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https://www.readbyqxmd.com/read/29453679/the-impact-of-timing-of-immunotherapy-with-cranial-irradiation-in-melanoma-patients-with-brain-metastases-intracranial-progression-survival-and-toxicity
#1
Rifaquat Rahman, Alfonso Cortes, Andrzej Niemierko, Kevin S Oh, Keith T Flaherty, Donald P Lawrence, Ryan J Sullivan, Helen A Shih
Immunotherapy (IT) is increasingly incorporated in the management of metastatic melanoma patients with brain metastases, but the impact of timing of IT with stereotactic radiosurgery (SRS) remains unclear. The aim of this study was to determine the temporal significance of IT in melanoma patients treated with cranial radiation therapy (RT) with respect to patterns of intracranial progression, overall survival (OS), and toxicity. We retrospectively reviewed consecutive melanoma patients with brain metastases undergoing cranial RT and IT between 2008 and 2015...
February 16, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29414150/hypo-fractionated-stereotactic-radiotherapy-of-five-fractions-with-linear-accelerator-for-vestibular-schwannomas-a-systematic-review-and-meta-analysis
#2
REVIEW
Thien Nguyen, Courtney Duong, John P Sheppard, Seung Jin Lee, Amar U Kishan, Percy Lee, Stephen Tenn, Robert Chin, Tania B Kaprealian, Isaac Yang
Vestibular schwannomas (VS) are benign tumors stemming from the eighth cranial nerve. Treatment options for VS include conservative management, microsurgery, stereotactic radiosurgery, and fractionated radiotherapy. Though microsurgery has been the standard of care for larger lesions, hypo-fractionated stereotactic radiotherapy (hypo-FSRT) is an emerging modality. However, its clinical efficacy and safety have yet to be established. We conducted a systematic review and meta-analysis of manuscripts indexed in PubMed, Scopus, Web of Science, Embase, and Cochrane databases reporting outcomes of VS cases treated with hypo-FSRT...
January 12, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29414140/evidence-on-the-efficacy-of-primary-radiosurgery-or-stereotactic-radiotherapy-for-drug-resistant-non-neoplastic-focal-epilepsy-in-adults-a-systematic-review
#3
REVIEW
Daniëlle B P Eekers, Esther N Pijnappel, Olaf E M G Schijns, Albert Colon, Ann Hoeben, Jaap D Zindler, Alida A Postma, Aswin L Hoffmann, Philippe Lambin, Esther G C Troost
PURPOSE: Although the majority of adult epilepsy patients respond well to the current antiepileptic drug treatment, 20-40% of them are drug-resistant. In these patients, resective epilepsy surgery is a curative treatment option, for which, however, only a limited number of patients is eligible. The purpose is to summarize the outcome of radiotherapy for drug-resistant non-neoplastic focal epilepsy and to elucidate its efficacy for seizure outcome and long-term toxicity in adults. METHOD: A systematic literature search was performed in Pubmed, Ovid Medline, Cochrane library, Embase and Web of Science...
January 27, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29402546/reconstruction-of-an-anterior-chest-wall-radionecrosis-defect-by-a-contralateral-latissimus-dorsi-flap-a-case-report
#4
A Vairinho, A Al Hindi, M Revol, A Legras, K Rem, Y Guenane, S Cristofari, T Sorin
INTRODUCTION: Soft tissue and bone radionecrosis are rare but serious complications may occur late after radiotherapy. CASE REPORT: We report the case of an 86-year-old woman with a history an infiltrating ductal carcinoma of the left breast, treated by total mastectomy, left axillary dissection and adjuvant radiotherapy. Eighteen years later, the first radionecrosis lesions appeared and grew progressively in a 6-month period. These lesions are deep, involving the anterior aspect of the 4th to the 6th ribs and infiltrating the chest wall to the left cardio-thoracic space communicating largely with the pericardium...
February 2, 2018: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29361268/gamma-ventral-capsulotomy-in-intractable-obsessive-compulsive-disorder
#5
Steven A Rasmussen, Georg Norén, Benjamin D Greenberg, Richard Marsland, Nicole C McLaughlin, Paul J Malloy, Stephen P Salloway, David R Strong, Jane L Eisen, Michael A Jenike, Scott L Rauch, Lee Baer, Christer Lindquist
BACKGROUND: Despite the development of effective pharmacologic and cognitive behavioral treatments for obsessive-compulsive disorder (OCD), some patients continue to be treatment-refractory and severely impaired. Fiber tracts connecting orbitofrontal and dorsal anterior cingulate cortex with subcortical nuclei have been the target of neurosurgical lesions as well as deep brain stimulation in these patients. We report on the safety and efficacy of ventral gamma capsulotomy for patients with intractable OCD...
December 15, 2017: Biological Psychiatry
https://www.readbyqxmd.com/read/29349605/improved-effectiveness-of-stereotactic-radiosurgery-in-large-brain-metastases-by-individualized-isotoxic-dose-prescription-an-in-silico-study
#6
Jaap D Zindler, Jacqueline Schiffelers, Philippe Lambin, Aswin L Hoffmann
INTRODUCTION: In large brain metastases (BM) with a diameter of more than 2 cm there is an increased risk of radionecrosis (RN) with standard stereotactic radiosurgery (SRS) dose prescription, while the normal tissue constraint is exceeded. The tumor control probability (TCP) with a single dose of 15 Gy is only 42%. This in silico study tests the hypothesis that isotoxic dose prescription (IDP) can increase the therapeutic ratio (TCP/Risk of RN) of SRS in large BM. MATERIALS AND METHODS: A treatment-planning study with 8 perfectly spherical and 46 clinically realistic gross tumor volumes (GTV) was conducted...
January 18, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/29339639/mri-guided-interstitial-laser-ablation-for-intracranial-lesions-a-large-single-institution-experience-of-133-cases
#7
Ashwin A Kamath, Daniel D Friedman, Carl D Hacker, Matthew D Smyth, David D Limbrick, Albert H Kim, Ammar H Hawasli, Eric C Leuthardt
BACKGROUND: Managing difficult-to-access lesions or surgically accessible lesions in fragile patients is a central problem in neurosurgery. MRI-guided interstitial laser ablation (ILA) is a minimally invasive option that may provide a safe means of treating these challenging patients. OBJECTIVE: We aim to (1) evaluate safety, efficacy, and preliminary outcomes within a diverse and large series of ILA treatments; and (2) report technical details and operative trends that proved useful over time in the authors' experience and that may be of use to neurosurgeons who perform ILA...
January 17, 2018: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/29336293/using-the-nasoseptal-flap-for-reconstruction-after-endoscopic-debridement-of-radionecrosis-in-nasopharyngeal-carcinoma
#8
Gwanghui Ryu, Yoon Kyoung So, Min Young Seo, Woori Park, Hyo Yeol Kim, Hun-Jong Dhong, Seung-Kyu Chung, Sang Duk Hong
BACKGROUND: Radionecrosis is a complication of nasopharyngeal carcinoma (NPC) that is difficult to treat. Endoscopic debridement is the first-line treatment for radionecrosis. After debridement, however, either bone or the internal carotid artery is exposed and requires mucosal coverage. OBJECTIVES: This study sought to demonstrate the effectiveness of a nasoseptal flap (NSF) after endoscopic debridement of radionecrosis in the reconstruction of nasopharyngeal or skull base defects...
January 25, 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29317649/synchrotron-generated-microbeams-induce-hippocampal-transections-in-rats
#9
Erminia Fardone, Benoît Pouyatos, Elke Bräuer-Krisch, Stefan Bartzsch, Hervè Mathieu, Herwig Requardt, Domenico Bucci, Giacomo Barbone, Paola Coan, Giuseppe Battaglia, Geraldine Le Duc, Alberto Bravin, Pantaleo Romanelli
Synchrotron-generated microplanar beams (microbeams) provide the most stereo-selective irradiation modality known today. This novel irradiation modality has been shown to control seizures originating from eloquent cortex causing no neurological deficit in experimental animals. To test the hypothesis that application of microbeams in the hippocampus, the most common source of refractory seizures, is safe and does not induce severe side effects, we used microbeams to induce transections to the hippocampus of healthy rats...
January 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29300187/a-treatment-planning-comparison-between-a-novel-rotating-gamma-system-and-robotic-linear-accelerator-based-intracranial-stereotactic-radiosurgery-radiotherapy
#10
Muhammad Mohsin Fareed, Ahmed A Eldib, Stephanie E Weiss, Shelly B Hayes, Jinsheng Li, Chang-Ming Charlie Ma
Purpose: To compare the dosimetric parameters of a novel Rotating Gamma Ray System (RGS) with well-established CyberKnife system (CK) for treating malignant brain lesions. Materials and Methods: RGS has a treatment head of 16 cobalt-60 sources focused to the isocenter, which can rotate 360° on the ring gantry and swing 35° in the superior direction. We compared several dosimetric parameters in 10 patients undergoing brain stereotactic radiosurgery including plan normalization, the number of beams and nodes for CK and shots for RGS, collimators used, estimated treatment time, D 2 cm and conformity index (CI) among two modalities...
January 4, 2018: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29295736/re-irradiation-in-the-brain-primary-gliomas
#11
A L K Ho, R Jena
Recurrence of gliomas is a challenging clinical scenario to treat. There has historically been reluctance among neuro-oncologists to consider re-irradiation owing to concerns regarding toxicity, including the risk of radionecrosis. This overview examines the evidence behind re-irradiation, which is predominately from single institution case series. The development, validation and modification of the Combs prognostic score are outlined. Published data on both fractionated radiotherapy and stereotactic radiosurgery suggest that it has an acceptable safety profile as long as the cumulative total dose normalised to 2 Gy/fraction (NTDcumulative) is limited to 100 Gy...
February 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29242363/diagnostic-accuracy-of-amino-acid-and-fdg-pet-in-differentiating-brain-metastasis-recurrence-from-radionecrosis-after-radiotherapy-a-systematic-review-and-meta-analysis
#12
H Li, L Deng, H X Bai, J Sun, Y Cao, Y Tao, L J States, M D Farwell, P Zhang, B Xiao, L Yang
BACKGROUND: Current studies that analyze the usefulness of amino acid and FDG-PET in distinguishing brain metastasis recurrence and radionecrosis after radiation therapy are limited by small cohort size. PURPOSE: Our aim was to assess the diagnostic accuracy of amino acid and FDG-PET in differentiating brain metastasis recurrence from radionecrosis after radiation therapy. DATA SOURCES: Studies were retrieved from PubMed, Embase, and the Cochrane Library...
December 14, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29218626/treatment-related-changes-in-glioblastoma-a-review-on-the-controversies-in-response-assessment-criteria-and-the-concepts-of-true-progression-pseudoprogression-pseudoresponse-and-radionecrosis
#13
REVIEW
P D Delgado-López, E Riñones-Mena, E M Corrales-García
The assessment of response to therapy in glioblastoma remains a challenge, because the surrogate measures of survival are subject to radiographic misinterpretation. A solid and reliable definition of progression is needed for both clinical decision-making and for evaluating response within the clinical trials. Historically, assessment criteria have used radiologic and clinical features aimed to correctly classify patients into progressive or non-progressive disease. The widely used RANO criteria are a valuable tool in disease evaluation, both in the clinical setting and in the clinical trials...
December 7, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29218301/long-term-outcomes-after-salvage-stereotactic-radiosurgery-srs-following-in-field-failure-of-initial-srs-for-brain-metastases
#14
Nitesh Rana, Praveen Pendyala, Ryan K Cleary, Guozhen Luo, Zhiguo Zhao, Lola B Chambless, Anthony J Cmelak, Albert Attia, Mark J Stavas
Purpose: The optimal treatment strategy following local recurrence after stereotactic radiosurgery (SRS) remains unclear. While upfront SRS has been extensively studied, few reports focus on outcomes after retreatment. Here, we report the results following a second course of SRS for local recurrence of brain metastases previously treated with SRS. Methods: Using institutional database, patients who received salvage SRS (SRS2) following in-field failure of initial SRS (SRS1) for brain metastases were identified...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/29203042/-treatment-of-radiation-induced-iliofemoral-arterial-complications-with-groin-radionecrosis
#15
J-M Fichelle
Long-term iliofemoral complications induced by radiation include vascular (arterial and venous) lesions, nervous lesions and soft tissue loss that can be cutaneous and subcutaneous and potentially lead to radionecrosis with vessel exposure. We present five cases of groin radionecrosis. There were three men and two women (age 30-73 years). Radiotherapy had been delivered 15 years earlier in three cases, and 2 years earlier in two cases. Symptoms were intermittent claudication (n=1), critical ischemia (n=1), and septic hemorrhage (n=1)...
December 2017: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29197712/radiotherapy-induced-reactivation-of-neurotrophic-human-herpes-viruses-overview-and-management
#16
REVIEW
Marigdalia K Ramirez-Fort, Jianying Zeng, Amir Feily, Luis A Ramirez-Pacheco, Joseph M Jenrette, David L Mayhew, Talal Syed, S Lewis Cooper, Craig Linden, Witney S Graybill, Lars E French, Christopher S Lange
PURPOSE: Infection by Human Herpes Viruses (HHV) types 1-3, are prevalent throughout the world. It is known that radiotherapy can reactivate HHVs, but it is unclear how and to what extent reactivations can interact with or affect radiotherapeutic efficacy, patient outcomes and mortality risk. Herein, we aim to summarize what is known about Herpes Simplex Virus (HSV)-1,2 and Varicella Zoster Virus (VZV) pathophysiology as it relates to tumor biology, radiotherapy, chemo-radiotherapy, diagnosis and management so as to optimize cancer treatment in the setting of active HHV infection...
November 22, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/29146179/soft-palate-reconstruction-after-radionecrosis-combined-anterolateral-thigh-adipofascial-and-nasoseptal-flaps
#17
Joseph Zenga, Jeffrey D Sharon, Jennifer Gross, Jay Gantz, Patrik Pipkorn
Although radiation-based treatment for nasopharyngeal cancer may achieve excellent long term oncologic results, late effects of therapy may lead to soft tissue radionecrosis and velopharyngeal insufficiency (VPI). Repair of these oro- and nasopharyngeal defects presents a complex reconstructive challenge. We present a case of a long-term survivor treated with chemoradiotherapy for nasopharyngeal cancer who developed progressive dysphagia, velopharyngeal insufficiency, and radionecrosis of the nasopharynx and soft palate, leading to tracheostomy and gastrostomy tube dependence...
November 13, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29128197/reirradiation-of-gliomas-under-stereotactic-conditions-prognostic-factors-for-survival-without-relapse-or-side-effects-a-retrospective-study-at-tours-regional-university-hospital-france
#18
S Lévy, S Chapet, N Scher, K Debbi, A Ruffier, G Bernadou, Y Pointreau, G Calais
PURPOSE: To search for factors correlated with relapse-free survival following stereotactic reirradiation in patients with recurrent glioma following radiochemotherapy and evaluate tolerance to this treatment. PATIENTS AND METHODS: Initial radiotherapy was given according to the protocol of Stupp and al. Reirradiation was performed using the CyberKnife® system. Patients could have had surgical resection initially and at the time of recurrence. We analysed 13 patients treated between July 2010 and September 2014...
December 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/29114607/the-impact-of-different-stereotactic-radiation-therapy-regimens-for-brain-metastases-on-local-control-and-toxicity
#19
Rachel B Jimenez, Brian M Alexander, Anand Mahadevan, Andrzej Niemierko, Selvan Rajakesari, Nils D Arvold, Scott R Floyd, Kevin S Oh, Jay S Loeffler, Helen A Shih
Purpose: Stereotactic radiation therapy (SRT) enables focused, short course, high dose per fraction radiation delivery to brain tumors that are less ideal for single fraction treatment because of size, shape, or close proximity to sensitive structures. We sought to identify optimal SRT treatment regimens for maximizing local control while minimizing morbidity. Methods and materials: We performed a retrospective review of patients treated with SRT for solid brain metastases using variable dose schedules between 2001 and 2011 at 3 academic hospitals...
July 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/29105011/modern-robot-assisted-radiosurgery-of-cerebral-angiomas-own-experiences-system-comparisons-and-comprehensive-literature-overview
#20
Thomas Feutren, Andres Huertas, Julia Salleron, René Anxionnat, Serge Bracard, Olivier Klein, Didier Peiffert, Valérie Bernier-Chastagner
Cerebral arteriovenous malformations (AVMs) are rare vascular lesions potentially responsible for substantial neurological morbidity and mortality. Over the past four decades, radiosurgery has become a valid therapeutic option for many patients with small intracranial AVMs, but reports describing the use of robotic stereotactic radiosurgery (SRS) are rare. The purposes of this study are to describe the efficacy and toxicity of robotic SRS for AVMs and to review the literature. The reports of 48 consecutive patients treated with SRS were reviewed...
November 5, 2017: Neurosurgical Review
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