scholarly journals Stereotactic radiosurgery for central neurocytomas: an international multicenter retrospective cohort study

2020 ◽  
pp. 1-10
Author(s):  
Yi-Chieh Hung ◽  
Cheng-Chia Lee ◽  
Huai-che Yang ◽  
Nasser Mohammed ◽  
Kathryn N. Kearns ◽  
...  
Keyword(s):  
Cohort Study ◽  
Stereotactic Radiosurgery ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Tumor Recurrence ◽  
Tumor Volume ◽  
Csf Shunt ◽  
Tumor Control ◽  
Shunt Surgery ◽  
Distant Tumor

OBJECTIVECentral neurocytomas (CNs) are uncommon intraventricular tumors, and their rarity renders the risk-to-benefit profile of stereotactic radiosurgery (SRS) unknown. The aim of this multicenter, retrospective cohort study was to evaluate the outcomes of SRS for CNs and identify predictive factors.METHODSThe authors retrospectively analyzed a cohort of patients with CNs treated with SRS at 10 centers between 1994 and 2018. Tumor recurrences were classified as local or distant. Adverse radiation effects (AREs) and the need for a CSF shunt were also evaluated.RESULTSThe study cohort comprised 60 patients (median age 30 years), 92% of whom had undergone prior resection or biopsy and 8% received their diagnosis based on imaging alone. The median tumor volume and margin dose were 5.9 cm3 and 13 Gy, respectively. After a median clinical follow-up of 61 months, post-SRS tumor recurrence occurred in 8 patients (13%). The 5- and 10-year local tumor control rates were 93% and 87%, respectively. The 5- and 10-year progression-free survival rates were 89% and 80%, respectively. AREs were observed in 4 patients (7%), but only 1 was symptomatic (2%). Two patients underwent post-SRS tumor resection (3%). Prior radiotherapy was a predictor of distant tumor recurrence (p = 0.044). Larger tumor volume was associated with pre-SRS shunt surgery (p = 0.022).CONCLUSIONSTreatment of appropriately selected CNs with SRS achieves good tumor control rates with a reasonable complication profile. Distant tumor recurrence and dissemination were observed in a small proportion of patients, which underscores the importance of close post-SRS surveillance of CN patients. Patients with larger CNs are more likely to require shunt surgery before SRS.

Tumor Control Following Stereotactic Radiosurgery in Patients with Vestibular Schwannomas – A Retrospective Cohort Study

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Peter L. Santa Maria ◽  
Yangyang Shi ◽  
Ksenia A. Aaron ◽  
Richard K. Gurgel ◽  
C. Eduardo Corrales ◽  
...  
Keyword(s):  
Cohort Study ◽  
Stereotactic Radiosurgery ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Vestibular Schwannomas ◽  
Tumor Control

Association of tumor volume and outcomes in T3 larynx cancer with organ preservation approach.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18044-e18044
Author(s):  
Nauman Malik ◽  
Nicolin Hainc ◽  
Gia Gill ◽  
Steven Nakoneshny ◽  
Paul Kerr ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cohort Study ◽  
Local Control ◽  
Systemic Therapy ◽  
Retrospective Cohort Study ◽  
Organ Preservation ◽  
Retrospective Cohort ◽  
Tumor Volume ◽  
Local Failure ◽  
Larynx Cancer

e18044 Background: Organ preservation approaches to treatment of locally advanced larynx cancers are widely used and consist of radiotherapy (RT) with or without concurrent systemic therapy (CRT). Analyses of the National Cancer Database point to decreasing survival as CRT became widely adopted in place of total laryngectomy (TL). Tumor volume in T3 laryngeal tumors has been postulated as one variable to explain this finding, with higher volume associated with lower local control based on small sample size studies largely in pre-intensity modulated radiotherapy (IMRT) era, and low volume T3 tumors being associated with improved local control with CRT. We sought to validate these findings in a contemporary cohort of T3 larynx patients treated with IMRT. Methods: This was a national, multicentre retrospective cohort study of patients diagnosed with American Joint Committee on Cancer (AJCC) T3 N0-3 M0 glottic and supraglottic cancers who underwent curative intent IMRT with or without systemic treatment from 2002-2018. Tumor volumes were calculated using a validated standardized approach by a Neuroradiologist. Primary predictor was tumor volume, primary outcome was local control (LC), and secondary outcomes included overall survival (OS), as well as late grade 3+ toxicities. Kaplan Meier estimates and log-rank tests were used for survival analyses, with Cox proportional hazards used for univariable analyses. Results: 246 patients met inclusion criteria, 147 glottic and 99 supraglottic cancers. At baseline, glottic patients were more likely to be male (p < 0.01), have a fixed vocal cord (p < 0.01), not have pre-epiglottic space invasion ( < 0.01), be cN0 (p < 0.01), and have lower grade tumors (p < 0.01). Mean tumor volumes for glottic and supraglottic tumors were 5.0 (4.2-5.8) cc and 13.0 (10.3–15.6) cc respectively. Univariable analysis showed systemic therapy was associated with improved local failure (HR 0.49, 95%CI 0.24 – 0.99, p = 0.05). Within the glottic cohort, tumor volume was not associated with local failure (HR 1.09, 95%CI 0.71 – 1.67, p = 0.38), however having a local failure event was associated with increased feeding tube dependence (HR 2.52, 95%CI 1.05 – 6.02, p = 0.04). Median local failure free survival in the overall cohort was 28.5 months, with median OS 23.2 months. There was a trend towards improved local control in the supraglottic cohort compared to glottic patients (log-rank p = 0.08), but the supraglottic cohort had significantly worse overall survival (log-rank p = 0.02). Conclusions: In this retrospective cohort study, there were baseline and outcome differences between patients with T3 glottic and supraglottic larynx cancer, with worse overall survival in supraglottic patients. Tumor volume was not associated with local control in the glottic cohort. These findings are pending further validation in a larger cohort and will be analyzed separately for supraglottic tumors.

scholarly journals Longitudinal Radiographic Outcomes of Vestibular Schwannoma in Single and Fractionated Stereotactic Radiosurgery: A Retrospective Cohort Study

2019 ◽  
Vol 81 (03) ◽  
pp. 308-316
Author(s):  
Mohamed H. Khattab ◽  
Neil B. Newman ◽  
David M. Wharton ◽  
Alexander D. Sherry ◽  
Guozhen Luo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Treatment Failure ◽  
Stereotactic Radiosurgery ◽  
Vestibular Schwannoma ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Treatment Success ◽  
Three Dimensional ◽  
Target Volume ◽  
Surveillance Imaging

AbstractManagement of vestibular schwannoma (VS) includes stereotactic radiosurgery (SRS) in single or fractionated treatments. There is a paucity of literature on the three-dimensional (3D) volumetric kinetics and radiological changes following SRS and no consensus on appropriate post-SRS surveillance imaging timeline. This is a retrospective cohort study with institutional review board approval. A total of 55 patients met study criteria. We collected volumetric kinetic data in VS treated with SRS over time using a target volume contouring software. We also tracked radiographic phenomena such as pseudoprogression and necrosis. A secondary objective was to describe our overall treatment success rate and any failures. For all treatments groups, pseudoprogression most typically occurred within 12 months post-SRS, after which tumor volumes on average normalized and then decreased from pretreatment size at the last follow-up. Only two patients required salvage therapy post-SRS and were considered SRS treatment failures. Both patients were in the five-fraction cohort but with a lower biologically equivalent dose. Our study is first to collect 3D volumetric kinetics of VS following single and fractionated SRS in contrast to extrapolations from single and two-dimensional measurements. Our longitudinal data also show initial increases in volume in the first 12 months post-SRS followed by later declines, setting up interesting questions regarding the utility of early posttreatment surveillance imaging in the asymptomatic patient. Finally, we show low rates of treatment failure (3.6%) and show in our cohort that SRS dose de-escalation posed a risk of treatment failure.

scholarly journals Stereotactic Radiosurgery for Acromegaly: An International Multicenter Retrospective Cohort Study

Neurosurgery ◽  
2018 ◽  
Vol 84 (3) ◽  
pp. 717-725 ◽  
Author(s):  
Dale Ding ◽  
Gautam U Mehta ◽  
Mohana Rao Patibandla ◽  
Cheng-Chia Lee ◽  
Roman Liscak ◽  
...  
Keyword(s):  
Cohort Study ◽  
Stereotactic Radiosurgery ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
International Multicenter
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