scholarly journals Tolerance of the Optic Apparatus in Single-Fraction Irradiation Using Stereotactic Radiosurgery

Neurosurgery ◽  
2010 ◽  
Vol 66 (4) ◽  
pp. 688-695 ◽  
Author(s):  
Toshinori Hasegawa ◽  
Tatsuya Kobayashi ◽  
Yoshihisa Kida
Keyword(s):  
Radiation Therapy ◽  
Optic Neuropathy ◽  
Survival Rates ◽  
Gamma Knife Radiosurgery ◽  
Progression Free Survival ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Single Fraction ◽  
Kaplan Meier ◽  
Radiation Induced

Abstract OBJECTIVE To determine the limiting dose to the optic apparatus in single-fraction irradiation in patients with craniopharyngioma treated with gamma knife radiosurgery (GKRS). METHODS One hundred patients with 109 craniopharyngiomas treated with GKRS were evaluated with a median follow-up period of 68 months. Tumor volume varied from 0.1 to 36.0 (median, 3.3) cm3. Marginal doses varied from 10 to 18 (median, 11.4) Gy. Maximum dose to any part of the optic apparatus varied from 2 to 18 (median, 10) Gy. RESULTS The actuarial 5- and 10-year overall rates of survival of tumor progression after GKRS were 93% and 88%, respectively. Similarly, the actuarial 5- and 10-year progression-free survival rates were 62% and 52%, respectively. Among 94 patients in whom visual function was evaluable after GKRS, only 3 patients developed radiation-induced optic neuropathy, indicating an overall Kaplan-Meier radiation-induced optic neuropathy rate of 5%. Of these patients, 2 received 15 Gy or greater to the optic apparatus. Another patient who received 8 Gy or less had undergone previous fractionated radiation therapy with a biologically effective dose of 60 Gy. CONCLUSION The optic apparatus seems to be more tolerant of irradiation than previously thought. Careful dose planning is essential, particularly in patients who underwent prior external beam radiation therapy.

scholarly journals Repeated CyberKnife stereotactic body radiation therapy in hepatocellular carcinoma

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Jing Sun ◽  
Can Ouyang ◽  
Xiaoyun Chang ◽  
Aimin Zhang ◽  
Quan Wang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiation Therapy ◽  
Stereotactic Body Radiation Therapy ◽  
Medical Center ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Interval Time ◽  
Stereotactic Body Radiation ◽  
Kaplan Meier ◽  
Radiation Induced

Abstract Background To explore the survival and side effects of repeated CyberKnife stereotactic body radiation therapy (CK-SBRT) on hepatocellular carcinoma patients. Methods 24 HCC patients were collected at The Fifth Medical Center of PLA General Hospital from November 2011 to July 2016. They received second-course CK-SBRT with a prescribed dose of 50(48–55) Gy/5-8fx, and a single dose of 10 (7–11) Gy/fx. Cumulative overall survival rates (OS), progression-free survival rates (PFS) and local control rates (LC) were calculated by Kaplan-Meier method. Results All patients finished their radiotherapy plans. The 1-,2- and 3-year cumulative OS rate were 95.8,81.1 and 60.8%. The 1-,2- and 3-year LC rate were 95.5,90.7 and 90.7%, respectively. The 1-, 2- and 3-year PFS were 74.8, 49.2 and 39.4%, respectively. 16 patients complained of fatigue during second-course therapy, 2 patients showed Grade 2 gastrointestinal reaction, 1 patient was diagnosed radiation-induced liver disease and none died. PFS was significantly higher in the interval time < 12 months group than in the interval time ≥ 12 months group (p = 0.030). Conclusions It is preliminarily believed that re-CK-SBRT is an effective and safe treatment for HCC patients, but the treatment criteria should be strictly controlled.

Combined stereotactic split-course fractionated gamma knife radiosurgery and conventional radiation therapy for unfavorable gliomas: a phase I study

2000 ◽  
Vol 93 (supplement_3) ◽  
pp. 37-41 ◽  
Author(s):  
William F. Regine ◽  
Roy A. Patchell ◽  
James M. Strottmann ◽  
Ali Meigooni ◽  
Michael Sanders ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Disease Progression ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
External Beam Radiation ◽  
Low Grade ◽  
Beam Radiation ◽  
Content Type ◽  
Group B ◽  
Fine Print

Object. This investigation was performed to determine the tolerance and toxicities of split-course fractionated gamma knife radiosurgery (FSRS) given in combination with conventional external-beam radiation therapy (CEBRT). Methods. Eighteen patients with previously unirradiated, gliomas treated between March 1995 and January 2000 form the substrate of this report. These included 11 patients with malignant gliomas, six with low-grade gliomas, and one with a recurrent glioma. They were stratified into three groups according to tumor volume (TV). Fifteen were treated using the initial FSRS dose schedule and form the subject of this report. Group A (four patients), had TV of 5 cm3 or less (7 Gy twice pre- and twice post-CEBRT); Group B (six patients), TV greater than 5 cm3 but less than or equal to 15 cm3 (7 Gy twice pre-CEBRT and once post-CEBRT); and Group C (five patients), TV greater than 15 cm3 but less than or equal to 30 cm3 (7 Gy once pre- and once post-CEBRT). All patients received CEBRT to 59.4 Gy in 1.8-Gy fractions. Dose escalation was planned, provided the level of toxicity was acceptable. All patients were able to complete CEBRT without interruption or experiencing disease progression. Unacceptable toxicity was observed in two Grade 4/Group B patients and two Grade 4/Group C patients. Eight patients required reoperation. In three (38%) there was necrosis without evidence of tumor. Neuroimaging studies were available for evaluation in 14 patients. Two had a partial (≥ 50%) reduction in volume and nine had a minor (> 20%) reduction in size. The median follow-up period was 15 months (range 9–60 months). Six patients remained alive for 3 to 60 months. Conclusions. The imaging responses and the ability of these patients with intracranial gliomas to complete therapy without interruption or experiencing disease progression is encouraging. Excessive toxicity derived from combined FSRS and CEBRT treatment, as evaluated thus far in this study, was seen in patients with Group B and C lesions at the 7-Gy dose level. Evaluation of this novel treatment strategy with dose modification is ongoing.

Comprehensive Analysis of the Kinetics of Radiation-Induced Lymphocyte Loss in Patients Treated with External Beam Radiation Therapy

2019 ◽  
Vol 193 (1) ◽  
pp. 73 ◽  
Author(s):  
Susannah G. Ellsworth ◽  
Anirudh Yalamanchali ◽  
Hong Zhang ◽  
Stuart A. Grossman ◽  
Robert Hobbs ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
External Beam Radiation Therapy ◽  
Comprehensive Analysis ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Radiation Induced ◽  
Kinetics Of

scholarly journals Can Tomato Powder Reduce Radiation-Induced Effects in a Murine Model of Prostate Cancer?

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 348-348
Author(s):  
Joe Rowles III ◽  
Matthew Wallig ◽  
Kimberly Selting ◽  
Timothy Fan ◽  
Rita Miller ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Inflammatory Markers ◽  
Cell Damage ◽  
External Beam Radiation ◽  
Surrounding Tissue ◽  
C Reactive Protein ◽  
Beam Radiation ◽  
Reactive Protein ◽  
Mouse Prostate ◽  
Radiation Induced

Abstract Objectives Tomatoes contain carotenoids and other potent antioxidants that may protect the surrounding tissue from the detrimental effects of external beam radiation therapy, while reducing rates of prostate carcinogenesis. The objective of this study was to determine whether dietary lyophilized tomato paste (TP) alters early inflammatory and oxidative events following a single dose of radiation and leads to a more successful therapeutic outcome. Methods Male Transgenic Adenocarcinoma of the Mouse Prostate (TRAMP) mice (n = 76) were provided a powdered AIN-93 G diet (Control) or a modified AIN-93 G diet containing 10% TP (w/w) at 4 weeks of age. Mice were monitored by ultrasound for in vivo tumor detection and 3-D volumetric measurement biweekly. Once tumors reached a volume of 1000 mm3, the caudal half of the mouse was irradiated with 7.5 gy (Rad, n = 18–19 per diet) or 0 gy (sham, n = 16–20 per diet) with a Cobalt-60 source. Mice were euthanized 24 hours after radiation or sham treatment. Antioxidants (carotenoids and α-tocopherol) were measured by high performance liquid chromatography (HPLC) in the serum, tumor, prostate, and liver. Sections of tumor, liver, kidneys, bladder, lymph, bladder and intestines were stained by hematoxylin and eosin (H&E) and cleaved-caspase 3 were assessed for radiation-induced changes and apoptosis. Inflammatory markers (C-reactive protein, IL-6, IL-17A, TNFα, IFNγ, and IL-10) were measured in serum, liver, prostate, tumor, and epididymal adipose tissues by ELISA. Results This study is the first to explore the effects of TP on the tumor microenvironment following irradiation. Initial results suggest that TP consumption does not alter circulating or tissue (liver and prostate) concentrations of inflammatory markers (C-reactive protein, TNFα, IFNγ, IL-6, IL-17, or IL-10). We hypothesize that TP-Rad will maintain similar levels of circulating concentrations of antioxidants (carotenoids and α-tocopherol) compared to sham-treated mice. Additionally, we hypothesize that TP will reduce markers of cell damage in surrounding tissues. Conclusions This study will provide important preclinical data to inform future clinical trials evaluating approaches to lessen extra-prostatic damage from radiation therapy and thus improve therapeutic outcomes. Funding Sources This work was supported by USDA NIFA ILLU-971–334.

scholarly journals COMPLICATIONS OF NEOADYAVANT THERAPY FOR CANCER OF THE HEAD OF THE PANCREAS

2019 ◽  
Vol 18 (3) ◽  
pp. 20-25
Author(s):  
R. I. Rasulov ◽  
M. V. Zemko ◽  
A. V. Shelekhov ◽  
K. G. Zubrinckiy ◽  
G. I. Songolov
Keyword(s):  
Radiation Therapy ◽  
Pancreatic Head ◽  
External Beam Radiation Therapy ◽  
Gastroduodenal Artery ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Pancreatic Head Cancer ◽  
Radiation Induced ◽  
Head Of The Pancreas

Aim: to study complications of preoperative chemoembolization of the gastroduodenal artery and external beam radiation therapy in patients with pancreatic head cancer.Material and Methods. Sixty patients underwent chemoembolization of the gastroduodenal artery and external beam radiation therapy. Femoral artery angiography was performed using the Seldinger’s technique. Lipiodol 5–7 ml and gemcitabine 400 mg/m2 were used for transarterial chemoembolization. Radiation therapy was given at a total dose of 50 Gy (2 Gy/fraction, 5 times a week, over 5 weeks) using AGAT -R apparatus.Results. Complications after chemoembolization of the gastroduodenal artery were observed in 18.3 % of patients: abdominal pain in 3.3 % of patients; pain and nausea in 3.3 %; pain, nausea and fever in 6.7 %; pain, nausea and increased blood amylase in 1.7 %; pain, nausea and fever, blood amylase in 1.7 %; nausea, fever and blood amylase in 1.7 %. Radiation-induced injuries were observed in 23.3 % of patients: erythema in 18.3 %, grade 1 leukopenia in 1.7% and grade 2 leukopenia in 3.3 %.Conclusion. Complications of neoadjuvant therapy in terms of frequency and severity were consistent with literature data, were manageable with conservative treatment, and did not increase the duration of the preoperative period.

scholarly journals RADT-40. TRENDS IN THE USE OF RADIATION FOR MENINGIOMA ACROSS THE UNITED STATES

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii190-ii190
Author(s):  
Hirsch Matani ◽  
Stephen Abel ◽  
Linda Xu ◽  
Alexander Yu ◽  
Tulika Ranjan ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Tumor Size ◽  
Survival Benefit ◽  
Survival Curve ◽  
Survival Rates ◽  
The United States ◽  
External Beam Radiation ◽  
Treatment Facility ◽  
Beam Radiation ◽  
Who Grade

Abstract BACKGROUND Meningiomas are tumors originating from arachnoid cap cells on the surface of the brain or spinal cord. Treatment differs by grade but can consist of surgery, radiation therapy or both. We utilized the national cancer database (NCDB) to compare trends in the use stereotactic radiosurgery (SRS) and external beam radiation therapy (EBRT) in the management of meningioma. METHODS We queried the NCDB from 2004-15 for meningioma patients (Grade 1-3) treated with radiation therapy, either SRS or EBRT. Multivariable logistic regression was used to identify predictors of each treatment and to generate a propensity score. Propensity adjusted Kaplan-Meier survival curve analysis and multivariable cox hazards ratios were used to identify predictors of survival. RESULTS We identified 5406 patients with meningioma meeting above criteria. Median follow up was 43 months. 45%, 44%, and 11% were Grade 1, 2, and 3, respectively. Predictors for SRS were distance from treatment facility and histology. Predictors of EBRT were tumor size and WHO grade 2 or 3 disease. Tumor size, treatment year, and receipt of chemotherapy were associated with improved survival. Five and ten year survival rates were 89.2% vs. 72.6% (p &lt; 0.0001) and 80.3% vs. 61.4% (p = 0.29) for SRS and EBRT respectively. After propensity matching 226 pairs were generated. For SRS, 5 year survival was not significantly improved at 88.2% (p = 0.056) CONCLUSIONS In the present analysis, predictors of SRS utilization in management of meningioma include distance from treatment facility and histology whereas conventional EBRT utilization was associated with tumor size and grade 2 or 3 disease. Despite a possible survival benefit with SRS, inherent selection bias may confound interpretation of the apparent survival benefit reflected in our study.

Comparision of survival rates of patients (pts) with localized prostate cancer (T1-2N0M0) treated with brachytherapy (BT) and external beam radiation therapy (EBRT): Surveillance Epidemiology and End Results (SEER) database review.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 124-124
Author(s):  
Anteneh A. Tesfaye
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
High Risk ◽  
Survival Rates ◽  
Localized Prostate Cancer ◽  
External Beam Radiation ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Beam Radiation ◽  
Risk Levels

124 Background: Unlike in localized prostate cancer with low recurrence risk features, the role of BT in localized prostate cancer with intermediate and high risk features is not well defined. The aim of this study is to compare the survival rates of such pts treated with BT & EBRT using the SEER database in the 3 different risk levels. Methods: The 1973-2009 SEER database was reviewed for men with T1-2N0M0 prostate cancer treated with radiation therapy alone between 2004-2009. Pts with additional malignancies and combination radiation therapy were excluded. Localized Prostate cancer was stratified into low (T1, T2a and PSA<10 and Gleason ≤6), intermediate (T2b or PSA=10-20 or Gleason =7) and high (T2c or PSA >20 or Gleason ≥8) risk for recurrence. Results: A total of 73,867 pts were retrieved from the database, of which 24,661 (33.4%) were treated with BT and 49,206 (66.6%) with EBRT. Pts treated with BT had younger median age, lower PSA, Gleason’s score, and T staging than EBRT. Five year overall survival (OS) and cancer specific survival (CSS) rates are shown in the table. On multivariate analyses, T staging, PSA level, Gleason’s score and type of radiation therapy were independent prognostic factors for 5 year CSS & OS. In pts with localized prostate cancer, those treated with EBRT had 47% higher odds of dying from prostate cancer compared to those treated with BT at the end of 5 years. (HR (95% CI) =1.47 (1.113-1.94); p=0.007). Conclusions: In patients with localized prostate cancer treated with radiation alone, BT is seen to have superior 5 year OS over EBRT in all 3 risk levels. BT also has superior 5 year CSS in low and high risk levels, while being comparable in intermediate risk levels. Prospective randomized controlled trials are needed to validate this finding. [Table: see text]

A phase II Salvage Trial of AR Inhibition with ADT and Apalutamide with Radiation therapy followed by docetaxel in men with PSA recurrent prostate cancer (PC) after radical prostatectomy (STARTAR).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. TPS5097-TPS5097 ◽  
Author(s):  
Tian Zhang ◽  
Bridget F. Koontz ◽  
Scott T. Tagawa ◽  
Himanshu Nagar ◽  
Rhonda L. Bitting ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Radical Prostatectomy ◽  
Progression Free Survival ◽  
Positive Margin ◽  
Dropout Rate ◽  
External Beam Radiation ◽  
Recurrence Rates ◽  
Beam Radiation ◽  
Psa Relapse ◽  
Psa Recurrence

TPS5097 Background: Androgen deprivation combined with salvage external beam radiation therapy (RT) have improved survival for patients (pts) with non-metastatic hormone naïve PC and PSA recurrence after radical prostatectomy (RP). Our recent STREAM trial showed addition of enzalutamide to RT and ADT had a 3-year progression free survival (PFS) of 53%. Adding effective PC treatments in this setting may further improve 3-year PFS. Methods: STARTAR is an investigator-initiated phase 2 trial for salvage treatment of biochemically recurrent PC following prostatectomy. Key inclusion criteria include histologic prostate adenocarcinoma, either Gleason 7 with T3/positive margin/1-4 positive lymph nodes or Gleason 8-10 disease, PSA relapse within 4 years of prostatectomy (minimum PSA 0.2 ng/mL to maximum PSA 4 ng/mL). Treatment involves ADT with apalutamide for 9 months, continue with with prostate bed +/- nodal RT at month 3, followed by 6 cycles of docetaxel 75mg/m2 IV every 3 weeks for 6 cycles. The primary endpoint of the study is 3-year PFS. With a one-sided alpha of 0.05 to improve 3-year PFS from 50% to 75%, we will have 92% power by enrolling 42 pts (including 10% dropout rate) based on the binomial test. Key secondary endpoints include 1, 2, and 3-year PSA recurrence rates with testosterone recovery, PSA PFS, PSA nadir, time to testosterone recovery, and safety of combination therapy. Quality of life will be assessed by EPIC questionnaire. As of February 2019, we have enrolled and treated 12 pts in this PCCTC trial. Accrual to the STARTAR trial is ongoing (NCT03311555). Clinical trial information: NCT03311555.

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