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stereotactic ablative radiotherapy

Gokoulakrichenane Loganadane, Florent Martinetti, Olaf Mercier, Samar Krhili, François-Georges Riet, Rodrigue Mbagui, Hanh To, Cécile Le Péchoux, Antonin Levy
Stereotactic ablative radiation therapy (SABR) has become the standard treatment for peripheral medically non-operable patients with early stage non-small cell lung cancer (NSCLC). Previous attempts of trials to compare SABR and surgery have failed and new randomized studies (SABRtooth, STABLEMATES, and VALOR) are ongoing. While predictive factors of relapse have been extensively studied in patients receiving surgery, there is scarce data on such putative factors in SABR patients. The purpose of this review is to analyze such predictive factors through a critical review of the literature...
October 13, 2016: Cancer Treatment Reviews
H A Marsman, M G Besselink
- The incidence of pancreatic cancer is increasing due to the ageing population among other things, while 5-year survival has improved in the past two decades from 3 to 7%.- In case of biliary obstruction due to pancreatic cancer, biliary drainage before surgery or ablative therapy using a covered metal stent instead of plastic reduces the rate of complications.- In patients with metastasized pancreatic cancer a combination of folinic acid, fluorouracil, irinotecan and oxaliplatin (FOLFIRINOX) results in improved survival...
2016: Nederlands Tijdschrift Voor Geneeskunde
William W Chance, Quynh-Nhu Nguyen, Reza Mehran, James W Welsh, Daniel R Gomez, Peter Balter, Ritsuko Komaki, Zhongxing Liao, Joe Y Chang
PURPOSE: We report our single-institution experience with stereotactic ablative radiotherapy (SABR) for adrenal metastasis and identify factors influencing outcomes, patterns of failure, and dosimetric thresholds for toxicity. METHODS AND MATERIALS: We identified patients with adrenal metastases treated with SABR from 2009 to 2015. Toxicity was evaluated with Common Terminology Criteria for Adverse Events v4.0. Local failures were categorized as in-field, marginal, or out-of-field...
September 13, 2016: Practical Radiation Oncology
Shao-Lun Lu, Feng-Ming Hsu, Kuan-Yu Chen, Chao-Chi Ho, James Chih-Hsin Yang, Jason Chia-Hsien Cheng
Maintenance pemetrexed offers survival benefit with well-tolerated toxicities for advanced non-squamous non-small cell lung cancer (NSCLC). We present 3 consecutively enrolled patients with advanced non-squamous NSCLC, receiving stereotactic ablative radiotherapy (SABR) for oligoprogressive disease during maintenance pemetrexed. All of them had sustained local control of thoracic oligoprogression after the SABR, while maintenance pemetrexed were kept for additionally long progression-free interval. SABR targeting oligoprogression with continued pemetrexed is an effective and safe approach to extend exposure of maintenance pemetrexed, thus maximizing the benefit from it...
May 2016: Case Reports in Oncology
Naomi E Verstegen, Alexander P W M Maat, Frank J Lagerwaard, Marinus A Paul, Michel I Versteegh, Joris J Joosten, Willem Lastdrager, Egbert F Smit, Ben J Slotman, Joost J M E Nuyttens, Suresh Senan
INTRODUCTION: The literature on surgical salvage, i.e. lung resections in patients who develop a local recurrence following stereotactic ablative radiotherapy (SABR), is limited. We describe our experience with salvage surgery in nine patients who developed a local recurrence following SABR for early stage non-small cell lung cancer (NSCLC). METHODS: Patients who underwent surgical salvage for a local recurrence following SABR for NSCLC were identified from two Dutch institutional databases...
October 3, 2016: Radiation Oncology
Young-Seok Seo, Mi-Sook Kim, Hyung-Jun Yoo, Won Il Jang, Eun Kyung Paik, Chul Ju Han, Byung-Hee Lee
The aim of this study is to compare radiofrequency ablation (RFA) with stereotactic body radiotherapy (SBRT) for hepatocellular carcinomas (HCC) smaller than 3 cm. A Markov cohort model was developed to simulate a cohort of patients aged 60-65 years with small HCCs who had undergone either RFA or SBRT and were followed up over their remaining life expectancy. The inclusion criteria were: (1) HCC ≤3 cm in diameter with ≤ 3 nodules; (2) absence of extrahepatic metastasis or portal/hepatic vein invasion; (3) Child-Pugh Class A or B...
October 5, 2016: Cancer Medicine
Karen Moore, Claire Paterson, Jonathan Hicks, Stephen Harrow, Mark McJury
OBJECTIVES: A clinical evaluation of the intrafraction and interfraction set up accuracy of a novel thermoplastic mould immobilisation device and patient position in early stage lung cancer being treated with stereotactic radiotherapy at the Beatson West of Scotland Cancer Centre. METHODS: 35 patients were immobilised in a novel, arms-down position, with a 4 point Klarity clear thermoplastic mould fixed to a SinMed head and neck board. A knee support was also used for patient comfort and support...
October 6, 2016: British Journal of Radiology
T de Baere, L Tselikas, V Catena, X Buy, F Deschamps, J Palussière
Percutaneous ablation of small-size non-small-cell lung cancer (NSCLC) has demonstrated feasibility and safety in nonsurgical candidates. Radiofrequency ablation (RFA), the most commonly used technique, has an 80-90% reported rate of complete ablation, with the best results obtained in tumors less than 2-3cm in diameter. The highest one-, three-, and five-year overall survival rates reported in NSCLC following RFA are 97.7%, 72.9%, and 55.7% respectively. Tumor size, tumor stage, and underlying comorbidities are the main predictors of survival...
October 2016: Diagnostic and Interventional Imaging
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
Rémy Kinj, Pierre-Yves Bondiau, Eric François, Jean-Pierre Gérard, Arash O Naghavi, Axel Leysalle, Emmanuel Chamorey, Ludovic Evesque, Bernard Padovani, Antoine Ianessi, Karen Benezery, Jérôme Doyen
INTRODUCTION: Patients with metastatic colorectal cancer (CRC) may present with oligometastatic lung lesions for which stereotactic ablative radiotherapy (SABR) can be utilized. This study aims to report efficacy and prognostic factors associated with colorectal lung metastases treated with SABR. MATERIAL AND METHODS: This is a retrospective study including patients who presented with lung oligometastasis from CRC treated with SABR from September 2007 to November 2014...
August 31, 2016: Clinical Colorectal Cancer
David Jonathan Heineman, Martijn Geert Ten Berge, Johannes Marlene Daniels, Michaël Ignatius Versteegh, Perla Jacqueline Marang-van de Mheen, Michael Wilhelmus Wouters, Wilhelmina Hendrika Schreurs
BACKGROUND: The clinical stage of non-small cell lung cancer (NSCLC) determines the initial treatment, whereas the pathologic stage best determines prognosis and the need for adjuvant treatment. In an era in which stereotactic ablative radiotherapy (SABR) has become an alternative modality to surgical intervention, clinical staging is even more important, because pathologic staging is omitted in the case of SABR. The objective of this study was to determine the concordance between clinical and pathologic stage in routine clinical practice for patients with early-stage NSCLC...
September 21, 2016: Annals of Thoracic Surgery
Joshua Kim, Qixue Wu, Bo Zhao, Ning Wen, Munther Ajlouni, Benjamin Movsas, Indrin J Chetty
BACKGROUND: To compare retrospectively generated gated plans to conventional internal target volume (ITV)-based plans and to evaluate whether gated radiotherapy provides clinically relevant dosimetric improvements to organs-at-risk (OARs). METHODS: Evaluation was performed of 150 stereotactic ablative radiotherapy treatment plans delivered to 128 early-stage (T1-T3 (<5 cm)) NSCLC patients. To generate gated plans, original ITV-based plans were re-optimized and re-calculated on the end-exhale phase and using gated planning target volumes (PTV)...
2016: Radiation Oncology
Jeremy T Booth, Vincent Caillet, Nicholas Hardcastle, Ricky O'Brien, Kathryn Szymura, Charlene Crasta, Benjamin Harris, Carol Haddad, Thomas Eade, Paul J Keall
BACKGROUND AND PURPOSE: Real time adaptive radiotherapy that enables smaller irradiated volumes may reduce pulmonary toxicity. We report on the first patient treatment of electromagnetic-guided real time adaptive radiotherapy delivered with MLC tracking for lung stereotactic ablative body radiotherapy. MATERIALS AND METHODS: A clinical trial was developed to investigate the safety and feasibility of MLC tracking in lung. The first patient was an 80-year old man with a single left lower lobe lung metastasis to be treated with SABR to 48Gy in 4 fractions...
September 17, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Rohann J M Correa, George B Rodrigues, Hanbo Chen, Andrew Warner, Belal Ahmad, Alexander V Louie
OBJECTIVES: Metastatic renal cell carcinoma represents a clinical scenario where aggressive treatment to the primary tumor (ie, cytoreductive nephrectomy) is associated with a survival benefit. We hypothesized that stereotactic ablative radiotherapy (SABR) could be a safe alternative local modality for inoperable metastatic renal cell carcinoma patients. Our study objectives were to report on technical considerations, toxicity, and clinical outcomes of our institutional experience with renal SABR...
September 15, 2016: American Journal of Clinical Oncology
Luis Munoz, Amy Ziebell, Jason Morton, Madhava Bhat
An in-house solution for the verification of dose delivered to a moving phantom as required for the clinical implementation of lung stereotactic ablative body radiation therapy was developed. The superior-inferior movement required to simulate tumour motion during a normal breathing cycle was achieved via the novel use of an Arduino Uno™, a low-cost open-source microcontroller board connected to a high torque servo motor. Slow CT imaging was used to acquire the image set and a 4D cone beam CT (4D-CBCT) verified the efficacy of contoured margins before treatment on the moving phantom...
September 15, 2016: Australasian Physical & Engineering Sciences in Medicine
Shin-Hyung Park, Jae-Chul Kim, Min Kyu Kang
Radiotherapy techniques have substantially improved in the last two decades. After the introduction of 3-dimensional conformal radiotherapy, radiotherapy has been increasingly used for the treatment of hepatocellular carcinoma (HCC). Currently, more advanced techniques, including intensity-modulated radiotherapy (IMRT), stereotactic ablative body radiotherapy (SABR), and charged particle therapy, are used for the treatment of HCC. IMRT can escalate the tumor dose while sparing the normal tissue even though the tumor is large or located near critical organs...
August 28, 2016: World Journal of Gastroenterology: WJG
D Antoni, S Bockel, E Deutsch, F Mornex
Thanks to recent advances achieved in oncologic systemic and local ablative treatment, the treatments become more and more efficient in term of local control and overall survival. Thus, the targeted therapies, immunotherapy or stereotactic radiotherapy have modified the management of patients, especially in case of oligometastatic disease. Many questions are raised by these innovations, particularly the diagnosis and management of new side effects or that of the combination of these different treatments, depending on the type of primary tumor...
October 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Alexander Chi, Sijin Wen, Manish Monga, Mohammed Almubarak, Xiaoqing He, Yon Rojanasakul, William Tse, Scot C Remick
BACKGROUND: Image-guided (IG) intensity-modulated radiotherapy (IMRT) enables maximal tumor margin reduction for the sparing of organs at risk (OARs) when used to treat locally advanced non-small cell lung cancer (NSCLC) with definitive chemo-radiation. It also allows for the incorporation of stereotactic ablative radiotherapy (SABR) into the treatment regimen. Here, we describe our initial experience in combining definitive upfront SABR to the primary lesion with chemo-radiation delivered with conventionally fractionated IG-IMRT to the remaining regional disease; along with clinical outcome following chemo-radiation with conventionally fractionated IG-IMRT alone in the treatment of locally advanced NSCLC...
2016: PloS One
Jakub Cvek, Lukas Knybel, Lukas Molenda, Bretislav Otahal, Tomas Jonszta, Daniel Czerny, David Feltl
AIM: To evaluate liver tumor motion and how well reference measurement predicts motion during treatment. MATERIAL AND METHODS: This retrospective study included 20 patients with colorectal cancer that had metastasized to the liver who were treated with stereotactic ablative radiotherapy. An online respiratory tumor tracking system was used. Tumor motion amplitudes in the superior-inferior (SI), latero-lateral (LL), and anterior-posterior (AP) directions were collected to generate patient-specific margins...
May 2016: Reports of Practical Oncology and Radiotherapy
Sarah Baker, Max Dahele, Frank J Lagerwaard, Suresh Senan
Lung cancer is the leading cause of cancer mortality, and radiotherapy plays a key role in both curative and palliative treatments for this disease. Recent advances include stereotactic ablative radiotherapy (SABR), which is now established as a curative-intent treatment option for patients with peripheral early-stage NSCLC who are medically inoperable, or at high risk for surgical complications. Improved delivery techniques have facilitated studies evaluating the role of SABR in oligometastatic NSCLC, and encouraged the use of high-technology radiotherapy in some palliative settings...
2016: Radiation Oncology
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