المؤلفون: Akira Masaoka, Shingo Ohira, Riho Komiyama, Hikari Ueda, Naoyuki Kanayama, Yoshihiro Ueda, Masaru Isono, Teruki Teshima, Masayoshi Miyazaki

المصدر: Journal of Applied Clinical Medical Physics

مصطلحات موضوعية: Patient Motion, medicine.medical_treatment, stereotactic radiosurgery, QFix EncompassTM immobilization system, Radiosurgery, Rotation, Patient Positioning, 030218 nuclear medicine & medical imaging, Stereotactic radiotherapy, Immobilization, 03 medical and health sciences, 0302 clinical medicine, HyperArc, Technical Note, Absolute maximum, medicine, Humans, Six degrees of freedom, Radiology, Nuclear Medicine and imaging, Instrumentation, Retrospective Studies, Physics, Radiation, Brain Neoplasms, business.industry, Radiotherapy Planning, Computer-Assisted, Aircraft principal axes, intra‐fractional patient motion, 030220 oncology & carcinogenesis, stereotactic radiotherapy, Treatment time, Technical Notes, Nuclear medicine, business

الوصف: Purpose This study investigated the intra‐fractional motion (IM) of patients immobilized using the QFix Encompass Immobilization System during HyperArc (HA) treatment. Method HA treatment was performed on 89 patients immobilized using the Encompass. The IM during treatment (including megavoltage (MV) registration) was analyzed for six degrees of freedom including three axes of translation (anterior‐posterior, superior‐inferior (SI) and left‐right (LR)) and three axes of rotation (pitch, roll, and yaw). Then, the no corrected IM (IMNC) was retrospectively simulated (excluding MV registration) in three directions (SI, LR, and yaw). Finally, the correlation between the treatment time and the IM of the 3D vector was assessed. Results The average IM in terms of the absolute displacement were 0.3 mm (SI), 0.3 mm (LR) and 0.2° (yaw) for Stereotactic radiosurgery (SRS), and 0.3 mm (SI), 0.2 mm (LR), and 0.2° (yaw) for stereotactic radiotherapy (SRT). The absolute maximum values of IM were 1 mm along the SI and LR axes and >1° along the yaw axis. In the correlation between the treatment time and the IM, the r‐values were −0.025 and 0.027 for SRS and SRT respectively, along the axes of translation. For the axes of rotation, the r‐values were 0.012 and 0.206 for SRS and SRT, respectively. Conclusion Encompass provided patient immobilization with adequate accuracy during HA treatment. The absolute maximum displacement IM was less than IMNC along the translational/rotational axes, and no statistically significant relationship between the treatment time and the IM was observed.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c1bafa5ce792aef461995349d40c13bcTest
https://doi.org/10.1002/acm2.13143Test

المؤلفون: Michael A. Dyer, H Xu, Yin Zhang, Suhong Yu, H Zhen, Minh Tam Truong, Xin Zhang, Ariel E. Hirsch

المصدر: Journal of Applied Clinical Medical Physics

مصطلحات موضوعية: Knowledge based planning, medicine.medical_treatment, Mean squared prediction error, stereotactic radiosurgery, Radiosurgery, Standard deviation, 030218 nuclear medicine & medical imaging, Stereotactic radiotherapy, 03 medical and health sciences, 0302 clinical medicine, Robotic Surgical Procedures, Cyberknife, Linear regression, medicine, Radiation Oncology Physics, Humans, Radiology, Nuclear Medicine and imaging, Instrumentation, Retrospective Studies, Mathematics, Radiation, business.industry, Radiotherapy Planning, Computer-Assisted, Radiotherapy Dosage, knowledge‐based planning, Conformity index, 030220 oncology & carcinogenesis, stereotactic radiotherapy, Radiotherapy, Intensity-Modulated, Nuclear medicine, business

الوصف: PURPOSE To develop a knowledge-based planning (KBP) model that predicts dosimetric indices and facilitates planning in CyberKnife intracranial stereotactic radiosurgery/radiotherapy (SRS/SRT). METHODS Forty CyberKnife SRS/SRT plans were retrospectively used to build a linear KBP model which correlated the equivalent radius of the PTV (req_PTV ) and the equivalent radius of volume that receives a set of prescription dose (req_Vi , where Vi = V10% , V20% … V120% ). To evaluate the model's predictability, a fourfold cross-validation was performed for dosimetric indices such as gradient measure (GM) and brain V50% . The accuracy of the prediction was quantified by the mean and the standard deviation of the difference between planned and predicted values, (i.e., ΔGM = GMpred - GMclin and fractional ΔV50% = (V50%pred - V50%clin )/V50%clin ) and a coefficient of determination, R2 . Then, the KBP model was incorporated into the planning for another 22 clinical cases. The training plans and the KBP test plans were compared in terms of the new conformity index (nCI) as well as the planning efficiency. RESULTS Our KBP model showed desirable predictability. For the 40 training plans, the average prediction error from cross-validation was only 0.36 ± 0.06 mm for ΔGM, and 0.12 ± 0.08 for ΔV50% . The R2 for the linear fit between req_PTV and req_vi was 0.985 ± 0.019 for isodose volumes ranging from V10% to V120% ; particularly, R2 = 0.995 for V50% and R2 = 0.997 for V100% . Compared to the training plans, our KBP test plan nCI was improved from 1.31 ± 0.15 to 1.15 ± 0.08 (P

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::941d1221bf3f2c4c2568d163f96b8679Test
https://doi.org/10.1002/acm2.13173Test

المؤلفون: M. Bredel, Elizabeth L. Covington, Richard A. Popple, John B. Fiveash, Evan M. Thomas, Kristen O. Riley, Dennis N. Stanley, Christopher D. Willey, S. Marcrom

المصدر: Journal of Applied Clinical Medical Physics

مصطلحات موضوعية: medicine.medical_treatment, stereotactic radiosurgery, Treatment parameters, Radiosurgery, Gantry angle, Patient Positioning, 030218 nuclear medicine & medical imaging, Stereotactic radiotherapy, Immobilization, Motion, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Radiation Oncology Physics, Radiology, Nuclear Medicine and imaging, Image guidance, Instrumentation, Medical systems, Radiation, business.industry, Radiotherapy Planning, Computer-Assisted, SGRT, surface guided radiotherapy, Cone-Beam Computed Tomography, Treatment management, optical surface imaging, 030220 oncology & carcinogenesis, Intrafraction motion, intrafraction motion, Nuclear medicine, business

الوصف: Purpose To report on the use of surface guided imaging during frameless intracranial stereotactic radiotherapy with automated delivery via HyperArcTM (Varian Medical Systems, Palo Alto, CA). Methods All patients received intracranial radiotherapy with HyperArcTM and were monitored for intrafraction motion by the AlignRT® (VisionRT, London, UK) surface imaging (SI) system. Immobilization was with the EncompassTM (Qfix, Avondale, PA) aquaplast mask device. AlignRT® log files were correlated with trajectory log files to correlate treatment parameters with SI reported offsets. SI reported offsets were correlated with gantry angle and analyzed for performance issues at non‐zero couch angles and during camera‐pod blockage during gantry motion. Demographics in the treatment management system were used to identify race and determine if differences in SI reported offsets are due to skin tone settings. Results A total of 981 fractions were monitored over 14 months and 819 were analyzed. The median AlignRT® reported motion from beginning to the end of treatment was 0.24 mm. The median offset before beam on at non‐zero couch angles was 0.55 mm. During gantry motion when camera pods are blocked, the median magnitude was below 1 mm. Median magnitude of offsets at non‐zero couch angles was not found to be significantly different for patients stratified by race. Conclusions Surface image guidance is a viable alternative to scheduled mid‐treatment imaging for monitoring intrafraction motion during stereotactic radiosurgery with automated delivery.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4738d334fa4d316fe9819c1ba8081aa4Test
https://doi.org/10.1002/acm2.13066Test

المؤلفون: Tony J. C. Wang, Richard G. Ellenbogen, Tyler Gutschenritter, Simon S. Lo, Anoop P. Patel, Matthew Foote, Arjun Sahgal, Samuel T. Chao, Eric L. Chang, Balamurugan Vellayappan, Vyshak Venur, John H. Suh, Stephanie E. Combs, Kristin J. Redmond

المصدر: Cancers
Cancers 13:70 (2021)
Cancers, Vol 13, Iss 70, p 70 (2021)

مصطلحات موضوعية: Cancer Research, medicine.medical_specialty, Hypofractionated Stereotactic Radiotherapy, Large Brain Metas-tases, Local Control, Radionecrosis, Stereotactic Radiosurgery, medicine.medical_treatment, stereotactic radiosurgery, Review, large brain metastases, lcsh:RC254-282, Radiosurgery, Resection, radionecrosis, Stereotactic radiotherapy, 03 medical and health sciences, 0302 clinical medicine, parasitic diseases, medicine, hypofractionated stereotactic radiotherapy, LEPTOMENINGEAL DISEASE, business.industry, Cancer, Maximum dimension, medicine.disease, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Patient population, Regimen, Oncology, local control, 030220 oncology & carcinogenesis, Radiology, business, 030217 neurology & neurosurgery

الوصف: Simple Summary Brain metastases are the most common cause of cancerous brain tumors in adults. Large brain metastases are an especially difficult clinical scenario as patients often have debilitating symptoms from these tumors, and large tumors are more difficult to control with traditional single treatment radiation regimens alone or after surgery. Hypofractionated stereotactic radiotherapy is a novel way to deliver the higher doses of radiation to control large tumors either after surgery (most common), alone (common), or potentially before surgery (uncommon). Herein, we describe how delivering high doses over three or five treatments may improve tumor control and decrease complication rates compared to more traditional single treatment regimens for brain metastases larger than 2 cm in maximum dimension. Abstract Brain metastases are the most common intracranial malignant tumor in adults and are a cause of significant morbidity and mortality for cancer patients. Large brain metastases, defined as tumors with a maximum dimension >2 cm, present a unique clinical challenge for the delivery of stereotactic radiosurgery (SRS) as patients often present with neurologic symptoms that require expeditious treatment that must also be balanced against the potential consequences of surgery and radiation therapy—namely, leptomeningeal disease (LMD) and radionecrosis (RN). Hypofractionated stereotactic radiotherapy (HSRT) and pre-operative SRS have emerged as novel treatment techniques to help improve local control rates and reduce rates of RN and LMD for this patient population commonly managed with post-operative SRS. Recent literature suggests that pre-operative SRS can potentially half the risk of LMD compared to post-operative SRS and that HSRT can improve risk of RN to less than 10% while improving local control when meeting the appropriate goals for biologically effective dose (BED) and dose-volume constraints. We recommend a 3- or 5-fraction regimen in lieu of SRS delivering 15 Gy or less for large metastases or resection cavities. We provide a table comparing the BED of commonly used SRS and HSRT regimens, and provide an algorithm to help guide the management of these challenging clinical scenarios.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2a0a095214295e68e5edcc0b3bc43473Test
https://pubmed.ncbi.nlm.nih.gov/33383817Test

المؤلفون: Toral R. Patel, Tu Dan, Strahinja Stojadinovic, Ankur R. Patel, Samuel Schroeder, Mindy Joo, Jameson Mendel, Robert Timmerman, Zabi Wardak, Aaron Plitt

المصدر: Cureus

مصطلحات موضوعية: medicine.medical_specialty, business.industry, medicine.medical_treatment, stereotactic radiosurgery, Neurosurgery, General Engineering, 030204 cardiovascular system & hematology, Gamma knife, Radiosurgery, gamma knife icon, Stereotactic radiotherapy, 03 medical and health sciences, 0302 clinical medicine, Radiation Oncology, Medicine, Intracranial lesions, stereotactic radiotherapy, Radiology, Icon, business, computer, 030217 neurology & neurosurgery, computer.programming_language

الوصف: The indications and techniques for the treatment of intracranial lesions continue to evolve with the advent of novel technologies. The Gamma Knife Icon™ (GK Icon™) is the most recent model available from Elekta, providing a frameless solution for stereotactic radiosurgery. At our institution, 382 patients with 3,213 separate intracranial lesions have been treated with frameless stereotactic radiotherapy using the GK Icon. The wide range of diagnoses include brain metastases, meningiomas, arteriovenous malformations, acoustic neuromas, pituitary adenomas, and several other histologies. The ability to perform both frame and frameless treatments on the GK Icon has significantly increased our daily volume by almost 50% on a single machine. Although the frameless approach allows one to take advantage of the precision in radiosurgery, the intricacies regarding treatment with this frameless system are not well established. Our initial experience will help to serve as a guide to those wishing to implement this novel technology in their practice.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b974af3d2bd8a7290003bc8b81e02443Test
https://doi.org/10.7759/cureus.13998Test

المؤلفون: Piera Navarria, Giuseppe Minniti, Filippo Alongi, Claus Belka, Maximilian Niyazi

المصدر: Radiation Oncology, Vol 16, Iss 1, Pp 1-14 (2021)
Radiation Oncology (London, England)

مصطلحات موضوعية: lcsh:Medical physics. Medical radiology. Nuclear medicine, medicine.medical_specialty, lcsh:R895-920, medicine.medical_treatment, Review, Radiosurgery, lcsh:RC254-282, Radionecrosis, Re-Irradiation, Hypofractionated radiotherapy, Stereotactic radiotherapy, 03 medical and health sciences, 0302 clinical medicine, Recurrent glioblastoma, Reirradiation, Stereotactic radiosurgery, Target delineation, medicine, Humans, Radiology, Nuclear Medicine and imaging, Radiation Injuries, Temozolomide, Brain Neoplasms, business.industry, Dose fractionation, Who grade, Prognosis, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, Survival Analysis, Radiation therapy, Oncology, 030220 oncology & carcinogenesis, Concomitant, Dose Fractionation, Radiation, Radiology, Neoplasm Recurrence, Local, Glioblastoma, business, 030217 neurology & neurosurgery, medicine.drug

الوصف: Despite aggressive management consisting of maximal safe surgical resection followed by external beam radiation therapy (60 Gy/30 fractions) with concomitant and adjuvant temozolomide, approximately 90% of WHO grade IV gliomas (glioblastomas, GBM) will recur locally within 2 years. For patients with recurrent GBM, no standard of care exists. Thanks to the continuous improvement in radiation science and technology, reirradiation has emerged as feasible approach for patients with brain tumors. Using stereotactic radiosurgery (SRS) or stereotactic radiotherapy (SRT), either hypofractionated or conventionally fractionated schedules, several studies have suggested survival benefits following reirradiation of patients with recurrent GBM; however, there are still questions to be answered about the efficacy and toxicity associated with a second course of radiation. We provide a clinical overview on current status and recent advances in reirradiation of GBM, addressing relevant clinical questions such as the appropriate patient selection and radiation technique, optimal dose fractionation, reirradiation tolerance of the brain and the risk of radiation necrosis.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0a7374ae13f1fc0c8b59d4f91f8471baTest
https://doi.org/10.1186/s13014-021-01767-9Test

المؤلفون: Richard A. Popple, Ivan A. Brezovich, John B. Fiveash, Elizabeth L. Covington, Xingen Wu, Kristen O. Riley, Christopher D. Willey

المصدر: Journal of Applied Clinical Medical Physics

مصطلحات موضوعية: Offset (computer science), Computer science, stereotactic radiosurgery, Radiosurgery, Patient Positioning, 030218 nuclear medicine & medical imaging, Stereotactic radiotherapy, Immobilization, 03 medical and health sciences, 0302 clinical medicine, Software, Optical surface, Humans, Radiation Oncology Physics, Radiology, Nuclear Medicine and imaging, Instrumentation, frameless radiosurgery, Radiation, Brain Neoplasms, Phantoms, Imaging, business.industry, Radiotherapy Planning, Computer-Assisted, Isocenter, Radiotherapy Dosage, Monitoring system, surface guided radiotherapy, Software changes, Surgery, Computer-Assisted, optical surface imaging, 030220 oncology & carcinogenesis, Intrafraction motion, intrafraction motion, Radiotherapy, Intensity-Modulated, business, Nuclear medicine

الوصف: Purpose To evaluate the accuracy of monitoring intrafraction motion during stereotactic radiotherapy with the optical surface monitoring system. Prior studies showing a false increase in the magnitude of translational offsets at non‐coplanar couch positions prompted the vendor to implement software changes. This study evaluated two software improvements intended to address false offsets. Methods The vendor implemented two software improvements: a volumetric (ACO) rather than planar calibration and, approximately 6 months later, an improved calibration workflow (CIB) designed to better compensate for thermal drift. Offsets relative to the reference position, obtained at table angle 0 following image‐guided setup, were recorded before beam‐on at each table position and at the end of treatment the table returned to 0° for patients receiving SRT. Results Prior to ACO, between ACO and CIB, and after CIB, 223, 155, and 436 fractions were observed respectively. The median magnitude of translational offsets at the end of treatment was similar for all three intervals: 0.29, 0.33, and 0.27 mm. Prior to ACO, the offset magnitude for non‐zero table positions had a median of 0.79 mm and was found to increase with increasing distance from isocenter to the anterior patient surface. After ACO, the median magnitude was 0.74 mm, but the dependence on surface‐to‐isocenter distance was eliminated. After CIB, the median magnitude for non‐zero table positions was reduced to 0.57 mm. Conclusion Ongoing improvements in software and calibration procedures have decreased reporting of false offsets at non‐zero table angles. However, the median magnitude for non‐zero table angles is larger than that observed at the end of treatment, indicating that accuracy remains better when the table is not rotated.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ff03be725c5064959c0dcb368f640f91Test
https://doi.org/10.1002/acm2.12611Test

المؤلفون: Thomas Weissmann, Dominik Oft, Rainer Fietkau, Johannes Roesch, Luitpold Distel, Sebastian Lettmaier, Florian Putz, Siti Masitho, Christoph Bert, Manuel Schmidt, Veit Mengling, Benjamin Frey

المصدر: Frontiers in Oncology, Vol 10 (2021)
Frontiers in Oncology

مصطلحات موضوعية: Cancer Research, medicine.medical_specialty, Multivariate analysis, medicine.medical_treatment, stereotactic radiosurgery, lcsh:RC254-282, 030218 nuclear medicine & medical imaging, Metastasis, Stereotactic radiotherapy, 03 medical and health sciences, 0302 clinical medicine, Bayesian multivariate linear regression, brain metastases, Medicine, ddc:610, Original Research, business.industry, volumetric regression, longitudinal analysis, medicine.disease, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Regression, Clinical trial, Radiation therapy, Oncology, 030220 oncology & carcinogenesis, Time course, volumetric analysis, stereotactic radiotherapy, Radiology, business, MRI

الوصف: BackgroundThere is insufficient understanding of the natural course of volumetric regression in brain metastases after stereotactic radiotherapy (SRT) and optimal volumetric criteria for the assessment of response and progression in radiotherapy clinical trials for brain metastases are currently unknown.MethodsVolumetric analysis via whole-tumor segmentation in contrast-enhanced 1 mm³-isotropic T1-Mprage sequences before SRT and during follow-up. A total of 3,145 MRI studies of 419 brain metastases from 189 patients were segmented. Progression was defined using a volumetric extension of the RANO-BM criteria. A subset of 205 metastases without progression/radionecrosis during their entire follow-up of at least 3 months was used to study the natural course of volumetric regression after SRT. Predictors for volumetric regression were investigated. A second subset of 179 metastases was used to investigate the prognostic significance of volumetric response at 3 months (defined as ≥20% and ≥65% volume reduction, respectively) for subsequent local control.ResultsMedian relative metastasis volume post-SRT was 66.9% at 6 weeks, 38.6% at 3 months, 17.7% at 6 months, 2.7% at 12 months and 0.0% at 24 months. Radioresistant histology and FSRT vs. SRS were associated with reduced tumor regression for all time points. In multivariate linear regression, radiosensitive histology (p=0.006) was the only significant predictor for metastasis regression at 3 months. Volumetric regression ≥20% at 3 months post-SRT was the only significant prognostic factor for subsequent control in multivariate analysis (HR 0.63, p=0.023), whereas regression ≥65% was no significant predictor.ConclusionsVolumetric regression post-SRT does not occur at a constant rate but is most pronounced in the first 6 weeks to 3 months. Despite decreasing over time, volumetric regression continues beyond 6 months post-radiotherapy and may lead to complete resolution of controlled lesions by 24 months. Radioresistant histology is associated with slower regression. We found that a cutoff of ≥20% regression for the volumetric definition of response at 3 months post-SRT was predictive for subsequent control whereas the currently proposed definition of ≥65% was not. These results have implications for standardized volumetric criteria in future radiotherapy trials for brain metastases.

وصف الملف: application/pdf; image/tiff

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::149ce0c5f432a16893a0ea6d00408771Test
https://www.frontiersin.org/articles/10.3389/fonc.2020.590980/fullTest

المؤلفون: Sabine Semrau, Johannes Roesch, Sebastian Lettmaier, Irina Filimonova, Thomas Weissmann, Florian Putz, Charlotte Schmitter, Manuel Schmidt, Dominik Oft, Veit Mengling, Rainer Fietkau, Luitpold Distel, Benjamin Frey, Christoph Bert, Hadi Siavooshhaghighi

المصدر: Frontiers in Oncology
Frontiers in Oncology, Vol 10 (2020)

مصطلحات موضوعية: 0301 basic medicine, Intervention trials, Cancer Research, medicine.medical_treatment, stereotactic radiotherapy (SRT), lcsh:RC254-282, Effective dose (radiation), Radiosurgery, Resection, Metastasis, Stereotactic radiotherapy, 03 medical and health sciences, 0302 clinical medicine, Medizinische Fakultät, brain metastases, radiobiological aspects, medicine, stereotactic radiosurgery (SRS), ddc:610, Original Research, business.industry, segmentation, fractionated stereotactic radiotherapy, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, Radiation necrosis, 030104 developmental biology, Oncology, Median time, 030220 oncology & carcinogenesis, volumetric analysis, Nuclear medicine, business

الوصف: Background: While the role of stereotactic radiotherapy for brain metastases is increasing, evidence on the comparative efficacy and safety of fractionated stereotactic radiotherapy (FSRT) and single-session radiosurgery (SRS) is scarce.Methods: Longitudinal volumetric analysis was performed in a consecutive cohort of 120 patients and 190 brain metastases (>0.065 cm3 in volume / > ~5 mm in diameter) treated exclusively with FSRT (n = 98) and SRS (n = 92), respectively. A total of 972 tumor segmentations was used, averaging 5.1 time points per metastasis. Progression was defined using a volumetric extension of the RANO-BM criteria. Local control and radionecrosis were compared for lesions treated with FSRT and SRS, respectively.Results: Metastases treated with FSRT were significantly larger at baseline (mean, 4.66 vs. 0.40 cm3, p < 0.001). Biologically effective dose (BED) for metastases (α/β = 12, linear-quadratic-cubic model) was significantly associated with local control, whereas BED for normal brain (α/β = 2, linear-quadratic model) was significantly associated with radionecrosis. Median time to local progression was 22.9 months in the FSRT group compared to 14.5 months in the SRS group (p = 0.022). Overall radionecrosis rate at 12 months was 3.4% for FSRT and 14.8% for SRS (p = 0.010). Radionecrosis °IV requiring resection with histologic proof of radiation necrosis also was significantly reduced in the FSRT group (FSRT 0.0% vs. SRS 3.9%, p = 0.041). In multivariate analysis, FSRT was associated with reduced risk of progression (HR 0.47, p = 0.015) and reduced risk of radionecrosis (HR 0.18, p = 0.045).Conclusions: This volumetric study provides initial evidence that the improvements in therapeutic ratio expected for FSRT in larger brain metastases, might equally extend into the domain of smaller metastases, traditionally less considered for fractionated treatment. FSRT might constitute an important tool to further increase local control and reduce radionecrosis risk in stereotactic radiotherapy for brain metastases, that should be assessed in randomized intervention trials.

وصف الملف: image/tiff; application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0e648d41ac2bf5a55484b7056d6bee35Test

المؤلفون: Ekkehard M. Kasper, Farhan A Mirza, Rafael Rojas, Anand Mahadevan, Fred C. Lam, Jianmin Liu

المصدر: Radiation Oncology (London, England)
Radiation Oncology, Vol 15, Iss 1, Pp 1-10 (2020)

مصطلحات موضوعية: lcsh:Medical physics. Medical radiology. Nuclear medicine, Male, medicine.medical_specialty, Olfactory groove meningiomas, lcsh:R895-920, medicine.medical_treatment, Radiosurgery, lcsh:RC254-282, Resection, Stereotactic radiotherapy, 03 medical and health sciences, 0302 clinical medicine, Cyberknife, Olfactory Groove Meningioma, medicine, Meningeal Neoplasms, Humans, Radiology, Nuclear Medicine and imaging, Stereotactic radiosurgery, Aged, Retrospective Studies, Aged, 80 and over, Fractionated stereotactic radiotherapy, Hypofractionated stereotactic radiotherapy, business.industry, Research, Rate control, CyberKnife radiotherapy, Radiotherapy Dosage, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Prognosis, Radiation therapy, Survival Rate, Oncology, 030220 oncology & carcinogenesis, Feasibility Studies, Female, Radiation Dose Hypofractionation, Radiology, Radiotherapy, Intensity-Modulated, Post treatment, business, Meningioma, 030217 neurology & neurosurgery

الوصف: Purpose To assess the safety and efficacy of CyberKnife® radiotherapy (CKRT) for the treatment of olfactory groove meningiomas (OGMs). Methods A retrospective review was performed of 13 patients with OGM treated with CKRT from September 2005 to May 2018 at our institution. Nine patients were treated primarily with CKRT, 3 for residual disease following resection, and 1 for disease recurrence. Results Five patients were treated with stereotactic radiosurgery (SRS), 6 with hypofractionated stereotactic radiotherapy (HSRT), and 2 with fractionated stereotactic radiotherapy (FSRT). The median tumor volume was 8.12 cm3. The median prescribed dose was 14.8 Gy for SRS, 27.3 Gy for HSRT, and 50.2 Gy for FSRT. The median maximal dose delivered was 32.27 Gy. Median post treatment follow-up was 48 months. Twelve of 13 patients yielded a 100% regional control rate with a median tumor volume reduction of 31.7%. Six of the 12 patients had reduced tumor volumes while the other 6 had no changes. The thirteenth patient had significant radiation-induced edema requiring surgical decompression. Twelve patients were alive and neurologically stable at the time of the review. One patient died from pneumonia unrelated to his CKRT treatment. Conclusions CKRT appears to be safe and effective for the treatment of OGMs.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::17e94d1f7c760e607a5bd4e3def70cd9Test
http://europepmc.org/articles/PMC7069021Test