Quantifying the Sensitivity of Target Dose on Intrafraction Displacement in Intracranial Stereotactic Radiosurgery

Schasfoort, Jannie; Ruschin, Mark; Sahgal, Arjun; MacDonald, R. Lee; Lee, Young; Pul, Carola van; Langenhuizen, Patrick; Hanssens, Patrick; Beute, Guus; Wittkämper, F.W.; Sonke, J.J.

doi:10.1016/j.prro.2021.11.012

Cited by 6 publications

(2 citation statements)

References 13 publications

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“…A recent publication evaluated dosimetric implications of intrafraction motion for Gamma Knife Icon-based SRS using simulated patient motion rather than observed intrafraction motion, but the authors plan to use actual patient motion to validate the methods developed during the initial study. 30 We believe we are the first to publish results of the potential dosimetric consequences after applying observed intrafraction motion to the individual patient's treatment plan for frameless linac-based SRS.…”

Section: Discussionmentioning

confidence: 98%

Dosimetric Analysis of Intra-Fraction Motion Detected by Surface-Guided Radiation Therapy During Linac Stereotactic Radiosurgery

Foster

Moeller

Robison³

et al. 2023

Advances in Radiation Oncology

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Section: Discussionmentioning

confidence: 98%

Dosimetric Analysis of Intra-Fraction Motion Detected by Surface-Guided Radiation Therapy During Linac Stereotactic Radiosurgery

Foster

Moeller

Robison³

et al. 2023

Advances in Radiation Oncology

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“…A 0.5-mm radial margin and 1-mm craniocaudal margin was applied to generate a PTV, as per our internally validated institutional protocol. [5][6][7] All treatment planning was performed using Leksell Gamma Plan (Elekta AB). All patients were followed with a volumetric MR brain scan every 3-4 months in conjunction with a clinical assessment.…”

Section: Methodsmentioning

confidence: 99%

Conventionally fully fractionated Gamma Knife Icon re-irradiation of primary recurrent intracranial tumors: the first report indicating feasibility and safety

Yan

Holden

Detsky

et al. 2023

Journal of Neurosurgery

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OBJECTIVE With the incorporation of real-time image guidance on the Gamma Knife system allowing for mask-based immobilization (Gamma Knife Icon [GKI]), conventionally fully fractionated (1.8–3.0 Gy/day) GKI radiation can now be delivered to take advantage of an inherently minimal margin for delivery uncertainty, sharp dose falloff, and inhomogeneous dose distribution. This case series details the authors’ preliminary experience in re-irradiating 7 complex primary intracranial tumors, which were considered to have been previously maximally radiated and situated adjacent to critical organs at risk. METHODS The authors retrospectively reviewed all patients who received fractionated re-irradiation using GKI at the Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada, between 2016 and 2021. Patients with brain metastases, and those who received radiotherapy courses in 5 or fewer fractions, were excluded. All radiotherapy doses were converted to the equivalent total dose in 2-Gy fractions (EQD2), with the assumption of an α/β ratio of 2 for late normal tissue toxicity and 10 for the tumor. RESULTS A total of 7 patients were included in this case series. Three patients had recurrent meningiomas, as well as 1 patient each with ependymoma, intracranial sarcoma, pituitary macroadenoma, and papillary pineal tumor. Six patients had undergone prior linear accelerator–based conventional fractionated radiotherapy and 1 patient had undergone prior proton therapy. Patients were re-irradiated with a median (range) total dose of 50.4 (30–63.4) Gy delivered in a median (range) of 28 (10–38) fractions with GKI. The median (range) target volume was 6.58 (0.2–46.3) cm3. The median (range) cumulative mean EQD2 administered to the tumor was 121.1 (107.9–181.3) Gy, and the median (range) maximum point EQD2 administered to the brainstem, optic nerves, and optic chiasm were 91.6 (74.0–111.5) Gy, 58.9 (6.3–102.9) Gy, and 59.9 (36.7–127.3) Gy, respectively. At a median (range) follow-up of 15 (6–42) months, 6 of 7 patients were alive with 4 having locally controlled disease. Only 3 patients experienced treatment-related toxicities, which were self-limited. CONCLUSIONS Fractionated radiotherapy using GKI may be a safe and effective method for the re-irradiation of complex progressive primary intracranial tumors, where the aim is to minimize the potential for serious late effects.

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Gamma Knife® Stereotactic Radiosurgery and Hypofractionated Stereotactic Radiotherapy

Prasad,

Madhugiri

2024

Adult CNS Radiation Oncology

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Quantifying the Sensitivity of Target Dose on Intrafraction Displacement in Intracranial Stereotactic Radiosurgery

Cited by 6 publications

References 13 publications

Dosimetric Analysis of Intra-Fraction Motion Detected by Surface-Guided Radiation Therapy During Linac Stereotactic Radiosurgery

Dosimetric Analysis of Intra-Fraction Motion Detected by Surface-Guided Radiation Therapy During Linac Stereotactic Radiosurgery

Conventionally fully fractionated Gamma Knife Icon re-irradiation of primary recurrent intracranial tumors: the first report indicating feasibility and safety

Gamma Knife® Stereotactic Radiosurgery and Hypofractionated Stereotactic Radiotherapy

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