Oscar I Molina-Romero, Juan Carlos Diez Palma, Andrés Fonnegra Caballero, Andrés Segura-Hernandez, Juan P Leal-Isaza, Julio R Fonnegra Pardo
{"title":"Bilateral anterior cingulotomy with Gamma Knife radiosurgery: Another alternative for the treatment of non-oncologic intractable chronic pain.","authors":"Oscar I Molina-Romero, Juan Carlos Diez Palma, Andrés Fonnegra Caballero, Andrés Segura-Hernandez, Juan P Leal-Isaza, Julio R Fonnegra Pardo","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 2","pages":"165-169"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jim X Leng, Chang Su, David J Carpenter, Warren Floyd, Eugene Vaios, Rachel Shenker, Peter G Hendrickson, Will Giles, Trey Mullikin, Scott R Floyd, John P Kirkpatrick, Michelle Green, Zachary J Reitman
{"title":"Impact of <i>TP53</i> mutations on brain metastasis control in non-small cell lung cancer patients undergoing stereotactic radiosurgery.","authors":"Jim X Leng, Chang Su, David J Carpenter, Warren Floyd, Eugene Vaios, Rachel Shenker, Peter G Hendrickson, Will Giles, Trey Mullikin, Scott R Floyd, John P Kirkpatrick, Michelle Green, Zachary J Reitman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether TP53 variants may be correlated with overall survival and local control following stereotactic radiosurgery (SRS) for brain metastases (BMs) from non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>Patients undergoing an initial course of SRS for NSCLC brain metastases between 1/2015 and 12/2020 were retrospectively identified. Overall survival and freedom from local intracranial progression (FFLIP) were estimated via Kaplan-Meier method. Cox models assessed TP53 variant status (pathogenic variant, PV; variant not detected, ND).</p><p><strong>Results: </strong>255 patients underwent molecular profiling for TP53, among whom 144 (56%) had a TP53 PV. Median follow-up was 11.6 months. OS was not significantly different across TP53 status. A trend toward superior FFLIP was observed for PV (95% CI 62.9 months-NR) versus ND patients (95% CI 29.4 months-NR; p=0.06). Superior FFLIP was observed for patients with one TP53 variant versus those with TP53 ND.</p><p><strong>Conclusion: </strong>Among NSCLC patients with BMs, the potential association between TP53 status and post-SRS FFLIP warrants further investigation in a larger prospective cohort.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 2","pages":"91-99"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Panos A Papanikolaou, Russell N Wesson, Nilofer S Azad, Jeffrey J Meyer
{"title":"Cytoreductive single-fraction stereotactic radiation therapy prior to living donor transplantation for inoperable liver-confined metastatic rectal cancer.","authors":"Panos A Papanikolaou, Russell N Wesson, Nilofer S Azad, Jeffrey J Meyer","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 2","pages":"181-183"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benjamin J Rich, Timoteo Almeida, Jared A Maas, Shahil Mehta, Raj Singh, Haley K Perlow, Benjamin Silver, Eric J Lehrer, Yash Soni, William H Jin, Crystal S Seldon, Gregory Azzam, Raphael Yechieli, Gregory Kubicek, Ricardo J Komotar, Carolina G Benjamin, Tejan Diwanji, Eric A Mellon
{"title":"Patient and physician attitudes towards salvage stereotactic radiosurgery or radiotherapy for brain metastases.","authors":"Benjamin J Rich, Timoteo Almeida, Jared A Maas, Shahil Mehta, Raj Singh, Haley K Perlow, Benjamin Silver, Eric J Lehrer, Yash Soni, William H Jin, Crystal S Seldon, Gregory Azzam, Raphael Yechieli, Gregory Kubicek, Ricardo J Komotar, Carolina G Benjamin, Tejan Diwanji, Eric A Mellon","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The experience of patients with brain metastases treated with stereotactic radiosurgery (SRS) may shape attitudes towards salvage therapy. Furthermore, physician attitudes towards salvage therapy may differ based on specialty and experience. Our objective is to compare physician attitudes and patient experiences with SRS.</p><p><strong>Methods: </strong>Eligible patients with brain metastases treated with one course of SRS or fractionated stereotactic radiotherapy (FSRT) without whole brain radiotherapy (WBRT) in the definitive or postoperative setting at a single institution were surveyed from 11/2021 to 11/2022 regarding their perspectives on salvage therapy. A separate 11-question multi-disciplinary physician survey was distributed to residents, fellows and attendings at seven additional academic institutions in the US. Chi-square test and Mann-Whitney U test were used to assess differences.</p><p><strong>Results: </strong>A total of 30 patients and 88 physicians were surveyed. Most patients reported being satisfied or very satisfied with initial SRS/FSRT (90%). When given an option between WBRT or SRS for salvage treatment, all patients favored SRS. The physicians consisted of radiation oncologists (69.3%), neurosurgeons (19.3%), medical oncologists (8.0%), and neuro-oncologists (3.4%). Most physicians were confident or very confident in their ability to discuss the risks and benefits of SRS for brain metastases (78.9%), but this was significantly lower if the patient had received prior SRS (56.6%, P<.001). In these cases, there were significant differences in response by medical specialty and confidence level (P<0.05).</p><p><strong>Conclusions: </strong>Patients and physicians view tumor control followed by long-term toxicity as the most important factors for salvage therapy after initial SRS for brain metastases.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 2","pages":"101-111"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Santosh K Prusty, Amrit Neupane, Rambha Pandey, Seema Sharma, Karan Madan, Madhavi Tripathy, Ipsita Pati, Subhash Gupta, K P Haresh
{"title":"Emergency SBRT to trachea and carina for adenoid cystic carcinoma of the trachea with partial airway obstruction.","authors":"Santosh K Prusty, Amrit Neupane, Rambha Pandey, Seema Sharma, Karan Madan, Madhavi Tripathy, Ipsita Pati, Subhash Gupta, K P Haresh","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 2","pages":"185-188"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Upper rectal fixation with an endorectal balloon in prostate cancer radiotherapy.","authors":"Yukihiro Hama, Etsuko Tate","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the efficacy of endorectal balloon (ERB) in reducing rectal radiation dose, the effectiveness of upper rectal fixation remains to be evaluated. The purpose of this study was to evaluate the impact of ERB on upper rectal fixation in patients diagnosed with localized prostate cancer.</p><p><strong>Materials: </strong>Cine MRI was performed in 46 patients with localized prostate cancer to assess the stability of the anterior rectal wall with and without ERB by calculating the standard deviation of the normalized signal intensity at the level of the midgland or the seminal vesicle.</p><p><strong>Results: </strong>The standard deviation of the normalized signal intensity for the anterior rectal wall decreased significantly with the use of ERB both at the level of the midgland (p < 0.05) and the seminal vesicle (p < 0.05). The standard deviation of the anterior rectal wall at the level of the seminal vesicle was significantly higher than at the level of the midgland without ERB (p < 0.05). But with ERB, the standard deviation of the normalized signal intensity at the level of the seminal vesicle became comparable to that at the level of the midgland (p = 0.392).</p><p><strong>Conclusion: </strong>The anterior rectal wall is stabilized by ERBs not only at the level of the midgland but also at the level of the seminal vesicle. ERBs can transform the rectum from a moving and deformable organ into a static and rigid organ.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 2","pages":"129-133"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Beehong Soon, Fuad Ismail, Marfu'ah Nik Ezzamudden, Shahizon Azura Mohamed Mukari, Aida-Widure Mustapha Mohd Mustapha, Aida Hani Mohd Kalok, Norlia Abdullah, Ian Paddick, Ramesh Kumar
{"title":"Experience of Gamma Knife radiosurgery for treatment of brain metastases in pregnancy with literature review.","authors":"Beehong Soon, Fuad Ismail, Marfu'ah Nik Ezzamudden, Shahizon Azura Mohamed Mukari, Aida-Widure Mustapha Mohd Mustapha, Aida Hani Mohd Kalok, Norlia Abdullah, Ian Paddick, Ramesh Kumar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Brain metastases during pregnancy poses complex conundrum in management. Stereotactic radiosurgery (SRS) offers valuable option to clinicians in this scenario. We reviewed and described the safety and effectiveness of Gamma Knife (GK) SRS in treating a solitary cerebellar metastasis in a patient with recurrent breast cancer at 28 weeks of gestation. Following multidisciplinary discussion, she consented for urgent single session GK SRS to the brain metastasis with 2 cycles of 3-weekly paclitaxel chemotherapy prior to planned delivery at term. Prior to the frame-based treatment, a trial run with dosimeters placed on the superior and inferior parts of foam knee support showed radiation exposure of 3.12 mSv and 1.06 mSv respectively. A prescription dose of 16 Gy at the 50% isodose was delivered using 24 isocentres over 39.7' of beam on time. The treatment plan had 98% coverage, 89% selectivity and a gradient index of 2.98. Dosimeters placed near the uterine fundus and suprapubic region (consistent with location of fetal head) during the actual treatment recorded 2.83 mSv and 0.27 mSv, which is lower than the trial dosimeter readings. The patient successfully completed SRS treatment and gave birth to a healthy baby two months later. Follow-up MRI at three months interval showed total resolution of the lesion. GK SRS is known for the lowest extracranial dose compared to other SRS modalities. This report and literature review confirmed that GK is a sharp and effective, yet gentle and safe treatment for pregnant patients with brain metastases.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 2","pages":"171-175"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Naba Ali, Jun Zhou, Bree R Eaton, Jeffrey M Switchenko, Yichun Cao, William A Stokes, Pretesh R Patel, Katja M Langen, Roelf Slopsema, Jeffrey D Bradley, Mark W McDonald
{"title":"Initial experience and patient tolerance of proton stereotactic body radiotherapy.","authors":"Naba Ali, Jun Zhou, Bree R Eaton, Jeffrey M Switchenko, Yichun Cao, William A Stokes, Pretesh R Patel, Katja M Langen, Roelf Slopsema, Jeffrey D Bradley, Mark W McDonald","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>To review our initial experience with proton-based SBRT to evaluate the planning outcomes and initial patient tolerance of treatment.</p><p><strong>Patients and methods: </strong>From Sep. 2019 to Dec. 2020, 52 patients were treated with proton SBRT to 62 lesions. Fractionation varied by indication and site with a median of 5 fractions and median fractional dose of 8 Gy. Planning outcomes, including plan heterogeneity, conformity, and PTV volume receiving 100% of the prescription dose (PTV V100%) were evaluated. Acute toxicities were prospectively recorded, and patient reported outcomes were assessed prior to and at completion of treatment using the MD Anderson Symptom Inventory (MDASI) and EQ-5D5L visual analogue score (VAS).</p><p><strong>Results: </strong>All treated patients completed their course of proton-based SBRT. The mean conformity index was 1.05 (range 0.51-1.48). R50% values were comparable to ideal photon parameters. PTV V100% was 89.9% on average (40.44% - 99.76%). 5 patients (10%) required plan modification due to setup or tumor changes. No patients developed a new grade 3 or greater toxicity during treatment. Comparing pretreatment to end of treatment timepoints, there was a significant improvement in the mean VAS (65 to 75, p = 0.014), with no significant change in the mean MDASI symptom (1.7, 1.8; p = 0.79) or interference (2.3, 2.4; p = 0.452) scores.</p><p><strong>Conclusion: </strong>Proton-based SBRT can achieve dosimetric goals required by major clinical photon trials. It was well-tolerated with no decrement in patient reported outcomes and a mean 10-point improvement in VAS at the conclusion of SBRT. Further follow-up is necessary for tumor control and late effects analysis.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 2","pages":"121-128"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tara Gray, Anna Maria Kolano, Chieh-Wen Liu, Young-Bin Cho, Jeremy Donaghue, Samuel Chao, John Suh, Ping Xia, Jonathan Farr
{"title":"Comprehensive assessment of proton plans with three different beam delivery systems for multiple brain metastases.","authors":"Tara Gray, Anna Maria Kolano, Chieh-Wen Liu, Young-Bin Cho, Jeremy Donaghue, Samuel Chao, John Suh, Ping Xia, Jonathan Farr","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>To compare plan quality among photon volumetric arc therapy (VMAT), Gamma Knife, and three different proton beam modalities.</p><p><strong>Methods: </strong>Fifty-five brain lesions from 20 patients were planned with three different proton spot size ranges of cyclotron-generated proton beams, CPBs (spot size σ: 2.7-7.0 mm), linear accelerator proton beams, LPBs (σ: 2.9-5.5 mm), and linear accelerator proton minibeams, LPMBs (σ: 0.9-3.9 mm), with and without apertures and compared against photon VMAT and Gamma Knife plans. Dose coverage to each lesion for each proton and photon plan was set to 99% of the GTV receiving the prescription (Rx) dose. All proton plans used ±2 mm setup uncertainty and ±2% range uncertainty in robust evaluation to achieve V<sub>100%Rx</sub> > 95% of the GTV. Apertures were applied to proton beams irradiating tumors <1 cm<sup>3</sup> volume and located <2.5 cm depth. Conformity index (CI), gradient index (GI), V<sub>12 Gy</sub>, V<sub>4.5 Gy</sub>, and mean brain dose were compared across all plan types. The Wilcoxon signed rank test was utilized to determine statistical significance of dosimetric results compared between photon and proton plans.</p><p><strong>Results: </strong>When compared to CPB generated plans, average CI and GI were significantly better for the LPB and LPMB plans. Aperture-based IMPT plans showed improvement from Gamma Knife for all dosimetric metrics. Aperture-based IMPT plans also showed improvement in all dosimetric metrics for shallow tumors (d < 2.5 cm) when compared with non-aperture-based plans.</p><p><strong>Conclusion: </strong>The LPB and LPMB stand as excellent alternatives to CPB or photon therapy and significantly increase the preservation of normal tissue.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 2","pages":"145-156"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141862057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Jose Perez-Calatayud, Antonio Menéndez, Françoise Lliso, Vicente Carmona, Antonio Conde, Francisco Celada, Mariola Bernisz, Carlos Botella, Jose Perez-Calatayud
{"title":"A single center, inter-observer evaluation of vestibular schwannoma stereotactic radiosurgery and its dosimetric impact.","authors":"Maria Jose Perez-Calatayud, Antonio Menéndez, Françoise Lliso, Vicente Carmona, Antonio Conde, Francisco Celada, Mariola Bernisz, Carlos Botella, Jose Perez-Calatayud","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of this work was to evaluate the inter- and intra-observer variation in contouring vestibular schwannoma (VS) and the organs-at-risk (OAR), and its dosimetric impact in Volumetric Modulated Arc Therapy (VMAT). Three VS typical cases were contoured by four clinicians. The Agreement Volume Index (AVI) appeared to be notably higher in VS than in OARs, such that the dose coverage of VS is fairly robust. In OARs, the largest variation was +1.02Gy in dmax for the brainstem, +0.78Gy in dmean for the cochlea and +1.05Gy in dmax of the trigeminal nerve. Accordingly, it was decided that all VS delineations for stereotactic radiosurgery (SRS), and all frame-based SRS contouring in general, should always be reviewed by a second physician. In addition, the retrospective presentation of VS cases at daily peer review meetings has also been adopted to ensure that the consensus is constantly updated, as well as for training purposes.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 2","pages":"113-120"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}