MEDICAL REPORT
This 41 years old gentleman a case of glomus jugulare tumour was diagnosed in 2005. He underwent embolisation in 15.03.2005 followed by excision of tumour on 18.03.2005 at Kerala.
On follow up in 5.05.2005 MRI showed residual lesion of size 3.4 x2.2 cm. Patient underwent SRS on 26.07.2005 for a dose of 10 Gy to 80% isodose at elsewhere.
On follow up found recurrence in 2007 for which he went to same center where no further treatment was offered.
Then he went to another hospital in Kerala where he was offered 2nd open surgery for which patient was not willing. Then in April 2010 MRI done showed increase in lesion size about 4.3 cm x 4.21 cm x6.0 cm in size.
TREATMENT
Patient came to Apollo speciality bospital for further treatment. Patient was treated with Cyberknife boost and IMRT after discussion through our tumour board
Now follow MRI revealed good regression of size of tumour and volume analysis showed almost close to 40 to 50 % of reduction in tumour volume.
For more information you may blog your comments or write to lakshmipriya_b@apollohospitals.com
Wednesday, November 16, 2011
INDICATIONS FOR CYBERKNIFE TREATMENT
The indications for which cyberknife treatment could be useful is indicated below : Dr.Rathna devi, Senior consultant, Radiation oncology
Intra Cranial Tumours – Indications
• Skull base Tumours
• Meningiomas
• Brain Metastases
• Acoustic Schwannoma
• AVM
• Pituitary adenoma
• Low/Hi grade Glioma
Boost Re- irradiation
• Functional
• Trigeminal Neuralgia
• Spinal Tumors - Primary
Re irradiation - Metastases
• Craniophrangioma
• Chordoma
• Hamartoma
• Harmangio blastoma
• Glomus Jugular Tumor
• Boost for Nasopharynx carcinoma
EXTRA CRANIAL SITES – INDICATIONS
. Lung - Primary
- Metastases
• Liver - Primary
- Metastases
• Head & Neck - Tonsil
(Re Irradiation) - Larynx
- Pharynx
- Lacrimal Gland
• Sino Nasal Carcinoma - Boost
- Re –irradiation
• Carcinoma Pancreas
• Carcinoma Gall Bladder
• Para arotic lymph nodes
• Melanoma
• Carcinoma prostate
• Recurrent Orbital Tumours Renal Tumours
• Soft tissue sarcoma
To find out if a particular condition qualifies for cyberknife treatment you may please blog your comments or send in your query to lakshmipriya_b@apollohospitals.com
Intra Cranial Tumours – Indications
• Skull base Tumours
• Meningiomas
• Brain Metastases
• Acoustic Schwannoma
• AVM
• Pituitary adenoma
• Low/Hi grade Glioma
Boost Re- irradiation
• Functional
• Trigeminal Neuralgia
• Spinal Tumors - Primary
Re irradiation - Metastases
• Craniophrangioma
• Chordoma
• Hamartoma
• Harmangio blastoma
• Glomus Jugular Tumor
• Boost for Nasopharynx carcinoma
EXTRA CRANIAL SITES – INDICATIONS
. Lung - Primary
- Metastases
• Liver - Primary
- Metastases
• Head & Neck - Tonsil
(Re Irradiation) - Larynx
- Pharynx
- Lacrimal Gland
• Sino Nasal Carcinoma - Boost
- Re –irradiation
• Carcinoma Pancreas
• Carcinoma Gall Bladder
• Para arotic lymph nodes
• Melanoma
• Carcinoma prostate
• Recurrent Orbital Tumours Renal Tumours
• Soft tissue sarcoma
To find out if a particular condition qualifies for cyberknife treatment you may please blog your comments or send in your query to lakshmipriya_b@apollohospitals.com
Stereotactic body radiotherapy for low-risk prostrate cancer
Stereotactic body radiotherapy for
low-risk prostate cancer:
five-year outcomes
Debra E. Freeman1 and Christopher R. King2
1 Naples Radiation Oncology, PA, USA
2 Department of Radiation Oncology, UCLA School of Medicine, CA, USA
Radiation Oncology 2011, 6:3doi:10.1186/1748-717X-6-3
Purpose
Hypofractionated, stereotactic body radiotherapy (SBRT) is an emerging treatment approach for prostate cancer. We present the outcomes for low-risk prostate cancer patients with a median follow-up of 5 years after SBRT.
Method and Materials
Between Dec. 2003 and Dec. 2005, a pooled cohort of 41 consecutive patients from Stanford, CA and Naples, FL received SBRT with CyberKnife for clinically localized, low-risk prostate cancer. Prescribed dose was 35-36.25 Gy in five fractions. No patient received hormone therapy. Kaplan-Meier biochemical progression-free survival (defined using the Phoenix method) and RTOG toxicity outcomes were assessed.
Results
At a median follow-up of 5 years, the biochemical progression-free survival was 93% (95% CI = 84.7% to 100%). Acute side effects resolved within 1-3 months of treatment completion. There were no grade 4 toxicities. No late grade 3 rectal toxicity occurred, and only one late grade 3 genitourinary toxicity occurred following repeated
urologic instrumentation.
Conclusion
Five-year results of SBRT for localized prostate cancer demonstrate the efficacy and safety of shorter courses of high dose per fraction radiation delivered with SBRT technique. Ongoing clinical trials are underway to further explore this treatment approach.
Source: www.accuray.com
For moreinformation you may blog your comments or write to lakshmipriya_b@apollohospitals.com
low-risk prostate cancer:
five-year outcomes
Debra E. Freeman1 and Christopher R. King2
1 Naples Radiation Oncology, PA, USA
2 Department of Radiation Oncology, UCLA School of Medicine, CA, USA
Radiation Oncology 2011, 6:3doi:10.1186/1748-717X-6-3
Purpose
Hypofractionated, stereotactic body radiotherapy (SBRT) is an emerging treatment approach for prostate cancer. We present the outcomes for low-risk prostate cancer patients with a median follow-up of 5 years after SBRT.
Method and Materials
Between Dec. 2003 and Dec. 2005, a pooled cohort of 41 consecutive patients from Stanford, CA and Naples, FL received SBRT with CyberKnife for clinically localized, low-risk prostate cancer. Prescribed dose was 35-36.25 Gy in five fractions. No patient received hormone therapy. Kaplan-Meier biochemical progression-free survival (defined using the Phoenix method) and RTOG toxicity outcomes were assessed.
Results
At a median follow-up of 5 years, the biochemical progression-free survival was 93% (95% CI = 84.7% to 100%). Acute side effects resolved within 1-3 months of treatment completion. There were no grade 4 toxicities. No late grade 3 rectal toxicity occurred, and only one late grade 3 genitourinary toxicity occurred following repeated
urologic instrumentation.
Conclusion
Five-year results of SBRT for localized prostate cancer demonstrate the efficacy and safety of shorter courses of high dose per fraction radiation delivered with SBRT technique. Ongoing clinical trials are underway to further explore this treatment approach.
Source: www.accuray.com
For moreinformation you may blog your comments or write to lakshmipriya_b@apollohospitals.com
Monday, March 21, 2011
Lung Optimized Treatment with the CyberKnife® Robotic Radiosurgery System
Lung Optimized Treatment with the CyberKnife® Robotic Radiosurgery System
Worldwide, lung cancer is the most common cancer in terms of both incidence and mortality, with 1.61 million new cases and 1.38million deaths in 2008.1 An ever growing number of patients with early stage disease are categorized as poor surgical candidatesdue to co-morbidities such as advanced lung and heart disease. For decades these patients were left with few treatment options and were most often treated with external beam radiation therapy (EBRT). EBRT has limited efficacy due to the inclusion of large volumes of normal tissue within the treatment field, limiting the ability to deliver the high doses needed for tumor control.2 Stereotactic body radiation therapy (SBRT) for the lung directly addresses the dose limitations of EBRT. SBRT allows clinicians to deliver much higher
biologically equivalent doses in one to five fractions. Clinical evidence and publications over the last several years have demonstratedsuperior local control results for SBRT as compared to EBRT3-5, and SBRT has become a standard for the treatment of medically inoperable early stage lung cancer.6
Delivering high doses of radiation in five or fewer fractions to lung tumors demands a high degree of precision and accuracy. The Synchrony® Respiratory Tracking Systemis the only available system that provides real-time tracking for tumors that move with respiration.7 Accurate alignment of each treatment beam with the moving target is
maintained by moving the beam dynamically during treatment.
One challenge to offering CyberKnife® SBRT treatments to lung cancer patients has been the system’s reliance on implanted fiducial markers for tracking.8 Developmentsover the past several years, specifically the advent of the Xsight® Lung Tracking System technology9, allow clinicians to offer fiducial-less treatments to a subset of these
patients (typically peripherally located tumors with a minimum dimension of 15 mm). Using the Synchrony System, with or without fiducial markers, CyberKnife SBRT lung cases have been treated with a total GTV-to-CTV expansion of 3 mm and a CTV-to-PTV expansion of 2 mm.10-12
Now, with the introduction of Lung Optimized Treatment, clinicians can offer the option of fiducial-less treatments to all CyberKnife lung patients, regardless of the location
of the tumor. Lung Optimized Treatment includes the current Xsight Lung Tracking System and provides two new tracking modes: 1-View Tracking and 0-View Tracking.
1-View Tracking is designed for cases in which the treatment target is clearly visible and therefore can be tracked in only one of two the X-ray projections. With 1-View Tracking, motion in the non-tracked plane is accounted for using an Internal Target Volume (ITV) expansion in one direction (along the source-detector imager axis of the
visible view). The ITV expansion needed for 1-View Tracking is expected to be slightly larger than the CTV-to-PTV expansion used with the Xsight Lung Tracking System.
0-View Tracking is designed for cases in which the treatment target is not clearly visible in either of the two X-ray projections. In this case, ITV expansion is used in all directions.
The CyberKnife System tracking technology for treatment of lung tumors includes:
1. The Synchrony Respiratory Tracking System, which provides real-time tracking for tumors that move with respiration
2. The Xsight Lung Tracking System and the Fiducial Tracking System, which allow the target to be treated with no ITV expansion
3. The new 1-View Tracking mode, which requires ITV expansion only along the axis normal to the tracking plane
4. The new 0-View Tracking mode, which requires ITV expansion in all directions
Source: www.accuray.com
For more information you may blog your comments or write to lakshmipriya_b@apollohospitals.com
Worldwide, lung cancer is the most common cancer in terms of both incidence and mortality, with 1.61 million new cases and 1.38million deaths in 2008.1 An ever growing number of patients with early stage disease are categorized as poor surgical candidatesdue to co-morbidities such as advanced lung and heart disease. For decades these patients were left with few treatment options and were most often treated with external beam radiation therapy (EBRT). EBRT has limited efficacy due to the inclusion of large volumes of normal tissue within the treatment field, limiting the ability to deliver the high doses needed for tumor control.2 Stereotactic body radiation therapy (SBRT) for the lung directly addresses the dose limitations of EBRT. SBRT allows clinicians to deliver much higher
biologically equivalent doses in one to five fractions. Clinical evidence and publications over the last several years have demonstratedsuperior local control results for SBRT as compared to EBRT3-5, and SBRT has become a standard for the treatment of medically inoperable early stage lung cancer.6
Delivering high doses of radiation in five or fewer fractions to lung tumors demands a high degree of precision and accuracy. The Synchrony® Respiratory Tracking Systemis the only available system that provides real-time tracking for tumors that move with respiration.7 Accurate alignment of each treatment beam with the moving target is
maintained by moving the beam dynamically during treatment.
One challenge to offering CyberKnife® SBRT treatments to lung cancer patients has been the system’s reliance on implanted fiducial markers for tracking.8 Developmentsover the past several years, specifically the advent of the Xsight® Lung Tracking System technology9, allow clinicians to offer fiducial-less treatments to a subset of these
patients (typically peripherally located tumors with a minimum dimension of 15 mm). Using the Synchrony System, with or without fiducial markers, CyberKnife SBRT lung cases have been treated with a total GTV-to-CTV expansion of 3 mm and a CTV-to-PTV expansion of 2 mm.10-12
Now, with the introduction of Lung Optimized Treatment, clinicians can offer the option of fiducial-less treatments to all CyberKnife lung patients, regardless of the location
of the tumor. Lung Optimized Treatment includes the current Xsight Lung Tracking System and provides two new tracking modes: 1-View Tracking and 0-View Tracking.
1-View Tracking is designed for cases in which the treatment target is clearly visible and therefore can be tracked in only one of two the X-ray projections. With 1-View Tracking, motion in the non-tracked plane is accounted for using an Internal Target Volume (ITV) expansion in one direction (along the source-detector imager axis of the
visible view). The ITV expansion needed for 1-View Tracking is expected to be slightly larger than the CTV-to-PTV expansion used with the Xsight Lung Tracking System.
0-View Tracking is designed for cases in which the treatment target is not clearly visible in either of the two X-ray projections. In this case, ITV expansion is used in all directions.
The CyberKnife System tracking technology for treatment of lung tumors includes:
1. The Synchrony Respiratory Tracking System, which provides real-time tracking for tumors that move with respiration
2. The Xsight Lung Tracking System and the Fiducial Tracking System, which allow the target to be treated with no ITV expansion
3. The new 1-View Tracking mode, which requires ITV expansion only along the axis normal to the tracking plane
4. The new 0-View Tracking mode, which requires ITV expansion in all directions
Source: www.accuray.com
For more information you may blog your comments or write to lakshmipriya_b@apollohospitals.com
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