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Liver sbrt

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
Kristofer Kainz, Douglas Prah, Ergun Ahunbay, X Allen Li
"Burst-mode" modulated arc therapy (hereafter referred to as "mARC") is a form of volumetric-modulated arc therapy characterized by variable gantry rotation speed, static MLCs while the radiation beam is on, and MLC repositioning while the beam is off. We present our clinical experience with the planning techniques and plan quality assurance measurements of mARC delivery. Clinical mARC plans for five representative cases (prostate, low-dose-rate brain, brain with partial-arc vertex fields, pancreas, and liver SBRT) were generated using a Monte Carlo-based treatment planning system...
2016: Journal of Applied Clinical Medical Physics
Jeffrey Meyer
Management of primary and secondary tumors of the liver is a complex undertaking involving multi- disciplinary input. Radiation therapy has held a minor role in the treatment of liver tumors, but with technological innovations and the growth of the field of stereotactic body radiation therapy (SBRT), this role is evolving. In this review, I discuss the issues of radiation-induced hepatic toxicity, the planning of liver SBRT treatments, clinical results with SBRT, its place amongst other non-surgical ablative treatments, and potential future avenues of investigation...
September 28, 2016: Minerva Gastroenterologica e Dietologica
Alejandra Méndez Romero, Robert A de Man
Technical developments allowed stereotactic body radiation therapy (SBRT) to deliver effective doses of irradiation with high precision in a small number of fractions. This paper reviews the role of SBRT for liver metastases, hepatocellular carcinoma and cholangiocarcinoma, paying special attention to patient eligibility and treatment outcomes regarding local control, toxicity and quality of life. As well as discussing specific issues of these different tumors, such as the presence of underlying liver cirrhosis and the impact on toxicity, it outlines the limitations of SBRT and future areas of development and research...
August 2016: Best Practice & Research. Clinical Gastroenterology
Ashley A Weiner, Jeffrey Olsen, Daniel Ma, Pawel Dyk, Todd DeWees, Robert J Myerson, Parag Parikh
BACKGROUND AND PURPOSE: To report outcomes and toxicities of a single-institution phase I/II study of stereotactic body radiotherapy (SBRT) in the treatment of unresectable hepatocellular cancer (HCC) and intrahepatic cholangiocarcinoma (IHC). MATERIALS AND METHODS: Patients with Child-Pugh score less than 8 were eligible. A total of 32 lesions in 26 patients were treated with SBRT. Kaplan-Meier survival analysis was performed. Toxicities were graded by CTCAEv4 criteria and response was scored by EASL guidelines...
August 23, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Esben S Worm, Jenny Bertholet, Morten Høyer, Walther Fledelius, Anders T Hansen, Lars P Larsen, Jens E Nielsen, Per R Poulsen
To minimize the risk of marker migration in fiducial marker guided liver SBRT it is common to add a delay of a week between marker implantation and planning CT. This study found that such a delay is unnecessary and could be avoided to minimize the treatment preparation time.
August 20, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
E Rio, F Mornex, D Peiffert, A Huertas
Recent technological developments led to develop the concept of focused liver radiation therapy. We must distinguish primary and secondary tumors as the indications are restricted and must be discussed as an alternative to surgical or medical treatments. For hepatocellular carcinoma 5 to 10cm (or more), a conformational radiation with or without intensity modulation is performed. Stereotactic body radiotherapy (SBRT) is being evaluated and is increasingly proposed as an alternative to radiofrequency ablative treatment for primary or secondary tumors (typically less than 5cm)...
September 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Victor W Wu, Marina A Epelman, Hesheng Wang, H Edwin Romeijn, Mary Feng, Yue Cao, Randall K Ten Haken, Martha M Matuszak
Liver stereotactic body radiation therapy (SBRT) patients differ in both pre-treatment liver function (e.g. due to degree of cirrhosis and/or prior treatment) and radiosensitivity, leading to high variability in potential liver toxicity with similar doses. This work investigates three treatment planning optimization models that minimize risk of toxicity: two consider both voxel-based pre-treatment liver function and local-function-based radiosensitivity with dose; one considers only dose. Each model optimizes different objective functions (varying in complexity of capturing the influence of dose on liver function) subject to the same dose constraints and are tested on 2D synthesized and 3D clinical cases...
September 7, 2016: Physics in Medicine and Biology
David Friedman, Jason R Baird, Kristina H Young, Benjamin Cottam, Marka R Crittenden, Scott Friedman, Michael J Gough, Pippa Newell
AIM: Small, solitary hepatocellular carcinoma (HCC) is curable with stereotactic radiation or other methods of tumor ablation, however regional and systemic tumor recurrence occurs in over 70% of patients. Here we describe the ability of immuno-radiotherapy to induce an anti-tumor immune response and delay the growth of tumors in immune-competent mice. METHODS: A syngeneic HCC cell line (Hep-55.1c) was injected directly into the livers of C57BL/6 mice using ultrasound guidance, then tumors were treated with stereotactic radiation using a Small Animal Radiation Research Platform with computed tomography (CT) guidance...
August 8, 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Matthias F Häfner, Jürgen Debus
BACKGROUND: Multimodal treatment approaches are indispensable for patients with advanced-stage colorectal cancer. Radiotherapy has been established as essential part of perioperative concepts and was introduced as an option to face challenges such as local relapse or oligometastases. METHODS: A literature review was performed to summarize evidence and current standards of radiotherapeutic concepts in the treatment of colorectal cancer. RESULTS: For stage II/III rectal cancer, neoadjuvant radiotherapy is superior to adjuvant treatment...
June 2016: Visc Med
Florence K Keane, Jennifer Y Wo, Andrew X Zhu, Theodore S Hong
BACKGROUND: The incidence of hepatocellular carcinoma (HCC) continues to increase world-wide. Many patients present with advanced disease with extensive local tumor or vascular invasion and are not candidates for traditionally curative therapies such as orthotopic liver transplantation (OLT) or resection. Radiotherapy (RT) was historically limited by its inability to deliver a tumoricidal dose; however, modern RT techniques have prompted renewed interest in the use of liver-directed RT to treat patients with primary hepatic malignancies...
July 2016: Liver Cancer
Xian-Liang Zeng, Huan-Huan Wang, Mao-Bin Meng, Zhi-Qiang Wu, Yong-Chun Song, Hong-Qing Zhuang, Dong Qian, Feng-Tong Li, Lu-Jun Zhao, Zhi-Yong Yuan, Ping Wang
BACKGROUND AND AIM: The aim of this study is to evaluate the efficacy and safety of stereotactic body radiation therapy (SBRT) using CyberKnife in the treatment of patients with recurrent pancreatic adenocarcinoma at the abdominal lymph node or stump after surgery. PATIENTS AND METHODS: Between October 1, 2006 and May 1, 2015, patients with recurrent pancreatic adenocarcinoma at the abdominal lymph node or stump after surgery were enrolled and treated with SBRT at our hospital...
2016: OncoTargets and Therapy
Judit Boda-Heggemann, Ulrike Attenberger, Johannes Budjan, Anika Jahnke, Lennart Jahnke, Lena Vogel, Anna O Simeonova-Chergou, Carsten Herskind, Frederik Wenz, Frank Lohr
AIM: CT morphologic and histopathologic alterations have been reported after SBRT. We analyzed the correlation of MRI morphologic alterations with radiation doses to assess the potential for MRI-based dose-effect correlation in healthy liver tissue. PATIENTS AND METHODS: MRI data of 24 patients with liver metastases 7±3 weeks after image-guided SBRT in deep-inspiration breath-hold were retrospectively analyzed. MRI images were intermodally matched to the planning CT and corresponding dose distribution...
September 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Zhi-Feng Wu, Jian-Ying Zhang, Xiao-Yun Shen, Le-Yuan Zhou, Ya-Bo Gao, Yong Hu, Zhao-Chong Zeng
PURPOSE: Lower radiation tolerance of the whole liver hinders dose escalations of stereotactic body radiation therapy (SBRT) in hepatocellular carcinoma (HCC) treatment. This study was conducted to define the exact doses that result in radiation-induced liver disease (RILD) as well as to determine dose constraints for the critical organs at risk (OARs) in mice; these parameters are still undefined in HCC SBRT. METHODS: This study consisted of two phases. In the primary phase, mice treated with helical tomotherapy-based SBRT were stratified according to escalating radiation doses to the livers...
July 2016: Medical Physics
Christian Heinz, Sabine Gerum, Philipp Freislederer, Ute Ganswindt, Falk Roeder, Stefanie Corradini, Claus Belka, Maximilian Niyazi
BACKGROUND: Fiducial markers are the superior method to compensate for interfractional motion in liver SBRT. However this method is invasive and thereby limits its application range. In this retrospective study, the compensation method for the interfractional motion using fiducial markers (gold standard) was compared to a new non-invasive approach, which does rely on the organ motion of the liver and the relative tumor position within this volume. METHODS: We analyzed six patients (3 m, 3f) treated with SBRT in 2014...
2016: Radiation Oncology
Kamran A Ahmed, Jimmy J Caudell, Ghassan El-Haddad, Anders E Berglund, Eric A Welsh, Binglin Yue, Sarah E Hoffe, Arash O Naghavi, Yazan A Abuodeh, Jessica M Frakes, Steven A Eschrich, Javier F Torres-Roca
PURPOSE/OBJECTIVES: Evidence from the management of oligometastases with stereotactic body radiation therapy (SBRT) reveals differences in outcomes based on primary histology. We have previously identified a multigene expression index for tumor radiosensitivity (RSI) with validation in multiple independent cohorts. In this study, we assessed RSI in liver metastases and assessed our clinical outcomes after SBRT based on primary histology. METHODS AND MATERIALS: Patients were identified from our prospective, observational protocol...
August 1, 2016: International Journal of Radiation Oncology, Biology, Physics
H N Ismael, J Denbo, S Cox, C H Crane, P Das, S Krishnan, R T Schroff, M Javle, C Conrad, J Vauthey, T Aloia
INTRODUCTION: Patients with unresectable liver tumors who fail initial treatment modalities have a poor prognosis (<1 yr). Although effective, delivery of high dose radiation therapy to these tumors is limited by proximity of radiosensitive bowel. We have previously reported that placement of a biologic mesh spacer (BMS) can effectively displace the bowel allowing for dose-intense radiation to be delivered with low short-term toxicity. The purpose of this study was to assess and report the long-term safety and oncologic outcomes of this cohort...
October 2016: European Journal of Surgical Oncology
Oluwadamilola T Oladeru, Joseph A Miccio, Jie Yang, Yaqi Xue, Samuel Ryu, Alexander M Stessin
BACKGROUND: Non-operative treatment for hepatocellular carcinoma (HCC) has expanded significantly with the use of selective internal radiotherapy (SIRT) mostly with yttrium 90 ((90)Y) tagged microspheres and highly conformal external beam radiation therapy such as stereotactic body radiotherapy (SBRT) to treat unresectable liver tumors for local tumor control. SBRT is a noninvasive procedure using external radiation source under image guidance, while SIRT delivers radioactive particles by transarterial radioembolization (TARE)...
June 2016: Journal of Gastrointestinal Oncology
Kevin I Kauweloa, Alonso N Gutierrez, Sotirios Stathakis, Niko Papanikolaou, Panayiotis Mavroidis
A toolkit has been developed for calculating the 3-dimensional biological effective dose (BED) distributions in multi-phase, external beam radiotherapy treatments such as those applied in liver stereotactic body radiation therapy (SBRT) and in multi-prescription treatments. This toolkit also provides a wide range of statistical results related to dose and BED distributions. MATLAB 2010a, version 7.10 was used to create this GUI toolkit. The input data consist of the dose distribution matrices, organ contour coordinates, and treatment planning parameters from the treatment planning system (TPS)...
July 2016: Computer Methods and Programs in Biomedicine
Nicolaus Andratschke, Alan Parys, Susanne Stadtfeld, Stefan Wurster, Stefan Huttenlocher, Detlef Imhoff, Müjdat Yildirim, Dirk Rades, Claus Michael Rödel, Jürgen Dunst, Guido Hildebrandt, Oliver Blanck
BACKGROUND: We retrospectively evaluated the efficacy and toxicity of gross tumor volume (GTV) mean-dose-optimized and real-time motion-compensated robotic stereotactic body radiation therapy (SBRT) in the treatment of liver metastases. METHODS: Between March 2011 and July 2015, 52 patients were treated with SBRT for a total of 91 liver metastases (one to four metastases per patient) with a median GTV volume of 12 cc (min 1 cc, max 372 cc). The optimization of mean GTV dose was prioritized during treatment planning at the potential cost of planning target volume (PTV) coverage reduction while adhering to safe normal tissue constraints...
2016: Radiation Oncology
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