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spine sbrt

Yurday Ozdemir, Nese Torun, Ozan Cem Guler, Berna Akkus Yildirim, Ali A Besen, Aylin Gunesli Yetisken, H Cem Onal, Erkan Topkan
Purpose: We aimed to retrospectively assess the incidence of vertebral compression fractures (VCF), examine clinicopathologic factors potentially associated with VCF, and evaluate treatment response in patients who received stereotactic body radiotherapy (SBRT) for spine metastases (spMets). Methods and Materials: We identified 78 patients with 125 spMets at baseline and subsequent assessments. Patients received SBRT doses of 16 or 18 Gy. Patients with pre-existing VCF and co-existing local progression were excluded...
April 2019: Journal of Bone Oncology
Michael C Roach, Tarita O Thomas, Anthony J Paravati, Anita Mahajan
PURPOSE: Insurance payers in the United States vary in the indications for which they consider stereotactic body radiation therapy (SBRT) "medically necessary." We compared changes in policies after the last update to the American Society for Radiation Oncology's (ASTRO) SBRT model policy. METHODS AND MATERIALS: We identified 77 payers with SBRT policies in 2015 from a policy aggregator, as well as 4 national benefits managers (NBMs). Of these, 65 payers and 3 NBMs had publicly available updates since 2015...
January 21, 2019: International Journal of Radiation Oncology, Biology, Physics
Tomohisa Furuya, Jun H Phua, Mark Ruschin, Hiroshi Tanaka, Keiji Nihei, Dilini Pinnaduwage, Yu Kumazaki, Masao Nakayama, Hideki Nishimura, Jason St-Hilaire, Isabelle Thibault, Daniel T Yat Harn, Lijun Ma, Naoto Shikama, Arjun Sahgal, Katsuyuki Karasawa
PURPOSE: This study aimed to assess the effectiveness of multiple dose-volume specifications in minimizing interinstitutional, target-prescribed, dose variations for spine stereotactic body radiation therapy (SBRT). METHODS AND MATERIALS: Seven institutions with a total of 10 treatment apparatuses participated in this study. SBRT plans for 3 representative spinal metastases were generated using 2 different protocols (Protocols 1 and 2) for target dose. While using just 2 target dose objectives (doses delivered to 95% and maximum point dose) in Protocol 1, 3 target dose constraints (doses delivered to 95% and 50% and maximum point dose) were defined in Protocol 2 with the intent to decrease target dose variation...
January 2019: Practical Radiation Oncology
Shearwood McClelland, Paul H Cooper, Anupama K Acheson, Jeremy N Ciporen, Jerry J Jaboin, Timur Mitin
Introduction: Stereotactic body radiotherapy (SBRT) of the spine has become an increasingly utilized modality in the United States, most commonly for metastatic disease (McClelland et al., 2017). Spinal SBRT in patients with spinal instrumentation has been sparsely examined. We report a patient who developed myelitis following spinal SBRT to a region with existing hardware. Methods: A 55-year-old woman with Stage IV breast cancer developed a T4 vertebral body metastasis and underwent tumor debulking with posteriorly instrumented T3-T5 fusion...
2018: Journal of Radiosurgery and SBRT
Daniel L Saenz, Richard Crownover, Sotirios Stathakis, Niko Papanikolaou
PURPOSE: The Brainlab Elements treatment planning system utilizes distinct modules for treatment planning specific to stereotactic treatment sites including single or multiple brain lesions as well as spine. This work investigates the hypothesis that an optimization tailored specifically to spine can in fact create dosimetrically superior plans to those created in more general use treatment planning systems (TPS). METHODS: Ten spine patients at our institution were replanned in Brainlab Elements, Phillips Pinnacle3 , and Elekta Monaco...
November 20, 2018: Journal of Applied Clinical Medical Physics
Marco Esposito, Laura Masi, Margherita Zani, Raffaela Doro, David Fedele, Cristina Garibaldi, Stefania Clemente, Christian Fiandra, Francesca Romana Giglioli, Carmelo Marino, Laura Orsingher, Serenella Russo, Michele Stasi, Lidia Strigari, Elena Villaggi, Pietro Mancosu
BACKGROUND: The dosimetric variability in spine stereotactic body radiation therapy (SBRT) planning was investigated in a large number of centres to identify crowd knowledge-based solutions. METHODS: Two spinal cases were planned by 48 planners (38 centres). The required prescription dose (PD) was 3 × 10 Gy and the planning target volume (PTV) coverage request was: VPD  > 90% (minimum request: VPD  > 80%). The dose constraints were: planning risk volume (PRV) spinal cord: V18Gy  < 0...
October 23, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Scott R Silva, Adam Gliniewicz, Brendan Martin, Vikram C Prabhu, Anand V Germanwala, Edward Melian, G Alex Jones, Abhishek A Solanki
BACKGROUND: The objective of our study was to describe the local control (LC) outcomes with 3 or 5 fraction stereotactic body radiotherapy (SBRT) to the spine in patients with oligometastatic (≤ 5 systemic metastases) versus polymetastatic disease (> 5 metastases). METHODS: We retrospectively reviewed outcomes of patients treated with SBRT for spinal metastases. No patients had prior surgical intervention or spinal cord compression. All patients were treated with 3 (median dose 27 Gy; range 24-30 Gy) or 5 fraction (median dose 35 Gy, range 25-40 Gy) SBRT...
October 13, 2018: World Neurosurgery
Ahmed Meleis, Sachin R Jhawar, Joseph P Weiner, Neil Majmundar, Aria Mahtabfar, Yong Lin, Salma Jabbour, Shabbar Danish, Sharad Goyal
BACKGROUND: In the setting of spinal metastases with epidural cord compression, radiosurgery is often only considered when there is sufficient separation between the epidural disease and the spinal cord. However, in patients who are nonsurgical candidates or those who prefer nonoperative management, there may be a benefit from stereotactic body radiation therapy, even when the epidural target is closer than the traditionally referenced 3 mm distance from the spinal cord. The purpose of this retrospective study is to evaluate our institution's experience in treating 20 such patients...
February 2019: World Neurosurgery
Myriam Khadige, Julia Salleron, Vincent Marchesi, Guillaume Oldrini, Didier Peiffert, Véronique Beckendorf
Background: CyberKnife® stereotactic radiotherapy allows for minimally invasive treatment with satisfactory results in patients with inoperable primary or metastatic lung cancer. The objective of this study was to identify factors influencing the probability of local control. Methods: Ninety-five patients (100 lung tumors) treated between January and December 2013 at our department by SBRT (stereotactic body radiation therapy) using CyberKnife® were included in the study...
August 2018: Journal of Thoracic Disease
K Liang Zeng, Sten Myrehaug, Hany Soliman, Chia-Lin Tseng, Eshetu G Atenafu, Mikki Campbell, Salman Faruqi, Young K Lee, Mark Ruschin, Leodante da Costa, Victor Yang, Julian Spears, Chris Heyn, Pejman Jabehdar Maralani, Cari Whyne, Albert Yee, Arjun Sahgal
Background: The unique anatomy and biomechanical features of the cervical spine and sacrum may impact treatment outcomes following spine stereotactic body radiotherapy (SBRT). Current data for spine metastases are not specific for these locations. Objective: To report imaging-based SBRT outcomes to cervical and sacral metastases. Methods: We retrospectively reviewed our prospective spine SBRT database for cervical and sacral metastases. Patients were followed at 2- to 3-mo intervals with a clinical visit and full spine magnetic resonance imaging (MRI) and we report overall survival (OS), vertebral compression fracture (VCF), and MR imaging-based local control (LC) rates...
August 29, 2018: Neurosurgery
Zhongjian Ju, Jingyuan Wang, Huaiwen Zhang, Lei Du, Wei Xu, Xiaoshen Wang, Ruigang Ge, Jiwei Li, Qingzeng Zheng, Jianxiong Li
CyberKnife stereotactic body radiation therapy (SBRT) is becoming increasingly used for cancer treatment and, to maximize its clinical application, it is important to define the dosimetric characteristics, optimal dose and fractionation regimens. The aim of this study was to evaluate the dose fall-off in two fractionated regimens of CyberKnife SBRT during the treatment of thoracic spinal metastasis. Patients with spinal metastasis involving a vertebra and pedicle were treated with 40 Gy in 5 fractions (n = 4), and patients with spinal metastasis involving only a vertebra received 33 Gy in 3 fractions (n = 4)...
August 2, 2018: Bosnian Journal of Basic Medical Sciences
Emma Maria Dunne, Ian Mark Fraser, Mitchell Liu
Stereotactic body radiation therapy (SBRT) also referred to as stereotactic ablative radiotherapy (SABR), is a technique which has emerged over the past two decades due to improvements in radiation technology. Unlike conventional external beam radiotherapy (cEBRT) which traditionally delivers radiation in small doses [approximately 2 Gray (Gy) per fraction] over several weeks, SBRT, typically delivered in one to eight fractions, is a technique whereby potentially ablative doses of radiotherapy (usually 7.5-20 Gy per fraction) can be delivered with steeper dose gradients and sub millimetre precision, minimising risk to surrounding normal tissues...
July 2018: Annals of Translational Medicine
Chia-Lin Tseng, Hany Soliman, Sten Myrehaug, Young K Lee, Mark Ruschin, Eshetu G Atenafu, Mikki Campbell, Pejman Maralani, Victor Yang, Albert Yee, Arjun Sahgal
PURPOSE: We report mature outcomes for a cohort of patients with no prior radiation (de novo) to the spine treated with 24 Gy in 2 daily fractions for metastases, which represents the same stereotactic body radiation therapy (SBRT) regimen under evaluation in the current Symptom Control-24 phase 3 randomized trial (NCT02512965). METHODS AND MATERIALS: The cohort consisted of 279 de novo spinal metastases in 145 consecutive patients treated with 24 Gy in 2 SBRT fractions, identified from a prospective single-institution database...
November 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Lijun Ma, Lei Wang, Young Lee, Chia-Lin Tseng, Scott Soltys, Steve Braunstein, Arjun Sahgal
Purpose: Doses to small spinal cord isodose volume (such as those ranging from Dmax 0.0 cc to 0.5 cc) as well as to large volumes (such as those ranging from 0.5 cc to 3.0 cc) are critical parameters to guide safe practice of spine SBRT. We here report a mathematical formula that links the most probable dose volume limits together for common spine SBRT cases.Methods and materials: A dose ripple formula parameterized with equivalent dose radius (EDR) was derived to model spinal cord small-volume doses for a spine SBRT treatment...
2018: Journal of Radiosurgery and SBRT
Seung Hyuck Jeon, Jin Ho Kim
PURPOSE: To investigate positional uncertainty and its correlation with clinical parameters in spine stereotactic body radiotherapy (SBRT) using thermoplastic mask (TM) immobilization. Materials and. METHODS: A total of 21 patients who underwent spine SBRT for cervical or upper thoracic spinal lesions were retrospectively analyzed. All patients were treated with image guidance using cone beam computed tomography (CBCT) and 4 degrees-of-freedom (DoF) positional correction...
June 2018: Radiation Oncology Journal
James Rijken, Barry Jordan, Scott Crowe, Tanya Kairn, Jamie Trapp
PURPOSE: Use of SBRT techniques is now a relatively common recourse for spinal metastases due to good local control rates and durable pain control. However, the technique has not yet reached maturity for gantry-based systems, so work is still required in finding planning approaches that produce optimum conformity as well as delivery for the slew of treatment planning systems and treatment machines. METHODS: A set of 32 SBRT spine treatment plans based on four vertebral sites, varying in modality and number of control points, were created in Pinnacle...
September 2018: Journal of Applied Clinical Medical Physics
Balamurugan A Vellayappan, Samuel T Chao, Matthew Foote, Matthias Guckenberger, Kristin J Redmond, Eric L Chang, Nina A Mayr, Arjun Sahgal, Simon S Lo
Owing to improvements in clinical care and systemic therapy, more patients are being diagnosed with, and living longer with, spinal metastases (SM). In parallel, tremendous technological progress has been made in the field of radiation oncology. Advances in both software and hardware are able to integrate three- (and four-) dimensional body imaging with spatially accurate treatment delivery methods. This leads to improved efficacy, shortened treatment schedule, and potentially reduced treatment-related toxicity...
September 2018: Expert Review of Anticancer Therapy
Colien Hazelaar, Wilko F A R Verbakel, Hassan Mostafavi, Lineke van der Weide, Ben J Slotman, Max Dahele
PURPOSE: The purpose was to report our initial experience with online markerless 3-dimensional (3D) spine position monitoring. We used template matching plus triangulation of fluoroscopic kilovoltage images acquired with the gantry-mounted imager during flattening filter-free volumetric modulated arc spine stereotactic body radiation therapy delivery on a conventional linear accelerator. METHODS AND MATERIALS: Kilovoltage images were acquired at 7 frames per second and streamed to a stand-alone computer...
August 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Kei Ito, Keiji Nihei, Takuya Shimizuguchi, Hiroaki Ogawa, Tomohisa Furuya, Shurei Sugita, Takahiro Hozumi, Keisuke Sasai, Katsuyuki Karasawa
OBJECTIVE This study aimed to clarify the outcomes of postoperative re-irradiation using stereotactic body radiotherapy (SBRT) for metastatic epidural spinal cord compression (MESCC) in the authors' institution and to identify factors correlated with local control. METHODS Cases in which patients with previously irradiated MESCC underwent decompression surgery followed by spine SBRT as re-irradiation between April 2013 and May 2017 were retrospectively reviewed. The surgical procedures were mainly performed by the posterior approach and included decompression and fixation...
September 2018: Journal of Neurosurgery. Spine
Ronny Kalash, Scott M Glaser, John C Flickinger, Steven Burton, Dwight E Heron, Peter C Gerszten, Johnathan A Engh, Nduka M Amankulor, John A Vargo
OBJECTIVE Akin to the nonoperative management of benign intracranial tumors, stereotactic body radiation therapy (SBRT) has emerged as a nonoperative treatment option for noninfiltrative primary spine tumors such as meningioma and schwannoma. The majority of initial series used higher doses of 16-24 Gy in 1-3 fractions. The authors hypothesized that lower doses (such as 12-13 Gy in 1 fraction) might provide an efficacy similar to that found with the dose de-escalation commonly used for intracranial radiosurgery to treat acoustic neuroma or meningioma and with a lower risk of toxicity...
August 2018: Journal of Neurosurgery. Spine
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