PO-0655 REDUCING HAEMATOLOGICAL TOXICITY FOR ADULT PATIENTS RECEIVING CRANIOSPINAL IRRADIATION WITH HELICAL TOMOTHERAPY

2012 ◽  
Vol 103 ◽  
pp. S256
Author(s):  
K. Petersson ◽  
M. Gebre-Medhin ◽  
C. Ceberg ◽  
P. Engström ◽  
T. Knöös ◽  
...  
Keyword(s):  
Helical Tomotherapy ◽  
Haematological Toxicity ◽  
Adult Patients ◽  
Craniospinal Irradiation

scholarly journals Haematological toxicity in adult patients receiving craniospinal irradiation – Indication of a dose-bath effect

2014 ◽  
Vol 111 (1) ◽  
pp. 47-51 ◽  
Author(s):  
Kristoffer Petersson ◽  
Maria Gebre-Medhin ◽  
Crister Ceberg ◽  
Per Nilsson ◽  
Per Engström ◽  
...  
Keyword(s):  
Haematological Toxicity ◽  
Adult Patients ◽  
Craniospinal Irradiation

scholarly journals Toxicity Reduction after Craniospinal Irradiation via Helical Tomotherapy in Patients with Medulloblastoma: A Unicentric Retrospective Analysis

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 501
Author(s):  
Anil Öztunali ◽  
Khaled Elsayad ◽  
Sergiu Scobioala ◽  
Mohammed Channaoui ◽  
Uwe Haverkamp ◽  
...  
Keyword(s):  
Helical Tomotherapy ◽  
Radiation Therapy Oncology Group ◽  
Survival Rates ◽  
Local Control Rate ◽  
Craniospinal Irradiation ◽  
Lower Grade ◽  
European Organization ◽  
Efficacious Treatment ◽  
Eortc Criteria ◽  
Reduced Rate

Objectives: Recent trials with craniospinal irradiation (CSI) via helical Tomotherapy (HT) demonstrated encouraging medulloblastoma results. In this study, we assess the toxicity profile of different radiation techniques and estimate survival rates. Materials and Methods: We reviewed the records of 46 patients who underwent irradiation for medulloblastoma between 1999 and 2019 (27 conventional radiotherapy technique (CRT) and 19 HT). Patient, tumor, and treatment characteristics, as well as treatment outcomes—local control rate (LCR), event-free survival (EFS), and overall survival (OS)—were reviewed. Acute and late adverse events (AEs) were evaluated according to the Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer (RTOG/EORTC) criteria. Results: In total, 43 courses of CSI and three local RT were administered to the 46 patients: 30 were male, the median age was 7 years (range 1–56). A median total RT dose of 55 Gy (range 44–68) and a median CSI dose of 35 Gy (range, 23.4–40) was delivered. During follow-up (median, 99 months), six patients (13%) developed recurrence. The EFS rate after 5 years was 84%. The overall OS rates after 5 and 10 years were 95% and 88%, respectively. There were no treatment-related deaths. Following HT, a trend towards lower grade 2/3 acute upper gastrointestinal (p = 0.07) and subacute CNS (p = 0.05) toxicity rates was detected compared to CRT-group. The risk of late CNS toxicities, mainly grade 2/3, was significantly lower following HT technique (p = 0.003). Conclusion: CSI via HT is an efficacious treatment modality in medulloblastoma patients. In all, we detected a reduced rate of several acute, subacute, and chronic toxicities following HT compared to CRT.

Boost Gamma Knife surgery during multimodality management of adult medulloblastoma

2008 ◽  
Vol 108 (2) ◽  
pp. 204-209 ◽  
Author(s):  
Anand V. Germanwala ◽  
Jeffrey C. Mai ◽  
Nestor D. Tomycz ◽  
Ajay Niranjan ◽  
John C. Flickinger ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Tumor Progression ◽  
Posterior Fossa ◽  
Gamma Knife ◽  
Gamma Knife Surgery ◽  
Adult Patients ◽  
Craniospinal Irradiation ◽  
Time Interval ◽  
Radiation Toxicity ◽  
Adult Medulloblastoma

Object The aim of this paper was to determine prognostic factors for adult medulloblastoma treated with boost Gamma Knife surgery (GKS) following resection and craniospinal irradiation. Methods The authors performed a retrospective analysis of 12 adult patients with histologically proven medulloblastoma or supratentorial primitive neuroectodermal tumor who between February 1991 and December 2004 underwent ≥ 1 sessions of GKS for posttreatment residual or recurrent tumors (6 tumors in each group). Before GKS, all patients had undergone a maximal feasible resection followed by craniospinal irradiation. Nine patients also received systemic chemotherapy. Stereotactic radiosurgery was applied to residual and recurrent posterior fossa tumor as well as to foci of intracranial medulloblastoma metastases. The median time interval from initial diagnosis and resection to the first GKS treatment was 24 months (range 2–37 months). The mean GKS-treated tumor volume was 9.4 cm3 (range 0.5–39 cm3). Results Following adjunctive radiosurgery, 5 patients had no evidence of tumor on magnetic resonance (MR) imaging, 3 patients had stable tumor burden on MR imaging, and 4 patients had evidence of tumor progression locally with or without intracranial metastases. All patients with tumor progression died. Eight patients survive with a mean cumulative follow-up of 72.4 months (range 21– 152 months). No acute radiation toxicity or delayed radiation necrosis was observed among any of the 12 patients. The majority of patients who achieved tumor eradication (80%) and tumor stabilization (67%) after GKS had residual tumor as the reason for their referral for GKS. The best outcomes were attained in patients with residual disease who were younger, had smaller tumor volumes, had no evidence of metastatic disease, and had received higher cumulative GKS doses. Conclusions Single or multiple GKS sessions were a well-tolerated, feasible, and effective adjunctive treatment for posterior fossa residual or recurrent medulloblastoma as well as intracranial metastatic medulloblastoma in adult patients.

Daily setup uncertainty analysis for craniospinal irradiation using helical tomotherapy

2013 ◽  
Vol 3 (4) ◽  
pp. 349-355 ◽  
Author(s):  
Rolina Al-Wassia ◽  
Houda Bahig ◽  
Emily Poon ◽  
William Parker ◽  
Carolyn Freeman
Keyword(s):  
Uncertainty Analysis ◽  
Helical Tomotherapy ◽  
Craniospinal Irradiation

scholarly journals Practical Aspects of the Application of Helical Tomotherapy for Craniospinal Irradiation

2020 ◽  
Author(s):  
Joongyo Lee ◽  
Euidam Kim ◽  
Nalee Kim ◽  
Hwa Kyung Byun ◽  
Chang-Ok Suh ◽  
...  
Keyword(s):  
Weight Loss ◽  
Risk Factor ◽  
Pediatric Patients ◽  
Helical Tomotherapy ◽  
Craniospinal Irradiation ◽  
Setup Errors ◽  
Ap Weight ◽  
Setup Verification ◽  
The Difference ◽  
Pre Treatment

Abstract We investigated the practical aspects of the application of craniospinal irradiation using helical tomotherapy (HT-CSI) by evaluating interfractional setup errors and intrafractional movement during each treatment in 83 patients undergoing HT-CSI between January 2014 and December 2018. Interfractional setup errors in each axis (mediolateral; ML, craniocaudal; CC, and anteroposterior; AP) were assessed as differences between pre-treatment megavoltage computed tomography (MVCT) images scanned (zygomatic arch to the C4 spine) and planning CT images. Intrafractional movements were evaluated as the difference between pre-treatment and post-treatment MVCT (T12–L4 spine) images at each fraction. Median interfractional setup error was acceptable in every axis (ML: 1.6 mm, CC: 1.9 mm, AP: 3.1 mm). Seven patients (8.4%) experienced significant intrafractional displacement from 1 to 10 fractions (0.35% for ML, 0.77% for CC, 1.26% for AP). Weight loss grade 1+ during treatment (p=0.016) was an independent risk factor for significant intrafractional displacement. The risk factor for significant intrafractional movement in pediatric patients was weight loss grade 1+ (p=0.020), while there was no factor in adults. HT-CSI could be a feasible treatment modality with acceptable setup verification. Inter- and intrafractional errors were acceptable; paying attention to weight loss during treatment is necessary, especially in pediatric patients.

SU-GG-T-62: Helical Tomotherapy for Craniospinal Irradiation with Field Junctioning

2008 ◽  
Vol 35 (6Part9) ◽  
pp. 2740-2740
Author(s):  
H Jaradat ◽  
L Xu ◽  
G Lucas ◽  
T Lee
Keyword(s):  
Helical Tomotherapy ◽  
Craniospinal Irradiation
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