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Stereotactic radiation therapy

Stefan Knippen, Florian Putz, Sabine Semrau, Ulrike Lambrecht, Arzu Knippen, Michael Buchfelder, Sven Schlaffer, Tobias Struffert, Rainer Fietkau
BACKGROUND: Intracranial arteriovenous malformations (AVMs) may show a harmful development. AVMs are treated by surgery, embolization, or radiation therapy. OBJECTIVE: This study investigated obliteration rates and side effects in patients with AVMs treated by radiation therapy. METHODS: A total of 40 cases treated between 2005 and 2013 were analyzed. Single-dose stereotactic radiosurgery (SRS) was received by 13 patients and 27 received hypofractionated stereotactic radiation therapy (HSRT)...
October 18, 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Thomas B Brunner, Ursula Nestle, Sonja Adebahr, Eleni Gkika, Rolf Wiehle, Dimos Baltas, Anca-Ligia Grosu
OBJECTIVE: Stereotactic radiotherapy near serial organs at risk (OAR) requires special caution. A novel intensity-modulated radiotherapy (IMRT) prescription concept termed simultaneous integrated protection (SIP) for quantifiable and comparable dose prescription to targets very close to OAR is described. MATERIALS AND METHODS: An intersection volume of a planning risk volume (PRV) with the total planning target volume (PTV) defined the protection volume (PTVSIP)...
October 18, 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
E Liniker, A M Menzies, B Y Kong, A Cooper, S Ramanujam, S Lo, R F Kefford, G B Fogarty, A Guminski, T W Wang, M S Carlino, A Hong, G V Long
The anti-PD-1 antibodies nivolumab and pembrolizumab are active in metastatic melanoma; however, there is limited data on combining anti-PD-1 antibody and radiotherapy (RT). We sought to review clinical outcomes of patients receiving RT and anti-PD-1 therapy. All patients receiving anti-PD-1 antibody and RT for metastatic melanoma were identified. RT and systemic treatment, clinical outcome, and toxicity data were collected. Fifty-three patients were included; 35 patients received extracranial RT and/or intracranial stereotactic radiosurgery (SRS) and 21 received whole brain radiotherapy (WBRT) (three of whom also received SRS/extracranial RT)...
2016: Oncoimmunology
Laure Vieillevigne, Sandra Bessieres, Monia Ouali, Christel Lanaspeze
PURPOSE: Flattening filter free (FFF) beams are frequently used for stereotactic body radiation therapy with various treatment modalities: conventional static fields, dynamic conformal arc (DCA) or Rapid Arc (RA). The goal of this study was to obtain some criteria to enable a conscious choice of the employment of FFF beams and of the DCA or RA technique, depending on the PTV size. METHODS AND MATERIALS: 24 PTVs from 1.52cm(3) to 445.24cm(3) were studied in various sites: virtual phantom, lung and liver...
October 15, 2016: Physica Medica: PM
Marcus Sonier, William Chu, Nafisha Lalani, Darby Erler, Patrick Cheung, Renee Korol
To develop a volumetric modulated arc therapy (VMAT) treatment planning solution in the treatment of primary renal cell carcinoma and oligometastatic adrenal lesions with stereotactic body radiation therapy. Single-arc VMAT plans (n = 5) were compared with clinically delivered step-and-shoot intensity-modulated radiotherapy (IMRT) with planning target volume coverage normalized between techniques. Target volume conformity, organ-at-risk (OAR) dose, treatment time, and monitor units were compared. A VMAT planning solution, created from a combination of arc settings and optimization constraints, auto-generated treatment plans in a single optimization...
October 13, 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Jaroslaw T Hepel, Kara Lynne Leonard, Howard Safran, Thomas Ng, Angela Taber, Humera Khurshid, Ariel Birnbaum, David E Wazer, Thomas DiPetrillo
PURPOSE: Stereotactic body radiation therapy (SBRT) boost to primary and nodal disease after chemoradiation has potential to improve outcomes for advanced non-small cell lung cancer (NSCLC). A dose escalation study was initiated to evaluate the maximum tolerated dose (MTD). METHODS AND MATERIALS: Eligible patients received chemoradiation to a dose of 50.4 Gy in 28 fractions and had primary and nodal volumes appropriate for SBRT boost (<120 cc and <60 cc, respectively)...
August 31, 2016: International Journal of Radiation Oncology, Biology, Physics
Lauren Henke, Rojano Kashani, Deshan Yang, Tianyu Zhao, Olga Green, Lindsey Olsen, Vivian Rodriguez, H Omar Wooten, H Harold Li, Yanle Hu, Jeffrey Bradley, Clifford Robinson, Parag Parikh, Jeff Michalski, Sasa Mutic, Jeffrey R Olsen
PURPOSE: To characterize potential advantages of online-adaptive magnetic resonance (MR)-guided stereotactic body radiation therapy (SBRT) to treat oligometastatic disease of the non-liver abdomen and central thorax. METHODS AND MATERIALS: Ten patients treated with RT for unresectable primary or oligometastatic disease of the non-liver abdomen (n=5) or central thorax (n=5) underwent imaging throughout treatment on a clinical MR image guided RT system. The SBRT plans were created on the basis of tumor/organ at risk (OAR) anatomy at initial computed tomography simulation (PI), and simulated adaptive plans were created on the basis of observed MR image set tumor/OAR "anatomy of the day" (PA)...
August 31, 2016: International Journal of Radiation Oncology, Biology, Physics
Jacob A Miller, Elizabeth E Bennett, Roy Xiao, Rupesh Kotecha, Samuel T Chao, Michael A Vogelbaum, Gene H Barnett, Lilyana Angelov, Erin S Murphy, Jennifer S Yu, Manmeet S Ahluwalia, John H Suh, Alireza M Mohammadi
BACKGROUND: The primary dose-limiting toxicity of stereotactic radiosurgery (SRS) is radiation necrosis (RN), which occurs after approximately 5% to 10% of treatments. This adverse event may worsen neurologic deficits, increase the frequency and cost of imaging, and necessitate prolonged treatment with steroids or antiangiogenic agents. Previous investigations have primarily identified lesion size and dosimetric constraints as risk factors for RN in small populations. We hypothesized that disease histology, receptor status, and mutational status are associated with RN...
September 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Ghaith Habboub, Mayur Sharma, Gene H Barnett, Alireza M Mohammadi
BACKGROUND: Minimally-invasive approaches are attractive alternative to standard craniotomy for large intracranial tumors with potentially lesser morbidity. In this report, we describe a sequential combination of two minimally-invasive surgical techniques to treat a large intracranial tumor. CLINICAL PRESENTATION: A 49year-old woman presented with a history of breast cancer and large left parietal metastasis with significant perilesional edema. This was initially managed by whole brain radiation therapy and stereotactic radiosurgery...
October 11, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Amar U Kishan, Percy Lee
Non-small cell lung cancer (NSCLC) is the second most common solid malignancy in the United States of America, and the leading cause of cancer-related mortality. Nearly 15% of patients present with early-stage disease, for which the standard of care is lobectomy. However, the median age at diagnosis ranges from 65 to 74 years, and many patients have significant comorbidities that preclude surgical treatment. Previously, the standard of care for these patients was definitive radiotherapy (RT) with conventional fractionation (i...
October 2016: Seminars in Respiratory and Critical Care Medicine
R Orecchia, A Surgo, M Muto, A Ferrari, G Piperno, M A Gerardi, S Comi, C Garibaldi, D Ciardo, A Bazani, F Golino, F Pansini, C Fodor, P Romanelli, D Maestri, V Scroffi, S Mazza, B A Jereczek-Fossa
PURPOSE: The aim of this retrospective study is to evaluate patient profile, feasibility, and acute toxicity of RadioTherapy (RT) delivered by VERO® in the first 20 months of clinical activity. METHODS: Inclusion criteria: 1) adult patients; 2) limited volume cancer (M0 or oligometastatic); 3) small extracranial lesions; 4) treatment between April 2012 and December 2013 and 5) written informed consent. Two techniques were employed: intensity modulated radiotherapy (IMRT) and stereotactic body radiotherapy (SBRT)...
2016: Ecancermedicalscience
Ying Hou, Stephanie Lee, Vishesh Agrawal, John Romano, Elizabeth H Baldini, Aileen B Chen, David E Kozono, Joseph H Killoran, Matthew Wagar, Fred L Hacker, Hugo Jwl Aerts, John H Lewis, Raymond H Mak
INTRODUCTION: Quantification of volume changes on cone beam computed tomography (CBCT) during lung stereotactic body radiation therapy (SBRT) for non-small cell lung cancer (NSCLC) may provide a useful radiological marker for radiation response and for adaptive treatment planning. This study quantifies inter-scan and inter-observer variability in tumour volume delineation on CBCT. METHODS: Three clinicians independently contoured the primary gross tumour volume (GTV) manually on CBCTs taken immediately before SBRT treatment (pre) and after the same SBRT treatment (post) for 19 NSCLC patients...
October 5, 2016: Journal of Medical Imaging and Radiation Oncology
Milly Buwenge, Savino Cilla, Alessandra Guido, Lucia Giaccherini, Gabriella Macchia, Francesco Deodato, Silvia Cammelli, Francesco Cellini, Gian C Mattiucci, Vincenzo Valentini, Markus Stock, Alessio G Morganti
AIM: Aim of this study was to perform a planning feasibility analysis of a 3-level dose prescription using an IMRT-SIB technique. BACKGROUND: Radiation therapy of locally advanced pancreatic cancer should administer a minimum dose to the duodenum and a very high dose to the vascular infiltration areas to improve the possibility of a radical resection. MATERIALS AND METHODS: Fifteen patients with pancreatic head adenocarcinoma and vascular involvement were included...
November 2016: Reports of Practical Oncology and Radiotherapy
Yuanli Dong, Chengrui Fu, Hui Guan, Tianyi Zhang, Zicheng Zhang, Tao Zhou, Baosheng Li
Despite advances in the fields of surgery, chemotherapy and radiotherapy, the prognosis for high-grade glioma (HGG) remains unsatisfactory. The majority of HGG patients experience disease recurrence. To date, no standard treatments have been established for recurrent HGG. Repeat surgery and chemotherapy demonstrate moderate efficacy. As recurrent lesions are usually located within the previously irradiated field, a second course of irradiation was once considered controversial, as it was considered to exhibit unsatisfactory efficacy and radiation-related toxicities...
October 2016: Oncology Letters
B K Kleinschmidt-DeMasters, Kevin O Lillehei
Radiation-induced vascular "malformations", designated cavernous hemangiomas/cavernomas ("RICHs"), are seldom biopsied and are usually diagnosed based on neuroimaging features. They are an increasingly recognized complication of both CNS external beam radiation therapy and stereotactic radiosurgery. We identified 13 patients with radiation-induced vascular "malformations" in our surgical neuropathology databases searched from 2000 to 2016; 4 had received their therapy during childhood; 5 had received radiosurgery...
September 30, 2016: Journal of Neuropathology and Experimental Neurology
Alvin Y Chan, Diem Kieu T Tran, Amandip S Gill, Frank P K Hsu, Sumeet Vadera
Laser interstitial thermal therapy (LITT) is a minimally invasive procedure used to treat a variety of intracranial lesions. Utilization of robotic assistance with stereotactic procedures has gained attention due to potential for advantages over conventional techniques. The authors report the first case in which robot-assisted MRI-guided LITT was used to treat radiation necrosis in the posterior fossa, specifically within the cerebellar peduncle. The use of a stereotactic robot allowed the surgeon to perform LITT using a trajectory that would be extremely difficult with conventional arc-based techniques...
October 2016: Neurosurgical Focus
James Wright, Jessey Chugh, Christina Huang Wright, Fernando Alonso, Alia Hdeib, Haley Gittleman, Jill Barnholtz-Sloan, Andrew E Sloan
OBJECTIVE Laser interstitial thermal therapy (LITT), sometimes referred to as "stereotactic laser ablation," has demonstrated utility in a subset of high-risk surgical patients with difficult to access (DTA) intracranial neoplasms. However, the treatment of tumors larger than 10 cm(3) is associated with suboptimal outcomes and morbidity. This may limit the utility of LITT in dealing with precisely those large or deep tumors that are most difficult to treat with conventional approaches. Recently, several groups have reported on minimally invasive transsulcal approaches utilizing tubular retracting systems...
October 2016: Neurosurgical Focus
Colette J Shen, Daniele Rigamonti, Kristin J Redmond, Megan N Kummerlowe, Michael Lim, Lawrence R Kleinberg
PURPOSE: Stereotactic radiosurgery (SRS) is widely used to treat brain metastases in place of whole brain radiation therapy (WBRT), with the goal of reducing treatment toxicity balanced against the risk of developing new metastases. We evaluated outcomes of repeated courses of SRS in the management of new brain metastases as an alternative to salvage WBRT. METHODS AND MATERIALS: We conducted a single-institution retrospective review of 239 patients treated with SRS without WBRT for brain metastases from 2004 to 2014...
April 26, 2016: Practical Radiation Oncology
Wambaka A Mampuya, Mitsuhiro Nakamura, Yoshinori Hirose, Kenji Kitsuda, Takashi Ishigaki, Takashi Mizowaki, Masahiro Hiraoka
The purpose of this study was to evaluate the difference in dose-volumetric data between the analytical anisotropic algorithms (AAA) and the two dose reporting modes of the Acuros XB, namely, the dose to water (AXB_Dw) and dose to medium (AXB_Dm) in lung stereotactic body radiotherapy (SBRT). Thirty-eight plans were generated using the AXB_Dm in Eclipse Treatment Planning System (TPS) and then recalculated with the AXB_Dw and AAA, using identical beam setup. A dose of 50 Gy in 4 fractions was prescribed to the isocenter and the planning target volume (PTV) D95%...
2016: Journal of Applied Clinical Medical Physics
Ilma Xhaferllari, Omar El-Sherif, Stewart Gaede
Volumetric-modulated arc therapy (VMAT) is emerging as a leading technology in treating early-stage, non-small cell lung cancer (NSCLC) with stereotactic ablative radiotherapy (SABR). However, two other modalities capable of deliver-ing intensity-modulated radiation therapy (IMRT) include fixed-beam and helical TomoTherapy (HT). This study aims to provide an extensive dosimetric compari-son among these various IMRT techniques for treating early-stage NSCLC with SABR. Ten early-stage NSCLC patients were retrospectively optimized using three fixed-beam techniques via nine to eleven beams (high and low modulation step-and-shoot (SS), and sliding window (SW)), two VMAT techniques via two partial arcs (SmartArc (SA) and RapidArc (RA)), and three HT techniques via three different fan beam widths (1 cm, 2...
2016: Journal of Applied Clinical Medical Physics
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