1
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Hori YS, Park DJ, Chang SD. Bilateral Multiple Orbital Metastases Successfully Treated with Standalone Stereotactic Radiosurgery: Clinical Image. World Neurosurg 2024; 191:186-189. [PMID: 39168242 DOI: 10.1016/j.wneu.2024.08.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 08/11/2024] [Accepted: 08/12/2024] [Indexed: 08/23/2024]
Abstract
Bilateral orbital metastases are extremely rare, and no previous literature has reported bilateral multiple orbital metastases treated with stereotactic radiosurgery (SRS). We present the impressive images of a patient with history of metastatic leiomyosarcoma with newly diagnosed bilateral multiple orbital metastases. The pre-SRS magnetic resonance imaging (MRI) showed 1 right and 2 left orbital metastatic lesions. The patient underwent SRS, and the post-SRS MRI at 2 months showed a decrease in size of the treated lesions. The positron emission tomography scan at 5 months after the treatment showed no avid F-fluorodeoxyglucose uptakes in the 3 orbital metastases. The presenting symptoms were all improved after the treatment with no adverse effects from the SRS. Our interesting images show the presence of multiple lesions in the orbital spaces with excellent treatment response post SRS. This is the first report of a patient who has bilateral and multiple orbital metastases that were successfully treated with standalone SRS.
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Affiliation(s)
- Yusuke S Hori
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - David J Park
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - Steven D Chang
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA.
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2
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Pezzulla D, Di Franco R, Zamagni A, Pastore F, Longo S, Dominici L, Lillo S, Ciabattoni A, Arcidiacono F, Deodato F, Muto P, Morganti AG, Cellini F, Maranzano E. Radiotherapy of orbital metastases: a systematic review of management and treatment outcomes on behalf of palliative care study group of Italian association of radiotherapy and clinical oncology (AIRO). Br J Radiol 2023; 96:20230124. [PMID: 37751164 PMCID: PMC10607395 DOI: 10.1259/bjr.20230124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/09/2023] [Accepted: 08/21/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVES We search the current literature on data regarding the role of RT in OM treatment, focusing on the improvement of symptoms and patient quality of life. METHODS This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. RESULTS From 340 citations, 60 papers were finally selected: 45 case reports and 15 case series. The case reports accounted for 47 patients. In 37/39 cases (95%), EBRT was done. Patients were mainly treated with 3DCRT, IMRT, and with SBRT. The most used RT regimens were 30 Gy in 10 fractions (23%) and 20-25 Gy in 5 fx (13%). No sever toxicity was reported. A median LC of 11 months (range 1-54 months) and a median OS of 12 months (range 1-54 months) were registered. Among the case series, a total of 457 patients were examined, 227 of whom underwent RT. The main used techniques were 3DCRT, CK, GK, SBRT, and BRT. RT doses could vary from 30 Gy/10 fractions to 60 Gy/30 fractions, 50 Gy/5 fractions, or 16.5-21 Gy in single fraction. No toxicity above G2 was reported. ORR could vary between 75 and 100%. Only two study provided information on response duration: a mean LC time of 22.8 months and a mean time to local progression of 5 months (range: 3-7). Regarding OS, the data were heterogeneous, ranging between 1 and 54 months. CONCLUSIONS RT for OM seems to be a safe and feasible option. More information on the RT ideal techniques and dose are still needed. ADVANCES IN KNOWLEDGE This paper tried to sum up the few and fragmented data on the use of radiotherapy for orbital metastases: the possible option ranged from 3D- and 2D-CRT to SBRT, CK, and GK, with different possible fractionations (30Gy in 10 fractions, 60 Gy/30 fractions, 20-50 Gy/5 fractions, or 16.5-21 Gy in single fraction). Regardless of the chosen approach, almost all treated patients experienced a benefit after RT in terms of OM-related symptom intensity reduction and a good acute and late toxicity profile.
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Affiliation(s)
- Donato Pezzulla
- Radiation Oncology Unit, Responsible Research Hospital, Largo A. Gemelli 1, Campobasso, Italy
| | - Rossella Di Franco
- Department of Radiation Oncology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Alice Zamagni
- Radiation Oncology, Department of Experimental Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum-Bologna University, Bologna, Italy
| | - Francesco Pastore
- Dipartimento di Diagnostica Per Immagini, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - Silvia Longo
- Dipartimento di Diagnostica Per Immagini, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - Luca Dominici
- Department of Radiotherapy, Humanitas Clinical and Research Center–IRCCS, Rozzano, Milan, Italy
| | - Sara Lillo
- Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | | | | | - Paolo Muto
- Department of Radiation Oncology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | | | - Francesco Cellini
- Dipartimento di Diagnostica Per Immagini, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, UOC di Radioterapia Oncologica, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - Ernesto Maranzano
- University of Perugia-Faculty of Medicine and Surgery Radiotherapy Oncology Centre-“S. Maria” Hospital, Terni, Italy
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3
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Terpolilli NA, Ueberschaer M, Niyazi M, Hintschich C, Egensperger R, Muacevic A, Thon N, Tonn JC, Schichor C. Long-term outcome in orbital meningiomas: progression-free survival after targeted resection combined with early or postponed postoperative radiotherapy. J Neurosurg 2020; 133:302-312. [PMID: 31200373 DOI: 10.3171/2019.3.jns181760] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 03/12/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE In meningiomas involving the orbit and optic canal, surgery is the mainstay of therapy. However, radical resection is often limited to avoid functional damage, so multidisciplinary treatment concepts are implemented. Data on the timing and value of early postoperative radiotherapy (PORT) are scarce. This retrospective study analyzes outcomes in patients who underwent targeted resection alone or in combination with early PORT. METHODS Patients undergoing resection of orbit-associated WHO grade I meningiomas from January 1999 to December 2013 who presented to the authors' department at least twice for follow-up were included. Clinical and radiological findings were analyzed retrospectively. Patients were stratified into two cohorts: follow-up with MRI scans at regular intervals, i.e., the watch and wait (W&W) group, and a PORT group receiving PORT within 6 months after surgery in addition to MRI follow-up. Patients in the W&W group were scheduled for treatment when tumor progression was detected by imaging. RESULTS One hundred twenty-two patients were included. The mean follow-up was 70 months. The most common symptoms at presentation were visual disturbances; 87.7% of patients received Simpson grade II-III targeted partial resection. Twenty-three patients received PORT, and 99 patients were regularly observed with MRI scans (W&W group). Tumor recurrence/progression occurred significantly later (76.3 vs 40.7 months) and less frequently in the PORT group (13%) than in the W&W group (46.5%). Cases of recurrence were diagnosed an average of 39 months after initial surgery in both groups. PORT patients demonstrated significantly less visual impairment at last follow-up. CONCLUSIONS These results indicate that receiving PORT early after targeted partial resection might help to postpone tumor recurrence and the need for additional treatment, while preserving or even improving visual outcome.
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Affiliation(s)
- Nicole Angela Terpolilli
- Departments of1Neurosurgery
- 6German Cancer Consortium (DKTK), partner site Munich, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Moritz Ueberschaer
- Departments of1Neurosurgery
- 6German Cancer Consortium (DKTK), partner site Munich, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Maximilian Niyazi
- 2Radiation Oncology
- 6German Cancer Consortium (DKTK), partner site Munich, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Christoph Hintschich
- 3Ophthalmology, and
- 6German Cancer Consortium (DKTK), partner site Munich, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rupert Egensperger
- 4Neuropathology, University Hospital, LMU Munich
- 6German Cancer Consortium (DKTK), partner site Munich, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Niklas Thon
- Departments of1Neurosurgery
- 6German Cancer Consortium (DKTK), partner site Munich, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jörg-Christian Tonn
- Departments of1Neurosurgery
- 6German Cancer Consortium (DKTK), partner site Munich, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Christian Schichor
- Departments of1Neurosurgery
- 6German Cancer Consortium (DKTK), partner site Munich, and German Cancer Research Center (DKFZ), Heidelberg, Germany
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4
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Cárdenas JRV, Penella ADV, Ibarra EC. Frameless radiosurgery for intraocular metastatic tumor: Case report. Rep Pract Oncol Radiother 2020; 25:1-5. [PMID: 32042271 PMCID: PMC7000959 DOI: 10.1016/j.rpor.2019.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 07/23/2019] [Accepted: 10/07/2019] [Indexed: 11/25/2022] Open
Abstract
AIM The aim of this case report is to describe the technique and response using frameless radiosurgery technique in intraocular metastases. BACKGROUND Intraocular metastases are the most common malignant lesion within the eye and its prevalence is probably underestimated. This is of great interest for oncologist as there are new treatment options with high rates of tumor control maintaining patient's quality of life. CASE REPORT We report a case of a 54-year-old female with intraocular metastases from breast cancer using a frameless radiosurgery technique allowing organ preservation. CONCLUSION The frameless robotic radiosurgery system is feasible and comfortable option for patients with intraocular metastases. Treatment planning and delivery requires an experienced interdisciplinary team.
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Affiliation(s)
| | | | - Erick Cardona Ibarra
- Derpartment of Physics, Hospital Alta Especialidad Christus Muguerza, Monterrey, Nuevo León, México
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5
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Agarwal A, Raghavan V, Rathnadevi R, Rishi P. Treatment of circumscribed choroidal hemangioma using CyberKnife: A viable alternative. Indian J Ophthalmol 2019; 67:704-706. [PMID: 31007252 PMCID: PMC6498904 DOI: 10.4103/ijo.ijo_1410_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Circumscribed choroidal hemangioma is a benign vascular hamartoma without systemic associations. For symptomatic cases, treatment options are photodynamic therapy (PDT), transpupillary thermotherapy (TTT), intravitreal injection of anti-vascular endothelial growth factor (VEGF), or radiation therapy. CyberKnife radiosurgery is an image-guided radiation therapy that delivers radiation to lesions anywhere in the body with an accuracy of 0.5 mm without damage to surrounding structures. We report a case of circumscribed choroidal hemangioma which was successfully treated with CyberKnife therapy. The literature search reveals cases of uveal melanoma, intraocular, and periocular lymphoma successfully treated with CyberKnife therapy. To the best of our knowledge, this is the first report on such treatment for choroidal hemangioma.
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Affiliation(s)
- Aditi Agarwal
- Shree Bhagwan Mahavir Vitreoretinal Services Department, Sankara Nethralaya, College Road, Nungambakkam, Tamil Nadu, India
| | - Venkatavaradan Raghavan
- Shree Bhagwan Mahavir Vitreoretinal Services Department, Sankara Nethralaya, College Road, Nungambakkam, Tamil Nadu, India
| | - Ramadas Rathnadevi
- Department of Radiation Oncology and Cyberknife Services, Apollo Hospitals, Teynampet, Chennai, Tamil Nadu, India
| | - Pukhraj Rishi
- Shree Bhagwan Mahavir Vitreoretinal Services Department, Sankara Nethralaya, College Road, Nungambakkam, Tamil Nadu, India
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6
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Desideri I, Francolini G, Carta GA, Di Cataldo V, Masi L, Meattini I, Bonomo P, Loi M, Greto D, Visani L, Lo Russo M, Grassi R, Teriaca MA, Garlatti P, Nardi C, Livi L. Efficacy and Tolerability of CyberKnife Stereotactic Robotic Radiotherapy for Primary or Secondary Orbital Lesions: A Single-Center Retrospective Experience. Technol Cancer Res Treat 2019; 18:1533033818818561. [PMID: 30803353 PMCID: PMC6373998 DOI: 10.1177/1533033818818561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: Orbital lesions are rare, but are likely to become symptomatic and can impact on
patients’ quality of life. Local control is often difficult to obtain, because of
proximity to critical structures. CyberKnife stereotactic robotic radiotherapy could
represent a viable treatment option. Materials and Methods: Data on patients treated for intraorbital lesions from solid malignancies were
retrospectively collected. All patients underwent treatment with CyberKnife system. We
analyzed local control, response rate, symptoms control, progression-free survival and
overall survival, acute and late toxicity. Results: From January 2012 to May 2017, 20 treatments on 19 patients were performed, with dose
ranging from 24 to 35 Gy in 1 to 5 fractions, prescribed at an average isodose line of
79.5% (range: 78-81). After a mean follow-up of 14.26 months (range: 0-58), overall
response rate was 75%, with 2 and 4 patients presenting a partial and complete response,
respectively. Mean time to best measured response was 15.16 months (range: 2-58).
Thirteen patients were alive, with a local control rate of 79%. Mean time to local
progression was 5 months (range: 3-7). Three patients reported improvement in symptoms
after treatment. Mean planning target volume dose coverage was 97.2% (range: 93.5-99.7).
Mean maximum dose (D max) to eye globe, optic nerve, optic chiasm, and lens was 2380.8
cGy (range: 290-3921), 1982.82 cGy (range: 777.3-2897.8), 713.14 cGy (range:
219.5-2273), and 867.9 cGy (range: 38-3118.5). Four patients presented acute
toxicity. Conclusion: This current retrospective series demonstrated that CyberKnife robotic stereotactic
radiotherapy is a feasible and tolerable approach for intraorbital lesions.
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Affiliation(s)
- Isacco Desideri
- 1 Department of Experimental and Clinical Biomedical Sciences, Radiation Oncology Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Giulio Francolini
- 1 Department of Experimental and Clinical Biomedical Sciences, Radiation Oncology Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Giulio Alberto Carta
- 1 Department of Experimental and Clinical Biomedical Sciences, Radiation Oncology Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Vanessa Di Cataldo
- 2 CyberKnife Center, Istituto Fiorentino di Cura ed Assistenza, Florence, Italy
| | - Laura Masi
- 2 CyberKnife Center, Istituto Fiorentino di Cura ed Assistenza, Florence, Italy
| | - Icro Meattini
- 1 Department of Experimental and Clinical Biomedical Sciences, Radiation Oncology Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Pierluigi Bonomo
- 1 Department of Experimental and Clinical Biomedical Sciences, Radiation Oncology Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Mauro Loi
- 1 Department of Experimental and Clinical Biomedical Sciences, Radiation Oncology Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Daniela Greto
- 1 Department of Experimental and Clinical Biomedical Sciences, Radiation Oncology Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Luca Visani
- 1 Department of Experimental and Clinical Biomedical Sciences, Radiation Oncology Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Monica Lo Russo
- 1 Department of Experimental and Clinical Biomedical Sciences, Radiation Oncology Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Roberta Grassi
- 1 Department of Experimental and Clinical Biomedical Sciences, Radiation Oncology Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Maria Ausilia Teriaca
- 1 Department of Experimental and Clinical Biomedical Sciences, Radiation Oncology Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Pietro Garlatti
- 1 Department of Experimental and Clinical Biomedical Sciences, Radiation Oncology Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Cosimo Nardi
- 3 Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Lorenzo Livi
- 1 Department of Experimental and Clinical Biomedical Sciences, Radiation Oncology Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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7
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Wösle M, Krause L, Sreenivasa S, Vordermark D, Ciernik IF. Stereotactic radiotherapy for choroidal melanomas by means of HybridArc™ : Physics and technique of linac-based photon beam therapy. Strahlenther Onkol 2018; 194:929-943. [PMID: 30116827 DOI: 10.1007/s00066-018-1349-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 08/02/2018] [Indexed: 01/06/2023]
Abstract
PURPOSE Stereotactic radiotherapy (SRT) is suitable to treat ocular tumours. The optimal beam geometry for SRT, however, has not been defined. Here we evaluate a combination technique with dynamic conformal arcs (DCAs) and intensity-modulated static fields (IMRT), known as HybridArc™ (HA). METHODS For the first consecutive 25 cases with choroidal melanomas with volumes of 0.02 to 1.18 cm3 treated with 50 Gy in five fractions, the results with respect to dose conformity, homogeneity, and dose distributions were summarised. To describe the dose distribution at the planning target volume (PTV) boundary, we defined a spatially averaged dose gradient (SADG) and compared it with Paddick's gradient index (GI). We made dosimetric comparisons between HA and other irradiation techniques. RESULTS The PTVs ranged from 0.42 to 3.37 cm3. The conformity index (CI) was 1.25 ± 0.15, and the homogeneity index (HI) 0.08 ± 0.02. The SADG was (-3.5 ± 0.5) Gy/mm or (-7.0 ± 1.0) %/mm between the isodose levels 95 and 20%; local minima reached -11.5 Gy/mm or -22.9%/mm. The coefficient of determination for a nonlinear regression of GI on SADG was 0.072. After a median follow-up time of 19.6 months, local tumour control was 100% without any case of post-therapeutic enucleation. Two patients (8%) developed liver metastases. CONCLUSION SRT of ocular tumours by HA is highly appropriate, and HA is superior to intensity-modulated arc therapy (IMAT) concerning dose reduction in organs at risk (OARs). The novel gradient measure SADG is more informative than Paddick's GI.
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Affiliation(s)
- Markus Wösle
- Klinik für Strahlentherapie und Radioonkologie, Städtisches Klinikum Dessau, Auenweg 38, 06847, Dessau-Roßlau, Germany.
| | - Lothar Krause
- Klinik für Augenheilkunde und Zentrum für Refraktive Chirurgie, Städtisches Klinikum Dessau, Auenweg 38, 06847, Dessau-Roßlau, Germany
| | - Shanthala Sreenivasa
- Klinik für Strahlentherapie und Radioonkologie, Städtisches Klinikum Dessau, Auenweg 38, 06847, Dessau-Roßlau, Germany.,Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Straße 8, 06108, Halle (Saale), Germany
| | - Dirk Vordermark
- Universitätsklinik und Poliklinik für Strahlentherapie, Universitätsklinikum Halle (Saale), Ernst-Grube-Straße 40, 06120, Halle (Saale), Germany
| | - Ilja F Ciernik
- Klinik für Strahlentherapie und Radioonkologie, Städtisches Klinikum Dessau, Auenweg 38, 06847, Dessau-Roßlau, Germany
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8
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Bazire L, Darmon I, Calugaru V, Costa É, Dumas JL, Kirova YM. [Technical aspects and indications of extracranial stereotactic radiotherapy]. Cancer Radiother 2018; 22:447-458. [PMID: 30064828 DOI: 10.1016/j.canrad.2017.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 09/10/2017] [Accepted: 09/16/2017] [Indexed: 12/25/2022]
Abstract
Extracranial stereotactic radiotherapy has developed considerably in recent years and is now an important part of the therapeutic alternatives to be offered to patients with cancer. It offers opportunities that have progressively led physicians to reconsider the therapeutic strategy, for example in the case of local recurrence in irradiated territory or oligometastatic disease. The literature on the subject is rich but, yet, there is no real consensus on therapeutic indications. This is largely due to the lack of prospective, randomized studies that have evaluated this technique with sufficient recoil. We propose a review of the literature on the technical aspects and indications of extracranial stereotactic radiotherapy.
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Affiliation(s)
- L Bazire
- Département de radiothérapie oncologie, institut Curie, 25, rue d'Ulm, 75005 Paris, France.
| | - I Darmon
- Département de radiothérapie oncologie, institut Curie, 25, rue d'Ulm, 75005 Paris, France
| | - V Calugaru
- Département de radiothérapie oncologie, institut Curie, 25, rue d'Ulm, 75005 Paris, France
| | - É Costa
- Département de radiothérapie oncologie, institut Curie, 25, rue d'Ulm, 75005 Paris, France
| | - J-L Dumas
- Département de radiothérapie oncologie, institut Curie, 25, rue d'Ulm, 75005 Paris, France
| | - Y M Kirova
- Département de radiothérapie oncologie, institut Curie, 25, rue d'Ulm, 75005 Paris, France
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9
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Riva G, Augugliaro M, Piperno G, Ferrari A, Rondi E, Vigorito S, Ciardo D, Orecchia R, Jereczek-Fossa BA. CyberKnife radiotherapy for orbital metastases: A single-center experience on 24 lesions. Eur J Ophthalmol 2018; 29:61-68. [PMID: 29587486 DOI: 10.1177/1120672118761728] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES: To evaluate the feasibility, in terms of acute toxicity and symptom control, of CyberKnife (Accuray, Sunnyvale, CA)-based stereotactic radiotherapy (CyberKnife-SRT) for metastatic orbital lesions. METHODS: This retrospective study included patients with symptomatic metastases wholly located within the orbit. Palliative radiation treatment was performed using CyberKnife image-guided technology. Gross tumor volume was defined on a pre-radiotherapy magnetic resonance imaging. Acute and late toxicity was recorded according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Scale. RESULTS: Between April 2012 and July 2016, 21 patients underwent CyberKnife-SRT for 24 orbital metastases from different primary tumors. Median treatment dose was 18 Gy (15-24 Gy) given in a median of 3 fractions (2-3 fractions) with a median dose of 6 Gy/fraction (5-10 Gy/fraction). Acute grade 1 toxicity was observed in eight cases. No local recurrence occurred after median follow-up of 6.2 months (1.1-30.0 months) among 16 lesions that underwent post-stereotactic radiotherapy magnetic resonance imaging. All patients reported decreasing pre-stereotactic radiotherapy symptoms without late toxicity. Follow-up >6 months (median 22.8 months) was available for nine lesions; complete and partial radiological response was registered in four and five of them, respectively. CONCLUSION: In our experience, CyberKnife-SRT is a well-tolerated treatment that offers high local and symptom control in patients with intraocular and periocular malignant lesions.
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Affiliation(s)
- Giulia Riva
- 1 Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.,2 Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - Matteo Augugliaro
- 1 Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.,2 Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - Gaia Piperno
- 2 Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - Annamaria Ferrari
- 2 Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - Elena Rondi
- 3 Unit of Medical Physics, European Institute of Oncology, Milan, Italy
| | - Sabrina Vigorito
- 3 Unit of Medical Physics, European Institute of Oncology, Milan, Italy
| | - Delia Ciardo
- 2 Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - Roberto Orecchia
- 4 Scientific Directorate, European Institute of Oncology, Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- 1 Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.,2 Department of Radiotherapy, European Institute of Oncology, Milan, Italy
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10
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Adamczyk M, Janiga P. Staged Radiosurgical Ablation for Choroid Melanoma: A Case Report with Emphasis on the Role of Patient Preparation, Treatment Planning, and Precision of Delivery. Cureus 2016; 8:e611. [PMID: 27335716 PMCID: PMC4911270 DOI: 10.7759/cureus.611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The aim of reporting this case of choroid melanoma of the left eye is to introduce the in-house-designed treatment planning protocol for fractionated radiosurgical ablation of an intraocular lesion. This is a clinical case with emphasis on treatment preparation and delivery using the Accuray CyberKnife Robotic Radiosurgery System (Accuray, Sunnyvale, CA, USA) for a patient immobilized with a head mask and our in-house-made eye fixation system.
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Affiliation(s)
- Marta Adamczyk
- Medical Physics Department, Greater Poland Cancer Centre
| | - Piotr Janiga
- Radiotherapy Ward I, Greater Poland Cancer Centre
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11
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Stereotactic radiotherapy of orbital metastasis from malignant melanoma: a case study. JOURNAL OF RADIOTHERAPY IN PRACTICE 2015. [DOI: 10.1017/s1460396914000417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:Orbital metastases lead to many distressful symptoms.Methods:A case-report of a 44-year-old woman with a melanoma metastasis in the orbital cavity, is reported. A patient presented with headache, proptosis and diplopia. The stereotactic radiotherapy of 19.5 Gy in three fractions using CyberKnife was performed. Follow-up examination 7 months later revealed satisfactory local control of the tumour, alleviation of orbital symptoms with no negative impact on visual function.Conclusion:Stereotactic radiotherapy seems to be a safe and effective treatment of orbital metastases from melanoma.
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Rohan Lee K, Chiang Ling K, Reza Peyman M, Subrayan V. Acute ptosis as the sole presenting symptom of a pulmonary adenocarcinoma. Eur Geriatr Med 2014. [DOI: 10.1016/j.eurger.2014.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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