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Stereotactic radiosurgery

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https://www.readbyqxmd.com/read/28106495/comparison-of-prognostic-indices-in-patients-who-undergo-melanoma-brain-metastasis-radiosurgery
#1
Hideyuki Kano, Alejandro Morales-Restrepo, Aditya Iyer, Gregory M Weiner, Seyed H Mousavi, John M Kirkwood, Ahmad A Tarhini, John C Flickinger, L Dade Lunsford
OBJECTIVE The goal of this study was to use 4 prognostic indices to compare survival times of patients who underwent Gamma Knife stereotactic radiosurgery (SRS) to treat melanoma brain metastases. METHODS The authors analyzed 422 consecutive patients (1440 brain metastases) who underwent Gamma Knife SRS. The median total brain tumor volume was 4.7 cm(3) (range 0.3-69.3 cm(3)), and the median number of metastases was 2 (range 1-32). One hundred thirty-two patients underwent whole-brain radiation therapy. Survival times were compared using recursive partitioning analysis (RPA), the Score Index for Radiosurgery (SIR), the Basic Score for Brain Metastases (BSBM), and the Diagnosis-Specific Graded Prognostic Assessment (DS-GPA)...
January 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28102944/a-simple-and-robust-trajectory-based-stereotactic-radiosurgery-treatment
#2
Byron Wilson, Karl Otto, Ermias Gete
INTRODUCTION: We present a Trajectory-based Volumetric Modulated Arc Therapy (TVMAT) technique for Stereotactic Radiosurgery (SRS) that takes advantage of a modern linacs ability to modulate dose rate and move the couch dynamically. In addition, we investigate the quality of the developed TVMAT method and the dosimetric accuracy of the technique. METHODS: The main feature of the TVMAT technique is a standard beam trajectory formed by dynamic motion of the treatment couch and the linac gantry...
January 2017: Medical Physics
https://www.readbyqxmd.com/read/28096269/differentiation-between-radiation-necrosis-and-tumor-progression-using-chemical-exchange-saturation-transfer
#3
Hatef Mehrabian, Kimberly L Desmond, Hany Soliman, Arjun Sahgal, Gregory J Stanisz
PURPOSE: Stereotactic radiosurgery (SRS) is a common treatment used in patients with brain metastases and is associated with high rates of local control, however, at the risk of radiation necrosis. It is difficult to differentiate radiation necrosis from tumor progression using conventional MRI making it a major diagnostic dilemma for practitioners. This prospective study investigated whether chemical exchange saturation transfer (CEST) was able to differentiate these two conditions. MATERIALS & METHODS: Fifteen patients with brain metastases who had been previously treated with SRS were included...
January 17, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28093345/stereotactic-radiosurgery-srs-for-melanoma-brain-metastases-a-comprehensive-clinical-case-series
#4
Rui Feng, Eric K Oermann, Raj Shrivastava, Ariel Gold, Brian T Collins, Douglas Kondziolka, Sean P Collins
BACKGROUND: Melanoma has high propensity to metastasize to the brain. With recent gains in improving patient survival, stereotactic radiosurgery may offer an effective and less neurotoxic alternative to whole brain radiation. In the study, we report on the safety and efficacy of stereotactic radiosurgery (SRS) in treating melanoma brain metastases in 87 patients. METHODS: This retrospective, multicenter study examined 87 patients with 309 metastases underwent single-dose or multifractionated SRS for treatment of intracranial metastases from malignant melanoma...
January 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28089525/radiotherapeutic-management-of-vestibular-schwannomas-using-size-and-location-adapted-fractionation-regimens-to-maximize-the-therapeutic-ratio
#5
Benjamin G Slane, Uma Goyal, Joel L Grow, Christopher Morrison, Craig R Hullet, John Gordon, Abhay Sanan, Baldassarre Stea
BACKGROUND: We evaluated and compared the radiographic and clinical outcomes of patients with vestibular schwannomas treated with single fraction stereotactic radiosurgery (SRS), 5 fractions of hypofractionated stereotactic radiation therapy (hSRT), or 25 to 30 fractions of conventionally fractionated stereotactic radiation therapy (cfSRT). METHODS AND MATERIALS: Fifty-six patients treated with LINAC-based SRS (median, 12.5 Gy), hSRT (25 Gy), or cfSRT (median, 54 Gy) were retrospectively reviewed...
October 28, 2016: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28089195/cumulative-volumetric-analysis-as-a-key-criterion-for-the-treatment-of-brain-metastases
#6
Il Kyoon Kim, Robert M Starke, Donald A McRae, Nadim M Nasr, Anthony Caputy, George D Cernica, Robert L Hong, Jonathan H Sherman
BACKGROUND: Recent studies have demonstrated diminished cognitive function, worse quality of life, and no overall survival benefit from the addition of adjuvant whole brain radiation therapy (WBRT) to stereotactic radiosurgery (SRS) in the management of brain metastases. This study analyzes the treatment outcome of SRS, specifically CyberKnife Radiosurgery, based on the total tumor volume compared to the absolute number of lesions. METHODS: A retrospective analysis of hospital records at Virginia Hospital Center for patients with brain metastases who underwent CyberKnife Radiosurgery between June 2008 and June 2014 was performed...
January 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28089192/commissioning-monte-carlo-algorithm-for-robotic-radiosurgery-using-cylindrical-3d-array-with-variable-density-inserts
#7
D Dechambre, V Baart, S Cucchiaro, C Ernst, N Jansen, P Berkovic, C Mievis, P Coucke, A Gulyban
INTRODUCTION: To commission the Monte Carlo (MC) algorithm based model of CyberKnife robotic stereotactic system (CK) and evaluate the feasibility of patient specific QA using the ArcCHECK cylindrical 3D-array (AC) with Multiplug inserts (MP). RESULTS: Four configurations were used for simple beam setup and two for patient QA, replacing water equivalent inserts by lung. For twelve collimators (5-60mm) in simple setup, mean (SD) differences between MC and RayTracing algorithm (RT) of the number of points failing the 3%/1mmgamma criteria were 1(1), 1(3), 1(2) and 1(2) for the four MP configurations...
January 11, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28089106/-edge-on-moskin-detector-for-stereotactic-beam-measurement-and-verification
#8
Wei Loong Jong, Ngie Min Ung, Ath Vannyat, Zulaikha Jamalludin, Anatoly Rosenfeld, Jeannie Hsiu Ding Wong
Dosimetry in small radiation field is challenging and complicated because of dose volume averaging and beam perturbations in a detector. We evaluated the suitability of the "Edge-on" MOSkin (MOSFET) detector in small radiation field measurement. We also tested the feasibility for dosimetric verification in stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT). "Edge-on" MOSkin detector was calibrated and the reproducibility and linearity were determined. Lateral dose profiles and output factors were measured using the "Edge-on" MOSkin detector, ionization chamber, SRS diode and EBT2 film...
January 6, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28081463/analysis-of-the-results-of-recurrent-intracranial-meningiomas-treated-with-re-radiosurgery
#9
Moinay Kim, Do Hee Lee, Hyun Jung Kim Rn, Young Hyun Cho, Jeong Hoon Kim, Do Hoon Kwon
OBJECTS: Meningioma is the most common intracranial neoplasm, comprising approximately 30% of all primary intracranial tumors (Claus et al., 2005) [1]. Treatment options include observation, microsurgical resection, stereotactic radiosurgery (SRS), and whole brain radiation therapy (WBRT). Gamma knife radiosurgery (GKRS) is a very effective treatment for intracranial meningiomas; previous studies showed the tumor control rate at 5-10 years of follow-up as 84.3%-100% in all cases (Feigl et al...
December 29, 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28078405/-radiosurgery-and-fractionated-stereotactic-radiotherapy-of-vestibular-schwannoma
#10
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/28071340/respiration-induced-intraorgan-deformation-of-the-liver
#11
Anna K Paulsson, Sue S Yom, Mekhail Anwar, Dilini Pinnaduwage, Atchar Sudhyadhom, Alexander R Gottschalk, Albert J Chang, Martina Descovich
Stereotactic body radiation therapy is a well-tolerated modality for the treatment of primary and metastatic liver lesions, and fiducials are often used as surrogates for tumor tracking during treatment. We evaluated respiratory-induced liver deformation by measuring the rigidity of the fiducial configuration during the breathing cycle. Seventeen patients, with 18 distinct treatment courses, were treated with stereotactic body radiosurgery using multiple fiducials. Liver deformation was empirically quantified by measuring the intrafiducial distances at different phases of respiration...
January 1, 2017: Technology in Cancer Research & Treatment
https://www.readbyqxmd.com/read/28070828/hypofractionated-stereotactic-radiosurgery-for-pituitary-metastases
#12
Haemin Chon, KyoungJun Yoon, Do Hoon Kwon, Chang Jin Kim, Min-Seon Kim, Young Hyun Cho
Pituitary metastases (PMs) are uncommon, representing only 1% of pituitary lesions. The diagnosis of PMs can be challenging and an optimal management remains to be determined. Here, we present a pilot clinical study on the efficacy and safety of hypofractionated stereotactic radiosurgery (SRS) with an optimized dosimetric plan in treating PMs. Between June 2013 and December 2014, seven consecutive patients (4 men and 3 women; median age 62 years) had been diagnosed with PMs based on their characteristic clinical and radiological features and subsequently treated using hypofractionated SRS...
January 9, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28070243/value-of-serial-magnetic-resonance-imaging-in-the-assessment-of-brain-metastases-volume-control-during-stereotactic-radiosurgery
#13
Gianvincenzo Sparacia, Francesco Agnello, Aurelia Banco, Francesco Bencivinni, Andrea Anastasi, Giovanna Giordano, Adele Taibbi, Massimo Galia, Tommaso Vincenzo Bartolotta
AIM: To evaluate brain metastases volume control capabilities of stereotactic radiosurgery (SRS) through serial magnetic resonance (MR) imaging follow-up. METHODS: MR examinations of 54 brain metastases in 31 patients before and after SRS were reviewed. Patients were included in this study if they had a pre-treatment MR examination and serial follow-up MR examinations at 6 wk, 9 wk, 12 wk, and 12 mo after SRS. The metastasis volume change was categorized at each follow-up as increased (> 20% of the initial volume), stable (± 20% of the initial volume) or decreased (< 20% of the initial volume)...
December 28, 2016: World Journal of Radiology
https://www.readbyqxmd.com/read/28068303/delayed-vestibular-schwannoma-regrowth-following-shrinkage-after-stereotactic-radiosurgery-implication-for-life-long-surveillance
#14
Emma Stapleton, John A Crowther, Richard Locke, Georgios Kontorinis
OBJECTIVE: To enhance understanding of the behavior of vestibular schwannomas (VS) after stereotactic radiosurgery (SRS), including the potential for late tumor regrowth, and the need for lifelong radiological and clinical surveillance. PATIENTS: From a total of 540 patients with VS and out of 95 patients receiving SRS for their growing VS, the cases of two women patients aged 58 and 59 years with medium sized, growing VS are presented. INTERVENTION: Both patients were treated with SRS...
February 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28068233/multi-institutional-nomogram-predicting-survival-free-from-salvage-whole-brain-radiation-after-radiosurgery-in-patients-with-brain-metastases
#15
Daniel Gorovets, Diandra Ayala-Peacock, David J Tybor, Paul Rava, Daniel Ebner, Deus Cielo, Georg Norén, David E Wazer, Michael Chan, Jaroslaw T Hepel
PURPOSE: Optimal patient selection for stereotactic radiosurgery (SRS) as the initial treatment for brain metastases is complicated and controversial. This study aimed to develop a nomogram that predicts survival without salvage whole brain radiation therapy (WBRT) after upfront SRS. METHODS AND MATERIALS: Multi-institutional data were analyzed from 895 patients with 2095 lesions treated with SRS without prior or planned WBRT. Cox proportional hazards regression model was used to identify independent pre-SRS predictors of WBRT-free survival, which were integrated to build a nomogram that was subjected to bootstrap validation...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28068232/analysis-of-the-factors-contributing-to-vertebral-compression-fractures-after-spine-stereotactic-radiosurgery
#16
David Boyce-Fappiano, Erinma Elibe, Lonni Schultz, Samuel Ryu, M Salim Siddiqui, Indrin Chetty, Ian Lee, Jack Rock, Benjamin Movsas, Farzan Siddiqui
PURPOSE: To determine our institutional vertebral compression fracture (VCF) rate after spine stereotactic radiosurgery (SRS) and determine contributory factors. METHODS AND MATERIALS: Retrospective analysis from 2001 to 2013 at a single institution was performed. With institutional review board approval, electronic medical records of 1905 vertebral bodies from 791 patients who were treated with SRS for the management of primary or metastatic spinal lesions were reviewed...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28061768/a-matched-pair-study-comparing-whole-brain-irradiation-alone-to-radiosurgery-or-fractionated-stereotactic-radiotherapy-alone-in-patients-irradiated-for-up-to-three-brain-metastases
#17
Dirk Rades, Stefan Janssen, Liesa Dziggel, Oliver Blanck, Amira Bajrovic, Theo Veninga, Steven E Schild
BACKGROUND: This matched-pair study was initiated to validate the results of a retrospective study of 186 patients published in 2007 that compared whole-brain irradiation (WBI) alone and radiosurgery (RS) alone for up to three brain metastases. METHODS: One-hundred-fifty-two patients receiving WBI alone for up to three brain metastases were matched with 152 patients treated with RS of fractionated stereotactic radiotherapy (FSRT) alone 1:1 for each of eight factors (age, gender, Eastern Oncology Cooperative Group (ECOG)-performance score, nature of tumor, brain metastases number, extra-cerebral spread, period from cancer detection to irradiation of brain metastases, and recursive partitioning analysis (RPA)-class...
January 6, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28059663/the-effect-of-timing-of-stereotactic-radiosurgery-treatment-of-melanoma-brain-metastases-treated-with-ipilimumab
#18
Or Cohen-Inbar, Han-Hsun Shih, Zhiyuan Xu, David Schlesinger, Jason P Sheehan
OBJECTIVE Melanoma represents the third most common cause of CNS metastases. Immunotherapy has evolved as a treatment option for patients with Stage IV melanoma. Stereotactic radiosurgery (SRS) also elicits an immune response within the brain and may interact with immunotherapy. The authors report on a cohort of patients treated for brain metastases with immunotherapy and evaluate the effect of SRS timing on the intracranial response. METHODS All consecutively treated melanoma patients receiving ipilimumab and SRS for treatment of brain metastases at the University of Virginia between 2009 and 2014 were included in this retrospective analysis; data from 46 patients harboring 232 brain metastases were reviewed...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28056412/toxicity-of-concurrent-stereotactic-radiotherapy-and-targeted-therapy-or-immunotherapy-a-systematic-review
#19
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/28054837/radiosurgery-alters-the-endothelial-surface-proteome-externalized-intracellular-molecules-as-potential-vascular-targets-in-irradiated-brain-arteriovenous-malformations
#20
Lucinda S McRobb, Vivienne S Lee, Margaret Simonian, Zhenjun Zhao, Santhosh George Thomas, Markus Wiedmann, Jude V Amal Raj, Michael Grace, Vaughan Moutrie, Matthew J McKay, Mark P Molloy, Marcus A Stoodley
Stereotactic radiosurgery (SRS) is an established treatment for brain arteriovenous malformations (AVMs) that drives blood vessel closure through cellular proliferation, thrombosis and fibrosis, but is limited by a delay to occlusion of 2-3 years and a maximum treatable size of 3 cm. In this current study we used SRS as a priming tool to elicit novel protein expression on the endothelium of irradiated AVM vessels, and these proteins were then targeted with prothrombotic conjugates to induce rapid thrombosis and vessel closure...
January 5, 2017: Radiation Research
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