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Stereotactic body radiation therapy

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
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
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
Mazen Soufi, Hidetaka Arimura, Takahiro Nakamoto, Taka-Aki Hirose, Saiji Ohga, Yoshiyuki Umezu, Hiroshi Honda, Tomonari Sasaki
PURPOSE: We aimed to explore the temporal stability of radiomic features in the presence of tumor motion and the prognostic powers of temporally stable features. METHODS: We selected single fraction dynamic electronic portal imaging device (EPID) (n = 275 frames) and static digitally reconstructed radiographs (DRRs) of 11 lung cancer patients, who received stereotactic body radiation therapy (SBRT) under free breathing. Forty-seven statistical radiomic features, which consisted of 14 histogram-based features and 33 texture features derived from the graylevel co-occurrence and graylevel run-length matrices, were computed...
February 2018: Physica Medica: PM
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
Yuko Harada, Shinichiro Miyazaki
Standard radiation therapy for cervical cancer consists of external beam radiation therapy followed by an intracavitary brachytherapy boost. When brachytherapy cannot be performed due to unfavorable anatomy or coexisting medical conditions, stereotactic body radiotherapy with the CyberKnife is another treatment option which is less invasive and can be performed in a shorter treatment time. We performed non-invasive therapy using the CyberKnife for five cases of urogenital cancer located in the cervix. The local tumor control was excellent with minimal toxicity...
December 29, 2017: Curēus
Natalie A Lockney, T Jonathan Yang, David Barron, Emily Gelb, Daphna Y Gelblum, Ellen Yorke, Weiji Shi, Zhigang Zhang, Andreas Rimner, Abraham J Wu
Objectives: Hyperactivation of the phosphatidylinositol-3-kinase (PI3K) pathway has been associated with radioresistance. It is unclear whether such mutations confer suboptimal local control for patients who receive lung stereotactic body radiation therapy (SBRT). Our objective was to examine whether mutations in the EGFR/AKT/PIK3CA signaling pathway are associated with local failure (LF) after lung SBRT. Methods: We retrospectively reviewed 166 patients who underwent SBRT to primary or metastatic lung lesions from 2007-2015 for whom genetic testing data was available for EGFR, AKT, and PIK3CA genes...
December 2017: Clinical and Translational Radiation Oncology
Christian Hyde, Shannon Kinser, Christopher Croft, Patricia Schantz, Kayla Brown, Rajendra Vazirani, Jikun Wei, Ioana Bonta
There is an ongoing debate as to the maximum number of brain metastases that can safely and practically be treated with a single course of radiosurgery. Despite evidence of durable local control and favorable overall survival when treating 10 or more brain metastases with radiosurgery alone, some institutions and guidelines still limit radiosurgery to an arbitrary number of metastases. As demonstrated by this case report, the number of lesions is not so important when the patient's life expectancy is otherwise good and body tumors are controllable...
December 25, 2017: Curēus
Matthias Guckenberger, Reinhart A Sweeney, Maria Hawkins, Jose Belderbos, Nicolaus Andratschke, Merina Ahmed, Indira Madani, Frederick Mantel, Sabrina Steigerwald, Michael Flentje
BACKGROUND: The objective of this study was to prospectively evaluate dose-intensified hypofractionated stereotactic body radiation therapy (SBRT) in patients with painful spinal metastases in a multicenter, single-arm, phase 2 study. METHODS: Patients with 2 or fewer distinct, noncontiguous, painful, mechanically stable, unirradiated spinal metastases from a solid tumor with a Karnofsky performance status ≥ 60 were eligible. Patients with a long (Mizumoto score ≤ 4) or intermediate overall survival expectancy (Mizumoto score = 5-9) received 48...
March 2, 2018: Cancer
Zhiwen Liang, Hongyuan Liu, Jun Xue, Bin Hu, Bin Zhu, Qin Li, Sheng Zhang, Gang Wu
PURPOSE: Tumor motion amplitude varies during treatment. The purpose of the study was to evaluate the intra- and interfraction tumor motion and variability in patients with liver cancer treated with fiducial-based real-time tracking stereotactic body radiotherapy (SBRT). METHODS: Fourteen liver patients were treated with SBRT using a CyberKnife. Two to four fiducial markers implanted near the tumor were used for real-time monitoring using the Synchrony system. The tumor motion information during treatment was extracted from the log files recorded by the Synchrony system...
February 28, 2018: Journal of Applied Clinical Medical Physics
Basem A Dahshan, Malcolm D Mattes, Sanjay Bhatia, Mary Susan Palek, Christopher P Cifarelli, Joshua D Hack, John A Vargo
The role of stereotactic radiosurgery (SRS) in the treatment of multiple brain metastases is controversial. While whole brain radiation therapy (WBRT) has historically been the mainstay of treatment, its value is increasingly being questioned as emerging data supports that SRS alone can provide comparable therapeutic outcomes for limited (one to three) intracranial metastases with fewer adverse effects, including neurocognitive decline. Multiple recent studies have also demonstrated that patients with multiple (> 3) intracranial metastases with a low overall tumor volume have a favorable therapeutic response to SRS, with no significant difference compared to patients with limited metastases...
December 19, 2017: Curēus
Ryo Toya, Tetsuo Saito, Shinya Shiraishi, Yudai Kai, Ryuji Murakami, Tomohiko Matsuyama, Takahiro Watakabe, Fumi Sakamoto, Noriko Tsuda, Yoshinobu Shimohigashi, Yasuyuki Yamashita, Natsuo Oya
BACKGROUND/AIM: We evaluated the influence of previous treatments on the parametric discrepancies between dose-volume histograms (DVHs) and dose-function histograms (DFHs) generated based on99m Tc-GSA SPECT images of hepatocellular carcinoma (HCC) patients treated with stereotactic body radiation therapy (SBRT). PATIENTS AND METHODS: Twelve patients underwent SBRT at 30-40 Gy. Registration between planning CT and SPECT/CT images was performed, and DFH parameters were calculated as follows: Fx=(sum of the counts within the liver volume receiving a dose of more than x Gy/sum of the counts within the whole liver volume) ×100...
March 2018: Anticancer Research
Hannah Linney, Sarah Barrett
AIM: Stereotactic body radiation therapy (SBRT) is emerging as a new treatment option for early-stage prostate cancer, theoretically providing clinical and economic benefits compared to conventionally fractionated external-beam radiation therapy (CF-EBRT). This review aimed to evaluate available published data to determine if the proposed theoretical benefits translate clinically. MATERIALS AND METHODS: A systematic search strategy was employed across three databases using predefined search terms, inclusion and exclusion criteria to identify relevant articles...
March 2018: Anticancer Research
Aman Sharma, Marloes Duijm, Esther Oomen-de Hoop, Joachim G Aerts, Cornelis Verhoef, Mischa Hoogeman, Joost Jan Nuyttens
BACKGROUND: Oligometastases refers to a state of limited metastatic disease. The use of local ablative therapies to patients with oligometastases can result in durable state of remission or long-term cure. Stereotactic body radiotherapy (SBRT) is a highly conformal radiation technique that delivers ablative doses to the target. The study aimed to evaluate local control (LC) and identify factors associated with poor LC in patients with pulmonary oligometastases treated with SBRT. Primary endpoint of the study was to assess LC; secondary endpoint was to determine factors associated with LC...
February 28, 2018: Acta Oncologica
William C Jackson, Yebin Tao, Mishal Mendiratta-Lala, Latifa Bazzi, Dan R Wahl, Matthew J Schipper, Mary Feng, Kyle C Cuneo, Theodore S Lawrence, Dawn Owen
PURPOSE: Stereotactic body radiation therapy (SBRT) and radiofrequency ablation (RFA) are widely used therapies for the treatment of intrahepatic metastases; however, direct comparisons are lacking. We sought to compare outcomes for these 2 modalities. METHODS AND MATERIALS: From 2000 to 2015, 161 patients with 282 pathologically diagnosed unresectable liver metastases were treated with RFA (n = 112) or SBRT (n = 170) at a single institution. The primary outcome was freedom from local progression (FFLP)...
March 15, 2018: International Journal of Radiation Oncology, Biology, Physics
Nora Sundahl, Katrien De Wolf, Vibeke Kruse, Annabel Meireson, Dries Reynders, Els Goetghebeur, Mireille Van Gele, Reinhart Speeckaert, Benjamin Hennart, Lieve Brochez, Piet Ost
PURPOSE: To report the results of a phase 1 trial evaluating the safety of the ipilimumab/radiation therapy combination in patients with metastatic melanoma. PATIENTS AND METHODS: Thirteen patients with metastatic melanoma were enrolled. Trial treatment consisted of 4 cycles of ipilimumab in combination with concurrent dose-escalated high-dose radiation therapy to 1 lesion administered before the third cycle of ipilimumab. RESULTS: Grade 3 or 4 ipilimumab-related adverse events occurred in 25% of patients...
March 15, 2018: International Journal of Radiation Oncology, Biology, Physics
Kelly C Younge, Robin B Marsh, Dawn Owen, Huaizhi Geng, Ying Xiao, Daniel E Spratt, Joseph Foy, Krithika Suresh, Q Jackie Wu, Fang-Fang Yin, Samuel Ryu, Martha M Matuszak
PURPOSE: To use knowledge-based planning (KBP) as a method of producing high-quality, consistent, protocol-compliant treatment plans in a complex setting of spine stereotactic body radiation therapy on NRG Oncology Radiation Therapy Oncology Group (RTOG) 0631. METHODS AND MATERIALS: An internally developed KBP model was applied to an external validation cohort of 22 anonymized cases submitted under NRG Oncology RTOG 0631. The original and KBP plans were compared via their protocol compliance, target conformity and gradient index, dose to critical structures, and dose to surrounding normal tissues...
March 15, 2018: International Journal of Radiation Oncology, Biology, Physics
Peter Ziegenhein, Cornelis Ph Kamerling, Martin F Fast, Uwe Oelfke
In this work we describe an ultra-fast, low-latency implementation of the energy/mass transfer (EMT) mapping method to accumulate dose on deforming geometries such as lung using the central processing unit (CPU). It enables the computation of the actually delivered dose for intensity-modulated radiation therapy on 4D image data in real-time at 25 Hz. In order to accumulate the delivered dose onto a reference phase a pre-calculated deformable vector field is used. The aim of this study is to present an online dose accumulation technique that can be carried out in less than 40 ms to accommodate the machine log update rate of our research linac...
February 26, 2018: Scientific Reports
Moyed Miften, Yevgeniy Vinogradskiy, Vitali Moiseenko, Jimm Grimm, Ellen Yorke, Andrew Jackson, Wolfgang A Tomé, Randall K Ten Haken, Nitin Ohri, Alejandra Méndez Romero, Karyn A Goodman, Lawrence B Marks, Brian Kavanagh, Laura A Dawson
Stereotactic body radiation therapy (SBRT) has emerged as an effective, noninvasive treatment option for primary liver cancer and metastatic disease occurring in the liver. Although SBRT can be highly effective for establishing local control in hepatic malignancies, a tradeoff exists between tumor control and normal tissue complications. The objective of the present study was to review the normal tissue dose-volume effects for SBRT-induced liver and gastrointestinal toxicities and derive normal tissue complication probability models...
January 6, 2018: International Journal of Radiation Oncology, Biology, Physics
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