Journal of radiosurgery and SBRT最新文献

{"title":"External validation of a genomic signature for oligometastatic non-small cell lung cancer.","authors":"Ariel R Choi, Ralph B D'Agostino, Claire M Lanier, Sarah Glynn, Patrick Young, Michael K Farris, Mohammed Abdulhaleem, Yuezhu Wang, Margaret R Smith, Jimmy Ruiz, Thomas W Lycan, W Jeffrey Petty, Christina K Cramer, Wencheng Li, Jing Su, Christopher T Whitlow, Fei Xing, Michael D Chan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>We previously presented a genomic signature predictive of both oligometastatic disease state and oligoprogression in patients with brain metastases. We sought to validate this oligometastatic genomic signature using an independent dataset of patients without brain metastases.</p><p><strong>Methods: </strong>Patients with non-small cell lung cancer (NSCLC) and liquid biopsy-based genomic profiling (Guardant Health) were identified in our departmental database. Those with brain metastases were excluded. Patients were assigned an oligometastatic risk score based on the previously derived genomic signature. Oligometastatic disease was defined as ≤5 metastases without diffuse single-organ involvement. For oligometastatic patients, we performed a competing risk analysis for the cumulative incidence of oligoprogression. Cox regression was used to determine association between oligometastatic risk score and oligoprogression.</p><p><strong>Results: </strong>A total of 225 patients met inclusion criteria for this validation dataset. 158 patients (70%) had oligometastatic disease. Patients with positive and neutral/negative risk scores had a 70 vs 48% likelihood of oligometastatic disease, respectively (<i>p</i> = 0.03 from Fisher's exact test). Patients with positive risk scores more frequently experienced oligoprogression with a hazard ratio of 1.72 (<i>p</i> = 0.11). Overall survival for patients with positive and neutral/negative risk scores was 92% vs 79% at 6 months; 46% vs 60% at 12 months; 23% vs 34% at 24 months (<i>p</i> = 0.25).</p><p><strong>Conclusion: </strong>In this independent dataset, our genomic signature predicted oligometastatic disease state and showed a trend towards prediction of oligoprogression. With further study, our findings may suggest a biomarker with future potential to direct local therapies in oligometastatic NSCLC patients.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 ","pages":"265-272"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12708001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774208","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":"Stereotactic body radiotherapy for unresectable or locally recurrent pancreatic cancer: A single centre experience.","authors":"Draghini Lorena, Tebala Giovanni Domenico, Casale Michelina, Marzo Alessandro Di, Desiderio Jacopo, Trippa Fabio","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>To refer our experience with stereotactic body radiotherapy (SBRT) in patients with pancreatic cancer.</p><p><strong>Materials and methods: </strong>45 Patients with unresectable or locally recurrent pancreatic cancer after primary surgery, were submitted to SBRT. Toxicities were graded according to CTCAE version 5. Statistical analysis was performed by the Kaplan-Meier method.</p><p><strong>Results: </strong>The characteristics of the patients were median age 70 years (range, 46-84 years), median KPS 90% (range, 80-90%). Six patients had recurrent cancer after surgery, the other 39 patients were unresectable. Median radiation dose was 35 Gy (range, 27-40 Gy) delivered in 5 fractions. Simultaneous integrated boost with median dose of 35 Gy (range, 30-45 Gy) was given in 7 patients.After median follow-up of 10 months (range, 3-61 months) median local control was 10 months (range,5-15 months) and 49% (±8%) at 1-year. Median overall survival (OS) was 10 months (range,7-14 months), 38 % (±7%) at 1 year. Type of radiological response statistically significant influenced LC and OS, stage only LC in non-significant way. Clinical response was obtained in 12 of 36 (33%) cases. Median Numeric Rating Scale (NRS) was 7 (range, 4-8) before radiotherapy and 1 (range, 0-5) post SBRT. Acute G1-2 gastrointestinal toxicities were registered in 15% of patients, no late toxicities were found.</p><p><strong>Conclusion: </strong>In our series we obtained a good local palliation with SBRT that is a safe and effective treatment option. Higher doses could be administered in selected patients to obtain better response to treatment that is correlated with LC and OS.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 3","pages":"207-213"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234427","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":"Evaluating the efficacy of stereotactic radiotherapy for metastatic colorectal cancer: A retrospective review of clinical outcomes.","authors":"Beini Chen, Justin Smith, Revadhi Chelvarajah, Alexandra Knesl, Parushka Moodley, David Pryor, Mark B Pinkham, G Tao Mai, Howard Y Liu, Yoo Young Lee","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in systemic therapy, survival in metastatic colorectal cancer (mCRC) remains poor. The utility of stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS), allowing dose escalation to achieve improved local control has risen in the treatment of mCRC. However, local control (LC) and overall survival (OS) varies widely between studies, and prognostic factors are not well defined.</p><p><strong>Methods: </strong>We retrospectively assessed LC and OS in patients with mCRC treated with SBRT/SRS between 2014 and 2022.</p><p><strong>Results: </strong>124 Patients were treated during the study period. Median follow up was 16.4 months (0.2-93.1 months). There were 310 lesions treated with 53% located in the brain, 22% lung, 16% liver, 4% bone, 4% nodal and 1% other. Biologically effective dose (BED10) ranged from 33.6 to 151.2 Gy.LC was 75% (95% CI 67-81%) at 1 year and 65% (95%CI 56-73%) 2 years. On multivariable analysis (MVA), older age (HR 1.04, <i>p</i> = 0.001) and tumour volume >2.5 cc (HR 3.13, <i>p</i> < 0.001) were associated with worse LC.OS from first course of SBRT/SRS was 68% at 1 year (95%CI 58-76%), and 48% at 2 years (95%CI 38-58%). On MVA, ≥2 or more lines of systemic therapy (HR 3.04, <i>p</i> < 0.001) and brain metastases (HR 4.24, <i>p</i> = 0.001) were associated with shorter OS. Living long enough to receive ≥2 courses of SBRT/SRS (HR 0.20, <i>p</i> = 0.004) was associated with longer OS.</p><p><strong>Conclusion: </strong>This study demonstrates that SBRT and SRS offer effective local control, and LC is associated with tumour volume.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 3","pages":"237-243"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234422","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":"Fractionated repeat Gamma Knife stereotactic radiosurgery for locally recurrent brain metastases.","authors":"Trent Kite, James Nassur, Yun Liang, Stephen Karlovits, Matthew J Shepard, Rodney E Wegner","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Survival of patients with brain metastases (BMs) is increasing. Consequently, local disease recurrence of previously treated BMs has become more prevalent. Stereotactic radiosurgery (SRS) has been employed as a salvage therapy; however, concerns over adverse radiation events (AREs) persist. Utilization of a fractionated approach may reduce AREs in this population.</p><p><strong>Methods: </strong>A retrospective review of locally recurrent BMs was conducted. The primary outcome was local control and AREs. Utilizing the Kaplan-Meier method, we analyzed the time to local control (LC) and overall survival (OS) for each recurrent lesion treated with SRS. Cox regression analysis was employed to examine predictors of LC and OS.</p><p><strong>Results: </strong>Our cohort consisted of 45 patients with a median age of 62 years [interquartile range (IQR): 56.3-68.0]. The median lesion volume at the time of repeat SRS was 3.3 cm³ (IQR: 0.75-8.8). Patients were treated with a median prescription dose of 27.0 Gy (IQR: 25.0-30.0) over a median of five fractions (range: 3-5). Actuarial LC rates at 3, 6, 12, and 24 months were: 79.4%, 72.2%, 61.7%, and 54.9%, respectively. There was no ≥grade 3 treatment toxicity reported. On univariate analysis Karnofsky performance status: >70 (HR: 0.17, 95% CI: 0.06-0.5, <i>p</i> = 0.001) and the presence of extracranial disease at SRS (HR: 2.7, 95% CI: 1.04-6.97, <i>p</i> = 0.04) were significantly associated with overall survival (OS).</p><p><strong>Conclusion: </strong>Repeat fractionated SRS is safe and efficacious for locally recurrent BMs. Performance status and systemic disease control are predictors of OS in this population.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 ","pages":"305-311"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774179","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":"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}

{"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}

{"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}

{"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":"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}

{"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}