain metastases. It is unclear what factors predict neurologic death for these patients. Materials/Methods: A total of 128 patients with breast cancer brain metastases were treated with upfront SRS alone in this study. Survival was estimated using the Kaplan-Meier method. Clinicopathologic factors evaluated included age, ER/PR status, Her2 status, numbers of brain metastases treated, minimum SRS dose, disease-specific GPA, extracranial disease status and systemic disease burden...
2018: Journal of Radiosurgery and SBRT
Kihwan Hwang, Dong Gyu Kim, Sun Ha Paek, Chae-Yong Kim, Chang-Ho Yun, Chang Wan Oh, Rahyeong Juh, Jung Ho Han
OBJECTIVE: We investigated seizure outcomes of patients with supratentorial meningiomas (ST-MNGs) treated with stereotactic radiosurgery (SRS). METHODS: One hundred and thirty-three patients with a total of 144 ST-MNGs, who were treated with SRS between 2009 and 2016, were included in this study. The mean age was 59.0±11.9 (range, 13-87) years. The mean follow-up duration was 49.8±24.5 (range, 9-96) months. The median tumor volume was 2.60 cm3 (range, 0.06-32...
December 5, 2018: World Neurosurgery
Walker Mainwaring, John Bowers, Ngoc Pham, Todd Pezzi, Mihir Shukla, Mark Bonnen, Michelle Ludwig
BACKGROUND: Metastases to the brain occur in 10%-16% of patients with breast cancer, with incidence reportedly increasing. Historically, brain metastases (BM) have been treated with whole-brain radiation therapy (WBRT), but stereotactic radiosurgery (SRS) is an increasingly favored treatment option. In this study we used a population-level database to compare patterns of care and survival between WBRT and SRS for BM from breast cancer. MATERIALS AND METHODS: The National Cancer Database was used to select patients treated with radiation for BM from primary breast cancer...
November 12, 2018: Clinical Breast Cancer
Corinna Fritz, Kim Borsky, Luisa S Stark, S Tanadini-Lang, Stephanie G C Kroeze, Jérôme Krayenbühl, Matthias Guckenberger, Nicolaus Andratschke
Purpose: Stereotactic radiosurgery (SRS) is the preferred primary treatment option for patients with a limited number of asymptomatic brain metastases. In case of relapse after initial SRS the optimal salvage treatment is not well defined. Within this retrospective analysis, we investigated the feasibility of repeated courses of SRS to defer Whole-Brain Radiation Therapy (WBRT) and aimed to derive prognostic factors for patient selection. Materials and Methods: From 2014 until 2017, 42 patients with 197 brain metastases have been treated with multiple courses of SRS at our institution...
2018: Frontiers in Oncology
Neha P Amin, Jill Remick, Manuj Agarwal, Nina A Desai, Carmen Bergom, Charles B Simone
OBJECTIVE: The objective of this study was to report on US radiation oncologists' (ROs) practice patterns and perceptions of concurrent radiation (RT) and immunotherapy (IT) (CRI). METHODS: A 22-question survey was emailed to radiation oncologists in February 2018. CRI was defined as RT completed within 1 week before initial IT infusion through 4 weeks after final IT infusion. RESULTS: Of the 323 respondents from 45 states, 88% had experience treating a patient with CRI, including 51% private and 48% academic physicians...
December 3, 2018: American Journal of Clinical Oncology
Aleksandra Napieralska, Iwona Brąclik, Michał Radwan, Marek Mandera, Sławomir Blamek
PURPOSE: To assess the results and tolerance of radiosurgery/hypofractionated stereotactic radiotherapy performed after craniospinal irradiation for recurrent tumor. METHODS: Fourteen patients aged 3-46 years, diagnosed with medulloblastoma (10), anaplastic ependymoma (3), and primitive neuroectodermal tumor (1). All patients had craniospinal irradiation (CSI) with the total dose of 30.6-36 Gy and boost to 53.9-60 Gy either during primary or during second-line treatment...
December 4, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Jane Roitsch, Rachael Redman, Anne M P Michalek, Rachel K Johnson, Anastasia M Raymer
OBJECTIVE: This review appraised the quality of systematic reviews (SRs) and meta-analyses (MAs) to summarize research on behavioral interventions for attention disorders in persons with traumatic brain injury. METHODS: A search of 7 databases revealed 15 MAs/SRs reporting outcomes for attention treatments in traumatic brain injury. Two examiners independently coded the quality of reviews with the Critical Appraisal of Systematic Review or Meta-Analysis and the Evidence in Augmentative and Alternative Communication Systematic Review Scale...
November 28, 2018: Journal of Head Trauma Rehabilitation
(no author information available yet)
OBJECTIVEGlioblastoma (GBM) is the most malignant form of astrocytoma. The average survival is 6-10 months in patients with recurrent GBM (rGBM). In this study, the authors evaluated the role of stereotactic radiosurgery (SRS) in patients with rGBMs.METHODSThe authors performed a retrospective review of their brain tumor database (1997-2016). Overall survival (OS) and progression-free survival (PFS) after salvage SRS were the primary endpoints evaluated. Response to SRS was assessed using volumetric MR images...
October 1, 2018: Journal of Neurosurgery
Fabiana Gregucci, Alba Fiorentino, Stefanie Corradini, Vanessa Figlia, Rosario Mazzola, Francesco Ricchetti, Ruggero Ruggieri, Filippo Alongi
AIM: The aim of this study was to analyze the feasibility and clinical results of linear accelerator (linac-)based stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (SFRT) with flattening filter-free (FFF) volumetric modulated arc therapy (VMAT) in elderly patients affected by brain metastases (BMs). PATIENTS AND METHODS: Patients selected for the present analysis were ≥65 years old with a life expectancy of >3 months, a controlled or synchronous primary tumor, and <10 BMs with a diameter <3 cm...
November 26, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Jeff D Winter, Fabio Y Moraes, Caroline Chung, Catherine Coolens
Our objective was to investigate direct voxel-wise relationship between dose and early MR biomarker changes both within and in the high-dose region surrounding brain metastases following stereotactic radiosurgery (SRS). Specifically, we examined the apparent diffusion coefficient (ADC) from diffusion-weighted imaging and the contrast transfer coefficient (Ktrans) and volume of extracellular extravascular space (ve) derived from dynamic contrast-enhanced (DCE) MRI data. We investigated 29 brain metastases in 18 patients using 3 T MRI to collect imaging data at day 0, day 3 and day 20 following SRS...
2018: PloS One
Nayan Lamba, Daniel N Cagney, Rachel H Brigell, Allison M Martin, Luke A Besse, Paul J Catalano, John G Phillips, Itai M Pashtan, Wenya Linda Bi, Elizabeth B Claus, Alexandra J Golby, Ian F Dunn, Timothy R Smith, Shyam K Tanguturi, Daphne A Haas-Kogan, Brian M Alexander, Ayal A Aizer
BACKGROUND: Brain metastases commonly manifest in cancer patients, with approximately 20-50% presenting with one intracranial lesion. Among patients with one, small brain metastasis and controlled or absent extracranial disease, it remains unclear if aggressive intracranial management utilizing neurosurgical resection and cavity stereotactic radiation (SRS/SRT) rather than SRS/SRT alone is beneficial. In patients with controlled or absent extracranial disease and one brain metastasis ≤2 cm in size, we evaluated the impact of surgery plus SRS/SRT compared to SRS/SRT on oncologic outcomes including overall survival...
November 21, 2018: World Neurosurgery
Rachel F Shenker, Emory R McTyre, Glen B Taksler, Ralph B D'Agostino, Christina K Cramer, Jimmy Ruiz, Natalie K Alphonse-Sullivan, Michael Farris, Kounosuke Watabe, Fei Xing, Adrian W Laxton, Stephen B Tatter, Michael D Chan
OBJECTIVES: We aimed to assess the driving factors for increased cost of brain metastasis management when using upfront stereotactic radiosurgery (SRS). PATIENT AND METHODS: 737 patients treated with upfront SRS without whole brain radiotherapy (WBRT). Patients were evaluated for use of craniotomy, length of hospital stay, need for rehabilitation or facility placement, and use of salvage SRS or salvage WBRT. Costs of care of these interventions were estimated based on 2013 Medicare reimbursements...
November 13, 2018: Clinical Neurology and Neurosurgery
Bina Kakusa, Summer Han, Sonya Aggarwal, Boxiang Liu, Gordon Li, Scott Soltys, Melanie Hayden Gephart
PURPOSE: Routine brain MRI surveillance frequently diagnoses small, asymptomatic brain metastases from non-small cell lung cancer (NSCLC) that are effectively treated with stereotactic radiosurgery (SRS). A subset of patients, however, may die prior to the onset of symptoms. This study identifies clinical features that distinguish neurologically-asymptomatic NSCLC brain metastases patients that die prior to routine 3 month follow-up after SRS. METHODS: Retrospective chart review from 2007 to 2017 identified 18 patients with neurologically-asymptomatic NSCLC brain metastases who died < 3 months after SRS...
November 20, 2018: Journal of Neuro-oncology
Minbiao Ji, Michal Arbel, Lili Zhang, Christian W Freudiger, Steven S Hou, Dongdong Lin, Xinju Yang, Brian J Bacskai, X Sunney Xie
One of the key pathological features of Alzheimer's disease (AD) is the existence of extracellular deposition of amyloid plaques formed with misfolded amyloid-β (Aβ). The conformational change of proteins leads to enriched contents of β sheets, resulting in remarkable changes of vibrational spectra, especially the spectral shifts of the amide I mode. Here, we applied stimulated Raman scattering (SRS) microscopy to image amyloid plaques in the brain tissue of an AD mouse model. We have demonstrated the capability of SRS microscopy as a rapid, label-free imaging modality to differentiate misfolded from normal proteins based on the blue shift (~10 cm-1 ) of amide I SRS spectra...
November 2018: Science Advances
Thomas M Churilla, Imran H Chowdhury, Elizabeth Handorf, Laurence Collette, Sandra Collette, Yanqun Dong, Brian M Alexander, Martin Kocher, Riccardo Soffietti, Elizabeth B Claus, Stephanie E Weiss
Importance: Brain metastases are a common source of morbidity for patients with cancer, and limited data exist to support the local therapeutic choice between surgical resection and stereotactic radiosurgery (SRS). Objective: To evaluate local control of brain metastases among patients treated with SRS vs surgical resection within the European Organization for the Research and Treatment of Cancer (EORTC) 22952-26001 phase 3 trial. Design, Setting, and Participants: This unplanned, exploratory analysis of the international, multi-institutional randomized clinical trial EORTC 22952-26001 (conducted from 1996-2007) was performed from February 9, 2017, through July 25, 2018...
November 8, 2018: JAMA Oncology
Erik Scott Blomain, Hyun Kim, Shivank Garg, Deepak Bhamidipati, Jenny Guo, Ingrid Kalchman, John McAna, Wenyin Shi
Background: Stereotactic radiosurgery (SRS) has emerged as an important modality for the treatment of intracranial metastases. There are currently few established guidelines delineating indications for SRS use and fewer still regarding plan evaluation in the treatment of multiple brain metastases. Methods: An 18 question electronic survey was distributed to radiation oncologists at National Cancer Institute (NCI) designated cancer centers in the USA (60). Centers without radiation oncologists were excluded...
September 2018: Journal of Radiation Oncology
Kathrin Nickel, Ludger Tebartz van Elst, Jacek Manko, Josef Unterrainer, Reinhold Rauh, Christoph Klein, Dominique Endres, Christoph P Kaller, Irina Mader, Andreas Riedel, Monica Biscaldi, Simon Maier
Objective: Autism spectrum (ASD) and attention-deficit/hyperactivity disorder (ADHD) are neurodevelopmental disorders with a high rate of comorbidity. To date, diagnosis is based on clinical presentation and distinct reliable biomarkers have been identified neither for ASD nor ADHD. Most previous neuroimaging studies investigated ASD and ADHD separately. Method: To address the question of structural brain differences between ASD and ADHD, we performed FreeSurfer analysis in a sample of children with ADHD ( n = 30), with high-functioning ASD ( n = 14), with comorbid high-functioning ASD and ADHD ( n = 15), and of typically developed controls (TD; n = 36)...
2018: Frontiers in Psychiatry
Claudia Scaringi, Linda Agolli, Giuseppe Minniti
Radiation therapy plays a critical role in the management of brain tumors. Recent advances in radiation techniques include the use of intensity-modulated radiotherapy (IMRT), volumetric-modulated arc therapy (VMAT) and stereotactic radiosurgery (SRS). All of these techniques allow the delivery of higher radiation doses to the target volume, at the same time reducing the risk of toxicity to normal tissues as compared with conventional 3D conformal radiotherapy (3D-CRT). Proton therapy may represent a treatment alternative to photon irradiation, due to the more favorable dose distribution to the target volume...
November 2018: Anticancer Research
Victor M Lu, Anshit Goyal, Richard A Rovin, Adrian Lee, Kerrie L McDonald
BACKGROUND: Immune checkpoint inhibition (ICI) is an emerging immunotherapy for metastatic brain disease (MBD). Current management options include stereotactic radiosurgery (SRS), which has been shown to confer prognostic benefit in combination with ICI. However, the effect, if any, of ICI timing on this benefit is currently unclear. The aim of this study was to evaluate the effect of concurrent ICI with SRS on survival outcomes in MBD compared to non-concurrent ICI administered before or after SRS...
November 3, 2018: Journal of Neuro-oncology
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