Principles of Image-Guided Hypofractionated Radiotherapy of Spine Metastases

Author(s):  
Johannes Roesch ◽  
Stefan Glatz ◽  
Matthias Guckenberger
2007 ◽  
Vol 34 (6Part18) ◽  
pp. 2566-2566
Author(s):  
Y Guan ◽  
C Della Biancia ◽  
J Chang ◽  
E Yorke ◽  
K Rosenzweig ◽  
...  

2017 ◽  
Vol 42 (1) ◽  
pp. E9 ◽  
Author(s):  
Eric Lis ◽  
Atin Saha ◽  
Kyung K. Peck ◽  
Joan Zatcky ◽  
Michael J. Zelefsky ◽  
...  

OBJECTIVE High-dose image-guided radiation therapy (HD IGRT) has been instrumental in mitigating some limitations of conventional RT. The recent emergence of dynamic contrast-enhanced (DCE) MRI to investigate tumor physiology can be used to verify the response of human tumors to HD IGRT. The purpose of this study was to evaluate the near-immediate effects of HD IGRT on spine metastases through the use of DCE MRI perfusion studies. METHODS Six patients with spine metastases from prostate, thyroid, and renal cell carcinoma who underwent HD IGRT were studied using DCE MRI prior to and 1 hour after HD IGRT. The DCE perfusion parameters plasma volume (Vp) and vascular permeability (Ktrans) were measured to assess the near-immediate and long-term tumor response. A Mann-Whitney U-test was performed to compare significant changes (at p ≤ 0.05) in perfusion parameters before and after RT. RESULTS The authors observed a precipitous drop in Vp within 1 hour of HD IGRT, with a mean decrease of 65.2%. A significant difference was found between Vp values for before and 1 hour after RT (p ≤ 0.05). No significant change was seen in Vp (p = 0.31) and Ktrans (p = 0.1) from 1 hour after RT to the first follow-up. CONCLUSIONS The data suggest that there is an immediate effect of HD IGRT on the vascularity of spine metastases, as demonstrated by a precipitous decrease in Vp. The DCE MRI studies can detect such changes within 1 hour after RT, and findings are concordant with existing animal models.


2012 ◽  
Vol 1 (4) ◽  
pp. 355-361 ◽  
Author(s):  
Chirag Shah ◽  
Neelam Tyagi ◽  
Inga S. Grills ◽  
Larry L. Kestin ◽  
Hong Ye ◽  
...  

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Maurizio Valeriani ◽  
Alessia Carnevale ◽  
Linda Agolli ◽  
Paolo Bonome ◽  
Adelaide Montalto ◽  
...  

Aim. To evaluate efficacy and toxicity of image-guided hypofractionated radiotherapy (HFRT) in the treatment of low-risk prostate cancer. Outcomes and toxicities of this series of patients were compared to another group of 32 low-risk patients treated with conventional fractionation (CFRT).Methods. Fifty-nine patients with low-risk prostate cancer were analysed. Total dose for the prostate and proximal seminal vesicles was 60 Gy delivered in 20 fractions.Results. The median follow-up was 30 months. The actuarial 4-year overall survival, biochemical free survival, and disease specific survival were 100%, 97.4%, and 97.4%, respectively. Acute grade 1-2 gastrointestinal (GI) and genitourinary (GU) toxicity rates were 11.9% and 40.7%, respectively. Grade 1 GI and GU late toxicity rates were 8.5% and 13.6%, respectively. No grade ≥2 late toxicities were recorded. Acute grade 2-3 GU toxicity resulted significantly lower (P=0.04) in HFRT group compared to the CFRT group. The cumulative 4-year incidence of grade 1-2 GU toxicity was significantly higher (P<0.001) for HFRT patients.Conclusions. Our study demonstrated that hypofractionated regimen provided excellent biochemical control in favorable risk prostate cancer patients. The incidence of GI and GU toxicity was low. However, HFRT presented higher cumulative incidence of low-grade late GU toxicity than CFRT.


2018 ◽  
Vol 124 (1) ◽  
pp. 65-78 ◽  
Author(s):  
Barbara Alicja Jereczek-Fossa ◽  
Alessia Surgo ◽  
Patrick Maisonneuve ◽  
Andrea Maucieri ◽  
Marianna Alessandra Gerardi ◽  
...  

2019 ◽  
Vol 125 (1) ◽  
pp. 107-107
Author(s):  
Barbara Alicja Jereczek-Fossa ◽  
Alessia Surgo ◽  
Patrick Maisonneuve ◽  
Andrea Maucieri ◽  
Marianna Alessandra Gerardi ◽  
...  

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