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stereotactic radiotherapy

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
Sweet Ping Ng, Joseph M Herman
Pancreatic cancer is a devastating disease with poor survival outcomes. Recent studies have shown that the addition of radiotherapy to chemotherapy in the setting of locally advanced pancreatic cancer did not improve overall survival outcome. These studies commonly utilize conventional radiotherapy treatment fractionation and technique (typically 3-D conformal radiotherapy or intensity modulated radiotherapy). Although no clear benefit in overall survival was demonstrated in those studies, those who received radiotherapy did have a clear benefit in terms of local control...
March 16, 2018: Cancers
Xiaowen Sun, Lei Deng, You Lu
Microvessels promote proliferation of tumor cells by delivering oxygen and nutrients, but rapid growth of tumors results in unmet demands for oxygen and nutrients, thereby creating a hypoxia microenvironment. Under hypoxic conditions, vascular endothelial cells (ECs) initiate the formation of immature and abnormal microvasculature. This results in leakage and tortuosity that facilitates tumor cell invasion, metastasis and resistance to cytotoxic treatment. Radiotherapy (RT) is a vital tumor treatment modality...
February 2018: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Atallah Baydoun, Neha Vapiwala, Lee E Ponsky, Musaddiq Awan, Ali Kassaee, David Sutton, Tarun K Podder, Yuxia Zhang, Donald Dobbins, Raymond F Muzic, Bryan Traughber, Mitchell Machtay, Rodney Ellis
PURPOSE: We conducted this dosimetric analysis to evaluate the feasibility of a multi-center stereotactic body radiation therapy (SBRT) trial for renal cell carcinoma (RCC) using different SBRT platforms. MATERIALS/METHODS: The computed tomography (CT) simulation images of 10 patients with unilateral RCC previously treated on a Phase 1 trial at Institution 1 were anonymized and shared with Institution 2 after IRB approval. Treatment planning was generated through five different platforms aiming a total dose of 48 Gy in three fractions...
March 14, 2018: Journal of Applied Clinical Medical Physics
Yee Pei Song, Rovel J Colaco
Stereotactic radiosurgery (SRS) provides excellent control in the treatment of brain metastases (BM). The use of newer, targeted and immunotherapy treatments have resulted in improved overall survival in patients even with an extensive metastatic disease. Hence, it is increasingly important to consider the potential for late toxicities like radiation-induced necrosis (RN) of the brain. We present a case of a patient with stage IV anaplastic lymphoma kinase (ALK) positive adenocarcinoma of the lung who underwent stereotactic radiosurgery to her brain metastases and received targeted treatment...
January 8, 2018: Curēus
HaYeon Kim, John A Vargo, Sushil Beriwal, David A Clump, James P Ohr, Robert L Ferris, Dwight E Heron, M Saiful Huq, Kenneth J Smith
BACKGROUND: The purpose of this study was to present our evaluation of the cost-effectiveness of salvage therapies for patients with recurrent head and neck cancer. METHODS: A Markov model was developed with 5 salvage treatment strategies: (1) platinum-based chemotherapy alone; (2) chemotherapy plus cetuximab; (3) stereotactic body radiotherapy (SBRT) alone; (4) SBRT plus cetuximab; and (5) intensity-modulated radiotherapy (IMRT) plus chemotherapy. Clinical parameters were obtained from comprehensive literature review and 2016 Medicare reimbursement...
March 14, 2018: Head & Neck
Robin De Roover, Wouter Crijns, Kenneth Poels, Ronald Peeters, Cédric Draulans, Karin Haustermans, Tom Depuydt
PURPOSE: Liquid fiducial markers have shown to be a promising alternative to solid gold markers in terms of imaging artifact reduction, patient comfort and compatibility with different imaging modalities. This study aims to investigate the performance of the novel BioXmark® liquid marker for state-of-the-art multi-modal imaging used in prostate cancer (PCa) radiotherapy, encompassing kV CT/CBCT, multi-parametric MRI and kV X-ray imaging. In addition, automatic detection of the liquid markers in X-ray imaging for prostate motion monitoring during treatment was investigated...
March 14, 2018: Medical Physics
Michael T Milano, Jimm Grimm, Scott G Soltys, Ellen Yorke, Vitali Moiseenko, Wolfgang A Tomé, Arjun Sahgal, Jinyu Xue, Lijun Ma, Timothy D Solberg, John P Kirkpatrick, Louis S Constine, John C Flickinger, Lawrence B Marks, Issam El Naqa
PURPOSE: Dosimetric and clinical predictors of radiation-induced optic nerve/chiasm neuropathy (RION) after single-fraction stereotactic radiosurgery (SRS) or hypofractionated (2-5 fractions) radiosurgery (fSRS) were analyzed from pooled data that were extracted from published reports (PubMed indexed from 1990 to June 2015). This study was undertaken as part of the American Association of Physicists in Medicine Working Group on Stereotactic Body Radiotherapy, investigating normal tissue complication probability (NTCP) after hypofractionated radiation...
January 31, 2018: International Journal of Radiation Oncology, Biology, Physics
N Andratschke, H Alheid, M Allgäuer, G Becker, O Blanck, J Boda-Heggemann, T Brunner, M Duma, S Gerum, M Guckenberger, G Hildebrandt, R J Klement, V Lewitzki, C Ostheimer, A Papachristofilou, C Petersen, T Schneider, R Semrau, S Wachter, D Habermehl
No abstract text is available yet for this article.
March 13, 2018: BMC Cancer
T Steuber, C Jilg, P Tennstedt, A De Bruycker, K Decaestecker, T Zilli, B A Jereczek-Fossa, U Wetterauer, A L Grosu, W Schultze-Seemann, H Heinzer, M Graefen, A Morlacco, R J Karnes, Piet Ost
BACKGROUND: Most prostate cancer (PCa) patients with a biochemical failure following primary multimodality treatment (surgery and postoperative radiotherapy) relapse in the nodes. OBJECTIVE: To perform a matched-case analysis in men with lymph node recurrent PCa comparing standard of care (SOC) with metastasis-directed therapy (MDT). DESIGN, SETTING, AND PARTICIPANTS: PCa patients with a prostate-specific antigen (PSA) progression following multimodality treatment were included in this retrospective multi-institutional analysis...
March 9, 2018: European Urology Focus
Rami A El Shafie, Angela Paul, Denise Bernhardt, Henrik Hauswald, Thomas Welzel, Tanja Sprave, Adriane Hommertgen, Johannes Krisam, Daniela Schmitt, Sebastian Klüter, Kai Schubert, Christina Klose, Meinhard Kieser, Jürgen Debus, Stefan Rieken
BACKGROUND: Neurosurgical resection is recommended for symptomatic brain metastases, in oligometastatic patients or for histology acquisition. Without adjuvant radiotherapy, roughly two-thirds of the patients relapse at the resection site within 24 mo, while the risk of new metastases in the untreated brain is around 50%. Adjuvant whole-brain radiotherapy (WBRT) can reduce the risk of both scenarios of recurrence significantly, although the associated neurocognitive toxicity is substantial, while stereotactic radiotherapy (SRT) improves local control at comparably low toxicity...
March 8, 2018: Neurosurgery
Waqar Haque, Vivek Verma, Gary D Lewis, Simon S Lo, Edward Brian Butler, Bin S Teh
AIM: This study evaluated national practice patterns of cT1N0M0 renal cell cancer, with a focus on stereotactic body radiation therapy (SBRT) utilization. METHODS: The National Cancer Database was queried (2004-2013) for patients with newly-diagnosed cT1a/bN0M0 renal cell cancer that received definitive treatment. Temporal trends in utilization were tabulated. RESULTS: Altogether, 138,495 patients met inclusion criteria; 13,725 (9.9%) patients received ablative therapy, 57,924 (41...
March 12, 2018: Future Oncology
Adam Mutsaers, Hanbo Chen, Alexander V Louie
PURPOSE OF REVIEW: Significant advances have been made in the field of stereotactic ablative radiotherapy (SABR) for the treatment of pulmonary neoplasms in recent years. This review aims to summarize recent salient evidence on SABR for early-stage nonsmall cell lung cancer (ES-NSCLC). RECENT FINDINGS: In medically inoperable patients, SABR remains the standard of care. The optimal SABR dosing regimen is being studied. Comparisons with non-SABR radiotherapy regimens with lower doses per fraction revealed benefit of SABR...
March 7, 2018: Current Opinion in Pulmonary Medicine
Dominik Schulz, Markus Wirth, Guido Piontek, Andreas Knopf, Christoph Straube, Steffi Pigorsch, Stephanie E Combs, Anja Pickhard
PURPOSE: While metastases directed therapy for oligometastatic disease is recommended in different cancer entities, the treatment of solitary metastases in head and neck squamous cell carcinoma (HNSCC) patients is not clearly defined. METHODS: A retrospective analysis was performed on data from 143 HNSCC patients treated between 2001 and 2016 in a tertiary university hospital. Clinical factors and outcome were measured using the median survival of patients receiving metastases specific therapy in comparison with matched control patients...
March 8, 2018: European Archives of Oto-rhino-laryngology
Ye Zheng, Anhui Shi, Weihu Wang, Huiming Yu, Rong Yu, Dongming Li, Bo Xu, Huimin Ma, Jing You, Dan Zhao, Leilei Jiang, Jianhao Geng, Guangying Zhu
PURPOSE: Stereotactic ablative body radiotherapy (SABR) represents an exciting, tolerable, and highly effective form of radiotherapy. Ongoing investigations into the interactions between radiotherapy and the immune system have uncovered new mechanisms that can be exploited to improve efficacy. We determined whether baseline or posttreatment immune parameters could predict disease control and toxicity in stage I non-small-cell lung cancer (NSCLC) patients treated with SABR. PATIENTS AND METHODS: Peripheral blood samples were collected from 62 patients 24 hours before treatment and within 4 weeks after treatment for lymphocyte subset count analysis...
January 4, 2018: Clinical Lung Cancer
Elena Gallio, Francesca Romana Giglioli, Andrea Girardi, Alessia Guarneri, Umberto Ricardi, Roberto Ropolo, Riccardo Ragona, Christian Fiandra
PURPOSE: Automated treatment planning is a new frontier in radiotherapy. The Auto-Planning module of the Pinnacle3 treatment planning system (TPS) was evaluated for liver stereotactic body radiation therapy treatments. METHODS: Ten cases were included in the study. Six plans were generated for each case by four medical physics experts. The first two planned with Pinnacle TPS, both with manual module (MP) and Auto-Planning one (AP). The other two physicists generated two plans with Monaco TPS (VM)...
February 2018: Physica Medica: PM
Merle I Ronden, David Palma, Ben J Slotman, Suresh Senan
Distinctive patterns of early and late benign fibrosis are commonly observed after stereotactic ablative radiotherapy (SABR) for lung malignancies. These changes on computed tomographic scans need to be distinguished from so-called 'high-risk' radiological features, which can be associated with a higher risk for tumor recurrence. This pictorial report illustrates the different radiological changes seen following SABR delivered using the volumetric modulated radiotherapy, a technique which is increasingly used in clinical care...
March 5, 2018: Journal of Thoracic Oncology
Jenny Bertholet, Jakob Toftegaard, Rune Hansen, Esben S Worm, Hanlin Wan, Parag J Parikh, Britta Weber, Morten Høyer, Per R Poulsen
The purpose of this study was to develop, validate and clinically demonstrate fully automatic tumour motion monitoring on a conventional linear accelerator by combined optical and sparse monoscopic imaging with kilovoltage x-rays (COSMIK). COSMIK combines auto-segmentation of implanted fiducial markers in cone-beam computed tomography (CBCT) projections and intra-treatment kV images with simultaneous streaming of an external motion signal. A pre-treatment CBCT is acquired with simultaneous recording of the motion of an external marker block on the abdomen...
March 8, 2018: Physics in Medicine and Biology
R J Klement, J Hoerner-Rieber, S Adebahr, N Andratschke, O Blanck, J Boda-Heggemann, M Duma, M J Eble, H C Eich, M Flentje, S Gerum, P Hass, C Henkenberens, G Hildebrandt, D Imhoff, K H Kahl, N D Klass, R Krempien, F Lohaus, C Petersen, E Schrade, T G Wendt, A Wittig, M Guckenberger
BACKGROUND: Stereotactic body radiotherapy (SBRT) for oligometastatic disease is characterized by an excellent safety profile; however, experiences are mostly based on treatment of one single metastasis. It was the aim of this study to evaluate safety and efficacy of SBRT for multiple pulmonary metastases. PATIENTS AND METHODS: This study is based on a retrospective database of the DEGRO stereotactic working group, consisting of 637 patients with 858 treatments...
March 3, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Bilgehan Sahin, Teuta Mustafayev, Gokhan Aydin, Gorkem Gungor, Bulend Yapici, Banu Atalar, Enis Ozyar
Brain metastases are commonly seen complications in non-small cell lung cancer (NSCLC) patients. The incidence of brain metastases is increasing as a result of more effective systemic targeted therapies with prolonged survival. The prognosis is usually poor, and up to six months of median survivals were reported with different therapeutic options. Here, we present an NSCLC case with multiple brain metastases treated with radiosurgery and systemic erlotinib therapy with prolonged survival. The use of tyrosine kinase inhibitors (TKI) in conjunction with either stereotactic radiosurgery or whole brain radiotherapy is not well established in terms of efficiency and toxicity...
December 29, 2017: Curēus
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