Conformal Static Field Stereotactic Radiotherapy for Larger Intracranial Lesions

1999 ◽  
pp. 91-99
Author(s):  
F.L. Hacker ◽  
M.R. Bellerive ◽  
H.M. Kooy ◽  
S.C. Dutton ◽  
T.D. Shafman
Keyword(s):  
Stereotactic Radiotherapy ◽  
Static Field ◽  
Intracranial Lesions

scholarly journals Predictors of leptomeningeal disease following hypofractionated stereotactic radiotherapy for intact and resected brain metastases

2019 ◽  
Vol 22 (1) ◽  
pp. 84-93 ◽  
Author(s):  
Timothy K Nguyen ◽  
Arjun Sahgal ◽  
Jay Detsky ◽  
Eshetu G Atenafu ◽  
Sten Myrehaug ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiotherapy ◽  
Median Overall Survival ◽  
Multivariable Analysis ◽  
Leptomeningeal Disease ◽  
Hypofractionated Stereotactic Radiotherapy ◽  
Increased Risk ◽  
Intact Brain ◽  
Intracranial Lesions

Abstract Background The objective was to evaluate the risk and predictors of developing leptomeningeal disease (LMD) in patients with brain metastases treated with 5-fraction hypofractionated stereotactic radiotherapy (HSRT). Methods Patients treated with HSRT for intact brain metastases and/or surgical cavities were reviewed from a prospectively maintained database. Radiographic patterns of LMD were classified as focal classical, diffuse classical, focal nodular, and diffuse nodular. Results HSRT was delivered, most commonly 30 Gy in 5 fractions, to 320 intracranial lesions (57% intact and 43% surgical cavities) in 235 patients. The median follow-up was 13.4 months (range, 0.8 to 60 mo). LMD developed in 19% of patients with a 1-year LMD rate of 12%. From the diagnosis of LMD, the median overall survival (OS) was 3.8 months (range, 2–20.8 mo). The most common LMD pattern was diffuse nodular (44%). No difference in OS was observed between LMD patterns (P = 0.203). Multivariable analysis identified surgical cavities at significantly higher risk of LMD compared with intact lesions (odds ratio [OR] = 2.30, 95% CI: 1.24, 4.29, P = 0.008). For cavities, radiosensitive tumors (OR = 2.35, 95% CI: 1.04, 5.35, P = 0.041) predicted for LMD, while, for intact metastases, patients receiving treatment with targeted agents or immunotherapy (TA/I) were at lower risk (OR = 0.178, 95% CI: 0.04, 0.79, P = 0.023). Conclusions Patients who had a brain metastasis resected were at an increased risk of LMD. OS was poor despite treatment of LMD, and no differences in OS based on the pattern of LMD was observed. Treatment with TA/I was observed to be protective against LMD and requires further study.

scholarly journals Fractionated stereotactic radiotherapy for the treatment of optic nerve sheath meningiomas

2018 ◽  
Vol 20 (2) ◽  
pp. 119-125
Author(s):  
David W. Andrews
Keyword(s):  
Treatment Planning ◽  
Stereotactic Radiotherapy ◽  
New Technologies ◽  
Cranial Nerves ◽  
Fractionated Stereotactic Radiotherapy ◽  
Linear Accelerators ◽  
Stereotactic Techniques ◽  
Efficient Treatment ◽  
Stereotactic Radiation ◽  
Intracranial Lesions

Radiosurgery has become an important treatment alternative to surgery for a variety of intracranial lesions. As currently practiced, it has in fact replaced surgery as a standard of care in some instances, compliments surgery as a post-operative adjunct in others, and most commonly represents an alternative to surgery or the only treatment option. Radiosurgery techniques have evolved quickly with the development of new technologies enabling more complex yet more efficient treatment plans. As a consequence, these technologies have broadened radiosurgery applications and improved radiosurgery outcomes. Among these newer techniques, treatments involving fractionated stereotactic radiation referred to as fractionated stereotactic radiotherapy, or FSR, have emerged as a consequence of linear accelerators designed for and dedicated to stereotactic techniques. Without the logistical constraints of retrofitted general purpose linear accelerators used in radiation oncology, often available only once or twice a week, dedicated units have enabled the design of treatment paradigms that strive for an ideal treatment based on the radiobiology of the target and dose-limiting contiguous tissues.This chapter will summarize our fifteen year experience with the Varian 600SR, initially with the Radionics software more recently modified to a Novalis shaped beam radiosurgery unit, and our practice of FSR for a variety of intracranial lesions. Special attention will be devoted to tumors involving or near the special sensory cranial nerves. Given the versatility of the Novalis treatment planning platform, one has the option of comparing different treatment planning solutions at once, including stereotactic intensity-modulated radiation therapy (IMRT). For selected skull base lesions, we have found that stereotactic IMRT yields greater conformality than FSR and we will therefore include its application among fractionation strategies. 

Hypofractionated Stereotactic Radiotherapy for Vestibular Schwannoma

Skull Base ◽  
2009 ◽  
Vol 19 (01) ◽  
Author(s):  
Rutger Balvers ◽  
Bianca Rijken ◽  
Alexandra Romero ◽  
Anne Linge ◽  
A.H.G. Dallenga ◽  
...  
Keyword(s):  
Vestibular Schwannoma ◽  
Stereotactic Radiotherapy ◽  
Hypofractionated Stereotactic Radiotherapy
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