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Brain srs

Charu Singh, Jack M Qian, James B Yu, Veronica L Chiang
OBJECTIVEConcurrent use of anti-PD-1 therapies with stereotactic radiosurgery (SRS) have been shown to be beneficial for survival and local lesional control in melanoma patients with brain metastases. It is not known, however, if immunotherapy (IT) confers the same outcome advantage in lung cancer patients with brain metastases treated with SRS.METHODSThe authors retrospectively reviewed 85 non-small cell lung cancer (NSCLC) patients with brain metastases who were treated with SRS between January 2006 and December 2016...
February 15, 2019: Journal of Neurosurgery
Arrvind Raghunath, Kunal Desai, Manmeet S Ahluwalia
In the past, the standard of care for treatment of BM was whole brain radiation therapy (WBRT), stereotactic radiosurgery (SRS), and surgery. There has been a greater role for medical therapies in the last two decades due to the discovery of driver mutations and corresponding targeted therapies. These innovations have dramatically altered the approach to treating these patients. Some of the important mutations include epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) mutations in small cell lung cancer, human epidermal growth factor receptor (HER2) mutation in breast cancer, and BRAF mutation in melanoma...
February 15, 2019: Current Treatment Options in Oncology
Carsten Nieder, Matthias Guckenberger, Laurie E Gaspar, Chad G Rusthoven, Dirk De Ruysscher, Arjun Sahgal, Timothy Nguyen, Anca L Grosu, Minesh P Mehta
BACKGROUND: Different management options exist for patients with brain metastases from non-small cell lung cancer (NSCLC), patients whose treatment with whole brain radiotherapy (WBRT) has become more controversial over the last decade. It is not trivial to find the optimal balance of over- versus undertreatment in these patients. Several recent trials, including the randomized QUARTZ trial now influence the decision to recommend or withhold WBRT for patients with unfavorable prognosis, and similarly, for favorable prognosis patients, the balance between radiosurgery alone or WBRT has become a nuanced decision...
February 15, 2019: Radiation Oncology
David M McDermott, Joshua D Hack, Christoper P Cifarelli, John A Vargo
BACKGROUND: Significant heterogeneity exists in target volumes for postoperative stereotactic radiosurgery (SRS) for brain metastases. A set of contouring guidelines was recently published, and we investigated the impact of deviations. METHODS: Patients (n = 41) undergoing single-fraction Gamma Knife SRS following surgical resection of brain metastases from 2011 to 2017 were retrospectively reviewed. SRS included the entire contrast-enhancing cavity with heterogeneity in inclusion of the surgical tract and no routine margin along the dura or clinical target volume margin...
February 14, 2019: Stereotactic and Functional Neurosurgery
Johannes Kraft, Jaap Zindler, Giuseppe Minniti, Matthias Guckenberger, Nicolaus Andratschke
PURPOSE OF REVIEW: To give an overview on the current evidence for stereotactic radiosurgery of brain metastases with a special focus on multiple brain metastases. RECENT FINDINGS: While the use of stereotactic radiosurgery in patients with limited brain metastases has been clearly defined, its role in patients with multiple lesions (> 4) is still a matter of controversy. Whole-brain radiation therapy (WBRT) has been the standard treatment approach for patients with multiple brain lesions and is still the most commonly used treatment approach worldwide...
February 13, 2019: Current Treatment Options in Neurology
Ricarda Rauschenberg, Johannes Bruns, Julia Brütting, Dirk Daubner, Fabian Lohaus, Lisa Zimmer, Andrea Forschner, Daniel Zips, Jessica C Hassel, Carola Berking, Katharina C Kaehler, Jochen Utikal, Ralf Gutzmer, Patrik Terheyden, Frank Meiss, David Rafei-Shamsabadi, Felix Kiecker, Dirk Debus, Evelyn Dabrowski, Andreas Arnold, Marlene Garzarolli, Marvin Kuske, Stefan Beissert, Steffen Löck, Jennifer Linn, Esther G C Troost, Friedegund Meier
BACKGROUND: Combining stereotactic radiosurgery (SRS) and active systemic therapies (STs) achieved favourable survival outcomes in patients with melanoma brain metastases (MBMs) in retrospective analyses. However, several aspects of this treatment strategy remain poorly understood. We report on the overall survival (OS) of patients with MBM treated with a combination of radiotherapy (RT) and ST as well as the impact of the v-Raf murine sarcoma viral oncogene homolog B (BRAF)-V600 mutation (BRAFmut) status, types of RT and ST and their sequence...
February 7, 2019: European Journal of Cancer
Swathi Chidambaram, Susan Pannullo, Theodore H Schwartz, A Gabriella Wernicke
Brain metastases occur in a large portion of patients with cancer. While advances in radiation therapy help improve survival, they also raise questions of what is the best modality for retreatment in the context of recurrent disease. The spectrum of treatment options for recurrent intracranial metastatic disease after prior radiotherapy includes salvage SRS, WBRT, and brachytherapy. In this study, we comprehensively review the existing data on the efficacy and toxicity of the various reirradiation treatment modalities...
February 7, 2019: World Neurosurgery
Shireen Parsai, Jacob A Miller, Aditya Juloori, Samuel T Chao, Rupesh Kotecha, Alireza M Mohammadi, Manmeet S Ahluwalia, Erin S Murphy, Gene H Barnett, Michael A Vogelbaum, Lilyana Angelov, David M Peereboom, John H Suh
OBJECTIVEWith increasing survival for patients with human epidermal growth factor receptor 2-positive (HER2+) breast cancer in the trastuzumab era, there is an increased risk of brain metastasis. Therefore, there is interest in optimizing intracranial disease control. Lapatinib is a small-molecule dual HER2/epidermal growth factor receptor inhibitor that has demonstrated intracranial activity against HER2+ breast cancer brain metastases. The objective of this study was to investigate the impact of lapatinib combined with stereotactic radiosurgery (SRS) on local control of brain metastases...
February 8, 2019: Journal of Neurosurgery
Rodney E Wegner, Shaakir Hasan, Richard W Williamson, Gene Finley, Russell Fuhrer, Athanasios Colonias, Stephen M Karlovits
OBJECTIVES: Large cell neuroendocrine carcinoma (LCNEC) of the lung is a rare pulmonary tumor, having similar natural history and management strategy as small cell lung cancer. Therefore, the management of brain metastases in these patients has mirrored that of SCLC through the use of whole brain radiation therapy (WBRT). We used the National Cancer Database (NCDB) to look at predictors of stereotactic radiosurgery (SRS) and any potential differences in outcomes for patients with brain metastases from LCNEC...
February 7, 2019: Acta Oncologica
Taoran Li, Peyton Irmen, Haisong Liu, Wenyin Shi, Michelle Alonso-Basanta, Wei Zou, Boon-Keng Kevin Teo, James M Metz, Lei Dong
Purpose: To evaluate the dosimetric performance and planning/delivery efficiency of a dual-layer MLC system for treating multiple brain metastases with a single isocenter. Materials and Methods: 10 patients each with 6-10 targets with volumes from 0.11 to 8.57 cc, and prescription doses from 15 to 24 Gy, were retrospectively studied. Halcyon has only coplanar delivery mode. Halcyon V1 MLC modulates only with the lower layer at 1 cm resolution, whereas V2 MLC modulates with both layers at an effective resolution of 0...
2019: Frontiers in Oncology
Jennifer L Perez, Alp Ozpinar, Hideyuki Kano, BaDoi Phan, Ajay Niranjan, L Dade Lunsford
BACKGROUND: The overall survival rates for breast cancer are increasing due to controlled brain disease and improved systemic treatments. This study examined neurological outcomes, tumor control, and survival data in breast cancer patients with multiple brain metastases, and who required salvage stereotactic radiosurgery (SRS) for recurrent breast cancer brain metastases. METHODS: The study included 231 patients with a primary diagnosis of breast cancer who underwent SRS for greater than one brain metastases from May 1993 and July 2007...
January 30, 2019: World Neurosurgery
Jie Wang, Yanjun Chen, Qiong Wang, Gilles van Luijtelaar, Meizhen Sun
OBJECTIVE: The putative neuroprotective and disease-modifying effects of lamotrigine (LTG) and ethosuximide (ESM) were investigated in the lithium-pilocarpine (Li-Pc) model of temporal-lobe epilepsy (TLE) in rats. Then, spontaneous recurrent seizures (SRS), neuronal loss and astrogliosis were assessed. METHODS: Status Epilepticus (SE) was induced by Li-Pc in five experimental groups: 24 h after SE, all rats received twice daily either a low (10 mg/kg) or high (20 mg/kg) dose of LTG, or a low (25 mg/kg) or high (50 mg/kg) dose of ESM, or solvent...
January 29, 2019: Brain Research
Cristiane J Gomes-Lima, Di Wu, Sarika N Rao, Sree Punukollu, Rama Hritani, Alexander Zeymo, Hala Deeb, Mihriye Mete, Edward F Aulisi, Douglas Van Nostrand, Jacqueline Jonklaas, Leonard Wartofsky, Kenneth D Burman
Background and Objective: The brain is an unusual site for distant metastases of differentiated thyroid carcinoma (DTC). The aim of this study was to document the prevalence of brain metastases from DTC at our institutions and to analyze the current therapies and the outcomes of these patients. Methods: We performed a retrospective chart review of patients with DTC and secondary neoplasia of the brain. Results: From 2002 to 2016, 9514 cases of thyroid cancer were evaluated across our institutions and 24 patients met our inclusion criteria, corresponding to a prevalence of 0...
February 1, 2019: Journal of the Endocrine Society
Priya Venkatesan
No abstract text is available yet for this article.
August 2018: Lancet Oncology
Sonya Kim, Marianne Mortera, Xiaolei Hu, Shilpa Krishnan, Lilian Hoffecker, Amy Herrold, Lauren Terhorst, Laurie King, Joseph Machtinger, Jennifer M Zumsteg, Ahmed Negm, Patricia Heyn
The purpose of this study was to conduct an overview of systematic reviews (SRs) to appraise the published evidence related to pharmacological interventions after traumatic brain injury (TBI). Searches were conducted with Medline, Embase, PsycINFO, Web of Science, PubMed. 780 retrieved SRs underwent a two-level screening to determine inclusion. Data extracted included participant characteristics, TBI severity, study design, pharmacological interventions, and outcomes. SRs were assessed for methodological quality by using the AMSTAR measurement tool...
January 29, 2019: Brain Injury: [BI]
Sotaro Otake, Taichiro Goto
Oligometastatic disease is defined as "a condition with a few metastases arising from tumors that have not acquired a potential for widespread metastases." Its behavior suggests a transitional malignant state somewhere between localized and metastatic cancer. Treatment of oligometastatic disease is expected to achieve long-term local control and to improve survival. Historically, patients with oligometastases have often undergone surgical resection since it was anecdotally believed that surgical resection could result in progression-free or overall survival benefits...
January 23, 2019: Cancers
Cheng-Chia Lee, Huai-Che Yang, Chung-Jung Lin, Ching-Jen Chen, Hsiu-Mei Wu, Cheng-Ying Shiau, Wan-Yuo Guo, David Hung-Chi Pan, Kang-Du Liu, Wen-Yuh Chung, Syu-Jyun Peng
OBJECTIVE: To assess the sensitivity and specificity of arteriovenous malformation (AVM) nidal component identification and quantification using unsupervised machine learning algorithm, and to evaluate the association between intervening nidal brain parenchyma and radiation-induced changes (RICs) after stereotactic radiosurgery (SRS). METHODS: Fully automated segmentation via unsupervised classification with fuzzy c-means clustering was used to analyze AVM nidus on T2-weighted magnetic resonance imaging...
January 21, 2019: World Neurosurgery
Wei Jiang, Waqar Haque, Vivek Verma, Brian Butler, Bin S Teh
BACKGROUND: Up-front stereotactic radiosurgery (SRS) has been historically thought of as inadequate for brain metastases (BM) from newly diagnosed small cell lung cancer (SCLC). This study evaluates national practice patterns and clinical outcomes for BM from SCLC. MATERIAL AND METHODS: The National Cancer Database was queried (2004-2013) for patients with newly diagnosed metastatic SCLC receiving intracranial radiotherapy. Patients were grouped into three categories: upfront SRS, whole-brain radiotherapy (WBRT) alone, or WBRT with boost (SRS or fractionated radiotherapy)...
January 24, 2019: Acta Oncologica
Aditya Juloori, Jacob A Miller, Shireen Parsai, Rupesh Kotecha, Manmeet S Ahluwalia, Alireza M Mohammadi, Erin S Murphy, John H Suh, Gene H Barnett, Jennifer S Yu, Michael A Vogelbaum, Brian Rini, Jorge Garcia, Glen H Stevens, Lilyana Angelov, Samuel T Chao
OBJECTIVEThe object of this retrospective study was to investigate the impact of targeted therapies on overall survival (OS), distant intracranial failure, local failure, and radiation necrosis among patients treated with radiation therapy for renal cell carcinoma (RCC) metastases to the brain.METHODSAll patients diagnosed with RCC brain metastasis (BM) between 1998 and 2015 at a single institution were included in this study. The primary outcome was OS, and secondary outcomes included local failure, distant intracranial failure, and radiation necrosis...
January 18, 2019: Journal of Neurosurgery
Jeremy J Heit, Neil H Thakur, Michael Iv, Nancy J Fischbein, Max Wintermark, Robert L Dodd, Gary K Steinberg, Steven D Chang, Krish B Kapadia, Gregory Zaharchuk
BACKGROUND AND PURPOSE: Brain arteriovenous malformation (AVM) treatment by stereotactic radiosurgery (SRS) is effective, but AVM obliteration following SRS may take two years or longer. MRI with arterial-spin labeling (ASL) may detect brain AVMs with high sensitivity. We determined whether brain MRI with ASL may accurately detect residual AVM following SRS treatment. MATERIALS AND METHODS: We performed a retrospective cohort study of patients who underwent brain AVM evaluation by DSA between June 2010 and June 2015...
January 15, 2019: Journal of Neuroradiology. Journal de Neuroradiologie
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