scholarly journals Analysis of using high-precision radiotherapy in the treatment of liver metastases regarding toxicity and survival

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Theresa Voglhuber ◽  
Kerstin A. Eitz ◽  
Markus Oechsner ◽  
Marco M. E. Vogel ◽  
Stephanie E. Combs
Keyword(s):  
Liver Metastases ◽  
High Precision ◽  
Cone Beam Ct ◽  
Hepatic Metastases ◽  
Grade 3 ◽  
Median Cumulative Dose ◽  
Loss Of Appetite ◽  
Enhanced Computed Tomography ◽  
Precision Radiotherapy ◽  
High Precision Radiotherapy

Abstract Background Hepatic metastases occur frequently in the context of many tumor entities. Patients with colorectal carcinoma have already developed liver metastases in 20% at the time of diagnosis, and 25–50% develop metastases in the further course of the disease and therapy. The frequent manifestation and the variable appearance of liver metastases result in an interdisciplinary challenge, regarding treatment management. The aim of this study was to evaluate high-precision stereotactic body radiotherapy (SBRT) for liver metastases. Methods A cohort of 115 patients with 150 irradiated liver metastases was analyzed. All metastases were treated between May 2004 and January 2020 using SBRT. A contrast-enhanced computed tomography (CT) was performed in all patients for treatment planning, followed by image-guided high-precision radiotherapy using cone-beam CT. A median cumulative dose of 35 Gy and a median single dose of 7 Gy was applied. Results Median OS was 20.4 months and median LC was 35.1 months with a 1-year probability of local failure of 18% (95%-CI: 12.0–24.3%). In this cohort, 18 patients were still alive at the time of evaluation. The median FU-time in total was 11.4 months and for living patients 26.6 months. 70.4% of patients suffered from acute toxicities. There were several cases of grade 1 and 2 toxicities, such as constipation (13.9%), nausea (24.4%), loss of appetite (7.8%), vomiting (10.4%), diarrhea (7.8%), and abdominal pain (16.5%). 10 patients (8.7%) suffered from grade 3 toxicities. Late toxicities affected 42.6% of patients, the majority of these affected the gastrointestinal system. Conclusion SBRT is becoming increasingly important in the field of radiation oncology. It has evolved to be a highly effective treatment for primary and metastasized tumors, and offers a semi-curative treatment option also in the case of oligometastatic patients. Overall, it represents a very effective and well-tolerated therapy option to treat hepatic metastases. Based on the results of this work and the studies already available, high-precision radiotherapy should be considered as a valid and promising treatment alternative in the interdisciplinary discussion.

scholarly journals High-Precision Radiotherapy for Benign Brain Tumors

2014 ◽  
Vol 23 (1) ◽  
pp. 37-42
Author(s):  
Yuta Shibamoto ◽  
Hiroyuki Ogino ◽  
Yoshihiko Manabe ◽  
Gakuo Iwabuchi ◽  
Hiromitsu Iwata ◽  
...  
Keyword(s):  
Brain Tumors ◽  
High Precision ◽  
Precision Radiotherapy ◽  
High Precision Radiotherapy

scholarly journals Patient-Reported Outcome (PRO) as an Addition to Long-Term Results after High-Precision Stereotactic Radiotherapy in Patients with Secreting and Non-Secreting Pituitary Adenomas: A Retrospective Cohort Study up to 17-Years Follow-Up

Cancers ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 1884
Author(s):  
Kerstin A. Kessel ◽  
Christian D. Diehl ◽  
Markus Oechsner ◽  
Bernhard Meyer ◽  
Jens Gempt ◽  
...  
Keyword(s):  
High Precision ◽  
Stereotactic Radiotherapy ◽  
Pituitary Adenomas ◽  
Patient Reported Outcome ◽  
Long Term Results ◽  
Effective Treatment Option ◽  
Patient Reported ◽  
Precision Radiotherapy ◽  
High Precision Radiotherapy

High-precision radiotherapy has been established as a valid and effective treatment option in patients with pituitary adenomas. We report on outcome after fractionated stereotactic radiotherapy (FSRT) in correlation with patient-reported outcomes (PROs). We analyzed 69 patients treated between 2000 and 2019. FSRT was delivered with a median total dose of 54 Gy (single fraction: 1.8 Gy). PRO questionnaires were sent to 28 patients. Median overall survival was 17.2 years; mean local control was 15.6 years (median not reached). Median follow-up was 5.8 years. Twenty (71%) patients participated in the PRO assessment. Physicians reported symptoms grade ≥3 in 6 cases (9%). Of all, 35 (51%) patients suffered from hypopituitarism at baseline, and during follow-up, new or progressive hypopituitarism was observed in 11 cases (16%). Patients reported 10 cases of severe side effects. Most of these symptoms were already graded as CTCAE (Common Terminology Criteria for Adverse Events) grade 2 by a physician in a previous follow-up exam. PROs are an essential measure and only correlate to a certain extent with the physician-reported outcomes. For high-precision radiotherapy of pituitary adenomas, they confirm excellent overall outcomes and low toxicity. In the future, the integration of PROs paired with high-end treatment will further improve outcomes.

Fine-needle Marker for IGRT, a New Fiducial Gold Anchor for High-precision Radiotherapy

2009 ◽  
Vol 75 (3) ◽  
pp. S608-S609 ◽  
Author(s):  
I. Naslund ◽  
P. Wersall ◽  
E. Castellanos ◽  
C. Beskow ◽  
S. Nyrén
Keyword(s):  
High Precision ◽  
Fine Needle ◽  
Precision Radiotherapy ◽  
High Precision Radiotherapy

scholarly journals Risk-adapted single or fractionated stereotactic high-precision radiotherapy in a pooled series of nonfunctioning pituitary adenomas

2014 ◽  
Vol 190 (12) ◽  
pp. 1095-1103 ◽  
Author(s):  
Jan Patrick Boström ◽  
Almuth Meyer ◽  
Bogdan Pintea ◽  
Rüdiger Gerlach ◽  
Gunnar Surber ◽  
...  
Keyword(s):  
High Precision ◽  
Pituitary Adenomas ◽  
Nonfunctioning Pituitary Adenomas ◽  
Precision Radiotherapy ◽  
High Precision Radiotherapy

First experience with a new implantable gold marker for extracranial high precision radiotherapy

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 5144-5144
Author(s):  
V. Vinh-Hung ◽  
J. De Mey ◽  
P. De Sutter ◽  
B. Neyns ◽  
Y. Van Nieuwenhove ◽  
...  
Keyword(s):  
High Precision ◽  
Precision Radiotherapy ◽  
Gold Marker ◽  
High Precision Radiotherapy

First experience with a new implantable gold marker for extracranial high precision radiotherapy

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 5144-5144
Author(s):  
V. Vinh-Hung ◽  
J. De Mey ◽  
P. De Sutter ◽  
B. Neyns ◽  
Y. Van Nieuwenhove ◽  
...  
Keyword(s):  
High Precision ◽  
Precision Radiotherapy ◽  
Gold Marker ◽  
High Precision Radiotherapy

Re-irradiation using high precision radiotherapy and concomitant temozolomide in patients with recurrent glioma: Re- challenge with radio-chemotherapy

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 12517-12517 ◽  
Author(s):  
S. E. Combs ◽  
D. Schulz-Ertner ◽  
T. Welzel ◽  
M. Bischof ◽  
J. Debus
Keyword(s):  
Tumor Progression ◽  
High Precision ◽  
Safety Margin ◽  
Recurrent Glioma ◽  
Subtotal Resection ◽  
Time Interval ◽  
Small Lesion ◽  
Who Grade ◽  
Precision Radiotherapy ◽  
High Precision Radiotherapy

12517 Background: This study was aimed to assess the toxicity and efficacy of radiochemotherapy (RCHT) with temozolomide performed as re-irradiation in patients with recurrent glioma. Patients and Methods: We treated 17 patients with RCHT for recurrent glioma between July 2005 and December 2006. Nine patients were female, eight were male. Pathology evaluation revealed WHO grade II astrocytoma in 5, anaplastic astrocytoma in 4 and glioblastoma multiforme (GBM) in 7 patients. One patient suffered from gliosarcoma. Median age at primary diagnosis was 33 years (range, 6–60 years). In 4 patients surgery had been performed as total resection, subtotal resection in 9 and as a biopsy in 4 patients. Median doses of radiotherapy (RT) of 60 Gy had been applied. Prior treatment with temozolomide either as RCHT or as chemotherapy alone for tumor progression had been performed in 8 patients. The median time interval between primary RT and re-irradiation was 29.5 months (range 5–180 months). Re-irradiation was performed as high precision radiotherapy using fractionated stereotactic radiotherapy (FSRT) in 16 patients with a median total dose of 36 Gy (range, 28–36 Gy); in one patients stereotactic radiosurgery (SRS) was applied for a very small lesion with a single dose of 18Gy/80% isodose. The target volume was defined as the area of contrast enhancement on T1-weighed MRI-scans including a safety margin of 0.5 to 1 cm. Chemotherapy was applied concomitantly in a median dose of 50 mg/m2 per day (median of 100mg TMZ qd); in 14 patients RCHT was followed by adjuvant cycles of temozolomide. Results: Treatment could be completed in all patients without interruptions due to side effects; no severe acute or long-term toxicities were observed. One patient with recurrent GBM showed tumor progression during therapy and treatment was stopped at 32 Gy out of 36 Gy. Progression-free survival was 56% at 6 months after FSRT; survival after FSRT was 75% at 6 months. Median overall survival was 39 months, with 92% at 1 and 2 years. Conclusions: High-precision RT and concomitant temozolomide is safe and effective when performed as re-irradiation in recurrent glioma. The data demonstrate that re-challenge with temozolomide justifies further evaluation. No significant financial relationships to disclose.

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