scholarly journals Stereotactic Body Radiation Therapy for Ventricular Arrhythmias: Efficacy, Safety and Image Analysis-First Asian Population Study

2020 ◽  
Author(s):  
Li-Ting Ho ◽  
Jenny Ling-Yu Chen ◽  
Hsing-Min Chan ◽  
Yu-Cheng Huang ◽  
Mao-Yuan Su ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Adverse Events ◽  
Stereotactic Body Radiation Therapy ◽  
Asian Population ◽  
Target Volume ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Lower Sensitivity ◽  
Stereotactic Body Radiation

Abstract Stereotactic body radiation therapy (SBRT) has been proved to be effective in refractory ventricular arrhythmia (VA). We report the first Asian series of SBRT for refractory VA in a group of Taiwanese. This study included patients with treatment-failure VA. 3D electroanatomic maps, delayed enhancement magnetic resonance imaging (DE-MRI) and dual energy computed tomography (CT) were used to identify scar substrates. The target volume was treated with a single radiation dose of 20 Gy delivered by Varian TrueBeam System. Efficacy was assessed by VA events recorded by implantable cardioverter defibrillator (ICD) or 24-hour Holter. Pre- and post-radiation therapy image studies were also performed. Adverse events were monitored during follow-up. From February 2019 to December 2019, 7 patients were enrolled. Six male and one female patients, mean age 55 years, received the treatment. Among the 7 patients with variety of cardiomyopathy, one patient died of hepatic failure. For the other 6 patients, at a median follow-up of 14.5 months, the burden of VA decreased significantly. Increased intensity of DE-MRI might be associated with lower risk of VA recurrence while the dual energy CT had lower sensitivity in the detection. No acute and minimal late adverse events were reported. We conclude that, in patients with refractory VA, SBRT was associated with a marked reduction in the burden of VA and DE-MRI might be useful to monitor treatment effect.

scholarly journals First Asian population study of stereotactic body radiation therapy for ventricular arrhythmias

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Li-Ting Ho ◽  
Jenny Ling-Yu Chen ◽  
Hsing-Min Chan ◽  
Yu-Cheng Huang ◽  
Mao-Yuan Su ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Three Dimensional ◽  
Asian Population ◽  
Target Volume ◽  
Dual Energy ◽  
Detection Sensitivity ◽  
Dual Energy Ct ◽  
Stereotactic Body Radiation ◽  
Integrated Boost ◽  
Monitoring Treatment

AbstractWe report the first Asian series on stereotactic body radiation (SBRT) for refractory ventricular arrhythmia (VA) in Taiwanese patients. Three-dimensional electroanatomic maps, delayed-enhancement magnetic resonance imaging (DE-MRI), and dual-energy computed tomography (CT) were used to identify scar substrates. The main target volume was treated with a single radiation dose of 25 Gy and the margin volume received 20 Gy using simultaneous integrated boost delivered by the Varian TrueBeam system. Efficacy was assessed according to VA events recorded by an implantable cardioverter-defibrillator (ICD) or a 24-h Holter recorder. Pre- and post-radiation therapy imaging studies were performed. From February 2019 to December 2019, seven patients (six men, one woman; mean age, 55 years) were enrolled and treated. One patient died of hepatic failure. In the remaining six patients, at a median follow-up of 14.5 months, the VA burden and ICD shocks significantly decreased (only one patient with one ICD shock after treatment). Increased intensity on DE-MRI might be associated with a lower risk for VA recurrence, whereas dual-energy CT had lower detection sensitivity. No acute or minimal late adverse events occurred. In patients with refractory VA, SBRT is associated with a marked reduction in VA burden and ICD shocks, and DE-MRI might be useful for monitoring treatment effects.

Stereotactic Body Radiation Therapy as a Salvage Treatment for Single Viable Hepatocellular Carcinoma at the Site of Incomplete Transarterial Chemoembolization

2021 ◽  
Author(s):  
Sumin Lee ◽  
Jinhong Jung ◽  
Jin-hong Park ◽  
So Yeon Kim ◽  
Jonggi Choi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiation Therapy ◽  
Adverse Events ◽  
Transarterial Chemoembolization ◽  
Stereotactic Body Radiation Therapy ◽  
Medical Center ◽  
Salvage Treatment ◽  
Iodized Oil ◽  
Stereotactic Body Radiation

Abstract Background: To evaluate the clinical outcomes of patients who received stereotactic body radiation therapy (SBRT) for single viable hepatocellular carcinoma (HCC) at the site of incomplete transarterial chemoembolization (TACE).Methods: Incomplete TACE was defined as (1) evidence of viable HCC at the site of TACE on follow-up images following one or more consecutive TACEs, (2) no definite tumor staining on celiac angiogram, or (3) no definite iodized oil uptake on post-embolization angiogram or computed tomography. A total of 302 patients were treated between 2012 and 2017 at Asan Medical Center (Seoul, South Korea). Doses of 10–15 Gy per fraction were given over 3–4 consecutive days. Treatment-related adverse events were evaluated according to the common terminology criteria for adverse events, version 4.03.Results: The median follow-up duration was 32.9 months (interquartile range [IQR], 23.6–41.7) and the median tumor size was 2.0 cm (range, 0.7–6.9). The local control (LC) and overall survival rates at 3 years were 91.2% and 72.7%, respectively. 95.4% of the tumors reached complete response (CR) during the entire follow-up period (anyCR). The median interval from SBRT to anyCR was 3.4 months (IQR, 1.9–4.7), and 39.9% and 83.3% of the lesions reached CR at 3- and 6-months after SBRT, respectively. Radiation-induced liver disease was observed in 8 (2.6%) patients. No patients experienced gastroduodenal bleeding within the radiation field.Conclusion: SBRT should be considered a feasible salvage treatment option for HCC after incomplete TACE.

scholarly journals Single-Fraction Spine Stereotactic Body Radiation Therapy for the Treatment of Chordoma

2016 ◽  
Vol 16 (3) ◽  
pp. 302-309 ◽  
Author(s):  
Edward W. Jung ◽  
David L. Jung ◽  
Ehsan H. Balagamwala ◽  
Lilyana Angelov ◽  
John H. Suh ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Radiation Therapy ◽  
Local Control ◽  
Stereotactic Body Radiation Therapy ◽  
Target Volume ◽  
Control Treatment ◽  
Single Fraction ◽  
Stereotactic Body Radiation ◽  
Pain Symptoms

Purpose: Chordoma is a radioresistant tumor that presents a therapeutic challenge with spine involvement, as high doses of radiation are needed for local control while limiting dose to the spinal cord. The purpose of this study is to determine the efficacy and safety of single-fraction spine stereotactic body radiation therapy for the treatment of spine chordoma. Methods: A retrospective review of our institutional database from 2006 to 2013 identified 8 patients (12 cases) with chordoma of the spine who were treated with spine stereotactic body radiation therapy. Surgical resection was performed in 7 of the 12 cases. The treatment volume was defined by the bony vertebral level of the tumor along with soft tissue extension appreciated on magnetic resonance imaging fusion. Medical records and imaging were assessed for pain relief and local control. Treatment toxicity was evaluated using Common Terminology Criteria for Adverse Events version 4.0. Results: Median age was 59 years (range, 17-91). Median target volume was 48 cm3 (1-304), and median prescription dose was 16 Gy (11-16). Median conformality index was 1.44 (1.14-3.21), and homogeneity index was 1.12 (1.05-1.19). With a median follow-up time of 9.7 months (.5-84), local control was achieved in 75% of the cases treated. One patient developed limited grade 2 spinal cord myelopathy that resolved with steroids. There were no other treatment toxicities from spine stereotactic body radiation therapy. Conclusion: Single-fraction spine stereotactic body radiation therapy can be safely delivered to treat chordoma of the spine with the potential to improve pain symptoms. Although the early data are suggestive, long-term follow-up with more patients is necessary to determine the efficacy of spine stereotactic body radiation therapy in the treatment of chordoma of the spine.

Surgical outcomes of patients with pancreatic cancer treated with stereotactic body radiation therapy.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 341-341
Author(s):  
Jin He ◽  
Shalini Moningi ◽  
Alex B Blair ◽  
Ahmed Zaki ◽  
Daniel A. Laheru ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Neoadjuvant Chemotherapy ◽  
Surgical Outcomes ◽  
Stereotactic Body Radiation Therapy ◽  
Locally Advanced ◽  
Vascular Resection ◽  
Complication Rates ◽  
Resection Rate ◽  
Stereotactic Body Radiation

341 Background: The surgical outcome of patients with borderline resectable or locally advanced pancreatic ductal adenocarcinoma (BRPC/LAPC) treated with stereotactic body radiation therapy (SBRT) is unclear. Methods: A comparative study was performed to determine if surgical outcomes were different among patients receiving neoadjuvant SBRT vs chemoradiation therapy (CRT) vs chemotherapy only. Results: Between 2011 and 2014, 29 patients with BR/LA-PDAC underwent neoadjuvant chemotherapy and SBRT (6.6 Gy x 5 fractions) followed by pancreatectomy. Eighteen of 29 patients (62%) had LAPC. Their outcomes were compared with 82 patients who received neoadjuvant CRT and 26 patients who received neoadjuvant chemotherapy only (Table). When compared to neoadjuvant CRT and chemo only, the neoadjuvant SBRT group had a higher R0 resection rate (90% vs 84% vs 62%, p=0.02) and vascular resection rate (41% vs 13% vs 31%, p=0.005), respectively. Although the vascular resection and complication rates (Clavien grade 3 or above) were higher in the neoadjuvant SBRT group, no in-hospital mortality was encountered. In the SBRT group, the complete pathological response rate (21%) was higher than that of the other groups (4% and 0% respectively, p<0.001). Survival will be updated later as the current median postoperative follow-up is 6 months in the SBRT group. Conclusions: Neoadjuvant chemotherapy and SBRT is associated with improved surgical outcomes and pathologic complete response rates in selected patients with BRPC/LAPC. Longer follow-up is needed to determine its impact on survival. [Table: see text]

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