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By Alessandro Franciscon doctor
Joern Wulf, Kurt Baier, Gerd Mueller, Michael P Flentje
The dose-response for local tumor control after stereotactic radiotherapy of 92 pulmonary tumors (36 NSCLC and 56 metastases) was evaluated. Short course irradiation of 1-8 fractions with different fraction doses was used. After a median follow-up of 14 months (2-85 months) 11 local recurrences were observed with significant advantage for higher doses. When normalization to a biologically effective dose (BED) is used a dose of 94Gy at the isocenter and 50Gy at the PTV-margin are demonstrated to give 50% probability of tumor control (TCD50)...
October 2005: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Sashendra Senthi, Frank J Lagerwaard, Cornelis J A Haasbeek, Ben J Slotman, Suresh Senan
BACKGROUND: Stereotactic ablative radiotherapy (SABR) is increasingly used in the treatment of medically inoperable early stage non-small-cell lung cancer (NSCLC). Because patterns of late disease recurrence after SABR are not well characterised, we aimed to assess these outcomes in a cohort of patients with NSCLC. METHODS: Patients with (18)F-fluorodeoxyglucose ((18)F-FDG)-PET confirmed stage 1-2 NSCLC who were treated with SABR at the VU University Medical Center (Amsterdam, Netherlands) were identified from an institutional database...
August 2012: Lancet Oncology
Daniel Gorovets, Diandra Ayala-Peacock, David J Tybor, Paul Rava, Daniel Ebner, Deus Cielo, Georg Norén, David E Wazer, Michael Chan, Jaroslaw T Hepel
PURPOSE: Optimal patient selection for stereotactic radiosurgery (SRS) as the initial treatment for brain metastases is complicated and controversial. This study aimed to develop a nomogram that predicts survival without salvage whole brain radiation therapy (WBRT) after upfront SRS. METHODS AND MATERIALS: Multi-institutional data were analyzed from 895 patients with 2095 lesions treated with SRS without prior or planned WBRT. Cox proportional hazards regression model was used to identify independent pre-SRS predictors of WBRT-free survival, which were integrated to build a nomogram that was subjected to bootstrap validation...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
Kristin J Redmond, Scott Robertson, Simon S Lo, Scott G Soltys, Samuel Ryu, Todd McNutt, Samuel T Chao, Yoshiya Yamada, Amol Ghia, Eric L Chang, Jason Sheehan, Arjun Sahgal
PURPOSE: To develop consensus contouring guidelines for postoperative stereotactic body radiation therapy (SBRT) for spinal metastases. METHODS AND MATERIALS: Ten spine SBRT specialists representing 10 international centers independently contoured the clinical target volume (CTV), planning target volume (PTV), spinal cord, and spinal cord planning organ at risk volume (PRV) for 10 representative clinical scenarios in postoperative spine SBRT for metastatic solid tumor malignancies...
January 1, 2017: International Journal of Radiation Oncology, Biology, Physics
Kristin J Redmond, Simon S Lo, Charles Fisher, Arjun Sahgal
Postoperative stereotactic body radiation therapy (SBRT) for metastatic spinal tumors is increasingly being performed in clinical practice. Whereas the fundamentals of SBRT practice for intact spinal metastases are established, there are as yet no comprehensive practice guidelines for the postoperative indications. In particular, there are unique considerations for patient selection and treatment planning specific to postoperative spine SBRT that are critical for safe and effective management. The purpose of this critical review is to discuss the rationale for treatment, describe those factors affecting surgical decision making, introduce modern surgical trends, and summarize treatment outcomes for both conventional postoperative external beam radiation therapy and postoperative spine SBRT...
August 1, 2016: International Journal of Radiation Oncology, Biology, Physics
S J Patrice, P K Sneed, J C Flickinger, D C Shrieve, B E Pollock, E Alexander, D A Larson, D S Kondziolka, P H Gutin, W M Wara, M W McDermott, L D Lunsford, J S Loeffler
PURPOSE: Between June 1988 and June 1994. 38 hemangioblastomas were treated with stereotactic radiosurgery (SR) at three SR centers to evaluate the efficacy and potential toxicity of this therapeutic modality as an adjuvant or alternative treatment to surgical resection. METHODS AND MATERIALS: SR was performed using either a 201-cobalt source unit or a dedicated SR linear accelerator. Of the 18 primary tumors treated, 16 had no prior history of surgical resection and were treated definitively with SR and two primary lesions were subtotally resected and subsequently treated with SR...
June 1, 1996: International Journal of Radiation Oncology, Biology, Physics
Giuseppe Minniti, Claudia Scaringi, Sergio Paolini, Gaetano Lanzetta, Andrea Romano, Francesco Cicone, Mattia Osti, Riccardo Maurizi Enrici, Vincenzo Esposito
PURPOSE: To investigate the local control and radiation-induced brain necrosis in patients with brain metastases >2 cm in size who received single-fraction or multifraction stereotactic radiosurgery (SRS); factors associated with clinical outcomes and the development of brain radionecrosis were assessed. METHODS AND MATERIALS: Two hundred eighty-nine consecutive patients with brain metastases >2.0 cm who received SRS as primary treatment at Sant'Andrea Hospital, University of Rome Sapienza, Rome, Italy, were analyzed...
July 15, 2016: International Journal of Radiation Oncology, Biology, Physics
Robert W Mutter, Fan Liu, Andres Abreu, Ellen Yorke, Andrew Jackson, Kenneth E Rosenzweig
PURPOSE: Chest wall (CW) pain has recently been recognized as an important adverse effect of stereotactic body radiation therapy (SBRT) for non-small-cell lung cancer (NSCLC). We developed a dose-volume model to predict the development of this toxicity. METHODS AND MATERIALS: A total of 126 patients with primary, clinically node-negative NSCLC received three to five fractions of SBRT to doses of 40-60 Gy and were prospectively followed. The dose-absolute volume histograms of two different definitions of the CW as an organ at risk (CW3cm and CW2cm) were examined for all 126 patients...
April 1, 2012: International Journal of Radiation Oncology, Biology, Physics
Kimmen Quan, Karen M Xu, Yongqian Zhang, David A Clump, John C Flickinger, Ron Lalonde, Steven A Burton, Dwight E Heron
Stereotactic ablative radiotherapy (SABR) with concomitant cetuximab is an effective treatment option for previously irradiated, locally recurrent squamous cell carcinoma of the head and neck. Its local control and overall survival are similar to those of other available treatment options. Each retreatment depends heavily on the prior treatment and every patient is a special case. Based on the experience of our institution and previously published studies, for patients who receive concomitant cetuximab with a median prior radiation therapy dose of 70Gy, we recommend a total dose of 40-44Gy delivered in 5 fractions on alternating days over 1-2 weeks...
April 2016: Seminars in Radiation Oncology
Jonathan W Lischalk, Ryan M Malik, Sean P Collins, Brian T Collins, Ismael A Matus, Eric D Anderson
BACKGROUND AND PURPOSE: Radiotherapy of central lung tumors carries a higher risk of treatment-related toxicity and local failure. In the era of aggressive oligometastic management the exploration of the proper dose-fractionation for metastatic central lung tumors is essential. MATERIALS AND METHODS: Patients diagnosed with high-risk metastatic lesions of the central pulmonary tree comprised this single-institutional retrospective analysis. "High-risk" central pulmonary lesions were defined as those with abutment and/or invasion of the mainstem bronchus...
February 27, 2016: Radiation Oncology
Omer Sager, Murat Beyzadeoglu, Ferrat Dincoglan, Bora Uysal, Hakan Gamsiz, Selcuk Demiral, Kaan Oysul, Bahar Dirican, Sait Sirin
BACKGROUND AND OBJECTIVES: Surgery is the principal treatment for safely accessible hemorrhagic and symptomatic cavernous malformations. Nevertheless, the role of linear accelerator (LINAC)-based stereotactic radiosurgery (SRS) in the management of high-risk, symptomatic cavernoma lesions warrants further refinement. In this study, we evaluate the use of LINAC-based SRS for cerebral cavernous malformations (CMs) and report our 15-year single-center experience. DESIGN AND SETTINGS: A retrospective study from the Department of Radiation Oncology and the Department of Neurosurgery at Gulhane Military Medical Academy and Medical Faculty, Ankara from April 1998 to June 2013...
January 2014: Annals of Saudi Medicine
M Fuetsch, F El Majdoub, M Hoevels, R P Müller, V Sturm, M Maarouf
BACKGROUND: The management of deep-seated cerebral cavernous malformations (CCMs) is still controversial. Although surgery remains the treatment of choice in patients with recurrent hemorrhage, patients with CCMs located in the brainstem are in many cases not eligible for resection due to high procedure-related morbidity and mortality. We evaluated the long-term outcome of LINAC radiosurgery (LINAC-RS) for the treatment of brainstem CCMs. PATIENTS AND METHODS: Between December 1992 and March 2008, 14 patients (6 men, 8 women) harboring brainstem CCMs underwent LINAC-RS...
April 2012: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Alan Nichol, Roy Ma, Fred Hsu, Lovedeep Gondara, Hannah Carolan, Robert Olson, Devin Schellenberg, François Germain, Arthur Cheung, Michael Peacock, Alanah Bergman, Emily Vollans, Rosemin Vellani, Michael McKenzie
PURPOSE: Interest is growing in treating multiple brain metastases with radiosurgery. We report on the effectiveness and tolerability of volumetric radiosurgery (VRS). METHODS AND MATERIALS: We enrolled patients with a ≥6-month estimated life expectancy and 1 to 10 brain metastases with a diameter of ≤3 cm at 5 cancer centers. Volumetric radiosurgery was delivered in 5 fractions with 98% target coverage, prescribed as 95% of 50 Gy (47.5 Gy in 5 fractions) to the metastases with no margin and 95% of 40 Gy (38 Gy in 5 fractions) to their 2-mm planning target volumes, concurrent with 20 Gy to the whole brain planning target volume...
February 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Joe Y Chang, Suresh Senan, Marinus A Paul, Reza J Mehran, Alexander V Louie, Peter Balter, Harry J M Groen, Stephen E McRae, Joachim Widder, Lei Feng, Ben E E M van den Borne, Mark F Munsell, Coen Hurkmans, Donald A Berry, Erik van Werkhoven, John J Kresl, Anne-Marie Dingemans, Omar Dawood, Cornelis J A Haasbeek, Larry S Carpenter, Katrien De Jaeger, Ritsuko Komaki, Ben J Slotman, Egbert F Smit, Jack A Roth
BACKGROUND: The standard of care for operable, stage I, non-small-cell lung cancer (NSCLC) is lobectomy with mediastinal lymph node dissection or sampling. Stereotactic ablative radiotherapy (SABR) for inoperable stage I NSCLC has shown promising results, but two independent, randomised, phase 3 trials of SABR in patients with operable stage I NSCLC (STARS and ROSEL) closed early due to slow accrual. We aimed to assess overall survival for SABR versus surgery by pooling data from these trials...
June 2015: Lancet Oncology
Bruce E Pollock, John C Flickinger
OBJECT: Radiosurgery is an effective treatment strategy for properly selected patients harboring arteriovenous malformations (AVMs). Grading scales that are currently used to predict patient outcomes after AVM resection are unreliable tools for the prediction of the results of AVM radiosurgery. METHODS: A grading system was developed to predict outcomes following AVM radiosurgery, based on the multivariate analysis of data obtained in 220 patients treated between 1987 and 1991 (Group 1)...
January 2002: Journal of Neurosurgery
I Paddick
A conformity index is a measure of how well the volume of a radiosurgical dose distribution conforms to the size and shape of a target volume. Because the success of radiosurgery is related to the extremely conformal irradiation of the target, an accurate method for describing this parameter is important. Existing conformity ratios and indices used in radiosurgery are reviewed and criticized. It will be demonstrated that previously proposed measurements of conformity can, under certain conditions, give false perfect scores...
December 2000: Journal of Neurosurgery
Ian Paddick, Bodo Lippitz
A dose gradient index (GI) is proposed that can be used to compare treatment plans of equal conformity. The steep dose gradient outside the radiosurgical target is one of the factors that makes radiosurgery possible. It therefore makes sense to measure this variable and to use it to compare rival plans, explore optimal prescription isodoses, or compare treatment modalities. The GI is defined as the ratio of the volume of half the prescription isodose to the volume of the prescription isodose. For a plan normalized to the 50% isodose line, it is the ratio of the 25% isodose volume to that of the 50% isodose volume...
December 2006: Journal of Neurosurgery
Alexander V Louie, Cornelis J A Haasbeek, Sahar Mokhles, George B Rodrigues, Kevin L Stephans, Frank J Lagerwaard, David A Palma, Gregory M M Videtic, Andrew Warner, Johanna J M Takkenberg, Chandana A Reddy, Alex P W M Maat, Neil M Woody, Ben J Slotman, Suresh Senan
PURPOSE: A prognostic model for 5-year overall survival (OS), consisting of recursive partitioning analysis (RPA) and a nomogram, was developed for patients with early-stage non-small cell lung cancer (ES-NSCLC) treated with stereotactic ablative radiation therapy (SABR). METHODS AND MATERIALS: A primary dataset of 703 ES-NSCLC SABR patients was randomly divided into a training (67%) and an internal validation (33%) dataset. In the former group, 21 unique parameters consisting of patient, treatment, and tumor factors were entered into an RPA model to predict OS...
September 1, 2015: International Journal of Radiation Oncology, Biology, Physics
Joe Y Chang, Hui Liu, Peter Balter, Ritsuko Komaki, Zhongxing Liao, James Welsh, Reza J Mehran, Jack A Roth, Stephen G Swisher
BACKGROUND: Stereotactic ablative radiotherapy (SABR) can achieve excellent local control rates in early-stage non-small cell lung cancer (NSCLC) and has emerged as a standard treatment option for patients who cannot undergo surgery or those with isolated recurrences. However, factors that may predict toxicity or survival are largely unknown. We sought here to identify predictors of survival and pneumonitis after SABR for NSCLC in a relatively large single-institution series. METHODS: Subjects were 130 patients with stage I NSCLC treated with four-dimensional computed tomography (4D CT) -planned, on-board volumetric image-guided SABR to 50 Gy in 4 fractions...
2012: Radiation Oncology
Roberto Spiegelmann, Zvi R Cohen, Ouzi Nissim, Dror Alezra, Raphael Pfeffer
One hundred and seventeen patients with cavernous sinus meningiomas had LINAC radiosurgery at our institution in the period 1993-2007. Six cases were lost and 9 had less than 1 year follow up. The remaining 102 patients were prospectively followed up at 1 y intervals with clinical, neuro-ophthalmological and MRI examinations. Patients' age ranged between 31 and 86 years (mean 57). Seventy percent were females. The mean tumor volume was 7 cc. Thirty-three patients had previous microsurgery. Tumors were defined with high resolution MRI obtained 1-2 days before treatment and fused to stereotactic CT...
June 2010: Journal of Neuro-oncology
2015-04-20 00:47:47
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