Single Fraction Radiosurgical Tolerance of Brainstem, Trigeminal Nerve, and Meckel's Cave for Facial Numbness.

Purpose: This article reviews toxicity outcomes for a series of patients treated with stereotactic radiosurgery for trigeminal neuralgia, focusing on dose to the brainstem, trigeminal nerve, and Meckel's cave as possible explanatory variables for the development of the most common posttreatment neuropathy, facial numbness.

Methods And Materials: A retrospective review of 136 cases treated with CyberKnife radiosurgery for trigeminal neuralgia was performed. Dose was initially (cohort 1) prescribed to 57 to 64 Gy covering a 6-mm cylindrical shaped target volume ≥2 mm from the dorsal root entry zone.

Nephron-Sparing Robotic Radiosurgical Therapy for Primary Renal Cell Carcinoma: Single-Institution Experience and Review of the Literature.

Purpose: We report our single-institution stereotactic body radiation therapy (SBRT) experience on stage I renal cancer with prospectively collected toxicity and efficacy data.

Methods And Materials: A total of 21 patients with solitary renal tumors, including 14 surgical candidates who refused surgery (66%), were treated with SBRT. Histologic confirmation was obtained on all patients before treatment; 2 had transitional cell carcinoma and 19 had renal cell carcinoma.

Prospectively-collected, tooth-specific dosimetry correlated with adverse dental outcomes.

Objectives: To correlate radiation dose to specific tooth-bearing portions of bone with adverse dental outcomes.

Study Design: Eighty-nine patients treated with intensity-modulated radiation therapy with or without chemotherapy had radiation dose to specific tooth-bearing portions of the mandible and the maxilla. Data were collected prospectively during treatment planning, which resulted in 2490 data points.

Prevention of needle displacement in multifraction high-dose-rate prostate brachytherapy: A prospective volumetric analysis and technical considerations.

Purpose: We conducted a prospective study to evaluate needle displacements between prostate high-dose-rate (HDR) brachytherapy fractions and offer technical recommendations to help prevent displacements from the outset.

Methods And Materials: Planning computed tomography and verification computed tomography scans were obtained at 1-mm slice thickness and prospectively assessed for interfraction needle movement for each fraction of a 2-fraction HDR prostate boost. For both the planning and verification CTs, distances from each needle tip to the centroid of 3 implanted prostate gold seeds were measured.

Dorsal vagal complex of the brainstem: conformal avoidance to reduce nausea.

Purpose: To investigate the role of dose to the dorsal vagal complex (DVC) as an emetic stimulus in head-and-neck cancer patients treated with intensity modulated radiation therapy but without chemotherapy.

Methods And Materials: Seventy consecutively treated patients were analyzed for factors associated with nausea. The DVC was contoured on treatment planning scans using a previously published template and mean dose to the structure was analyzed for dose response.

Clinical outcomes of image guided radiation therapy (IGRT) with gold fiducial vaginal cuff markers for high-risk endometrial cancer.

Objective: To report two year clinical outcomes of image guided radiation therapy (IGRT) to the vaginal cuff and pelvic lymph nodes in a series of high-risk endometrial cancer patients.

Methods: Twenty-six consecutive high-risk endometrial cancer patients requiring adjuvant radiation to the vaginal cuff and regional lymph nodes were treated with vaginal cuff fiducial-based IGRT. Seventeen (65%) received sequential chemotherapy, most commonly with a sandwich technique.

CyberKnife radiosurgery for trigeminal neuralgia: unanticipated iatrogenic effect following successful treatment.

This case report of 74-year-old man with trigeminal neuralgia is presented to underscore the importance of evaluating the entire treatment plan, especially when delivering large doses where even a low percentage of the prescription dose can contribute a substantial dose to an unintended target. The patient was treated using the CyberKnife stereotactic radiosurgery system utilizing a nonisocentric beam treatment plan with a 5-mm fixed collimator generating 111 beams to deliver 6000 cGy to the 79% isodose line with a maximum dose of 7594 cGy to the target. Two weeks after treatment the patient's trigeminal neuralgia symptoms resolved; however, the patient developed oral mucositis due to the treatment.

Accelerated fractionation head and neck intensity-modulated radiation therapy and concurrent chemotherapy in the community setting: safety and efficacy considerations.

Background: This article reviews our community cancer center's experience treating head and neck cancer primarily with accelerated fractionation intensity-modulated radiation therapy (IMRT), with or without concurrent chemotherapy, focusing on acute toxicity and efficacy.

Methods: Fifty-two patients treated with IMRT at the Penrose Cancer Center between 2002 and 2007 constitute the cohort. The majority (75%) received an accelerated, altered fractionation regimen, typically concomitant boost to 7200 cGy.

High-dose-rate brachytherapy for large prostate volumes (> or =50cc)-Uncompromised dosimetric coverage and acceptable toxicity.

Purpose: The purpose of this study was to review our single-institution experience using high-dose-rate (HDR) brachytherapy in patients with large-volume prostate glands (> or =50cc).

Methods And Materials: Fifty-four patients treated with HDR brachytherapy for prostate cancer at the Penrose Cancer Center between 2001 and 2006 were identified as having an ultrasound volume of at least 50cc at the time of implant (range, 50-97.3cc; mean, 61.

Factors associated with radiation-induced nausea and vomiting in head and neck cancer patients treated with intensity modulated radiation therapy.

Background And Purpose: To investigate factors associated with radiation-induced nausea and vomiting (RINV) in the setting of head and neck intensity modulated radiation therapy (IMRT).

Materials And Methods: Forty-three patients treated with IMRT for head and neck cancer between 2002 and 2007 comprise the cohort. The majority (79%) were treated with an accelerated altered fractionation scheme, and concurrent chemotherapy was delivered to 23.

Low morbidity following high dose rate brachytherapy in the setting of prior transurethral prostate resection.

Purpose: We reviewed our single institution experience with high dose rate brachytherapy in patients who underwent prior transurethral prostate resection.

Materials And Methods: A total of 28 patients treated with high dose rate brachytherapy for prostate cancer at our institution between 2001 and 2006 were identified as having undergone prior transurethral prostate resection. All patients received high dose rate brachytherapy as a boost before or after conformal external beam radiation therapy to 4,500 cGy.

Does altered fractionation influence the risk of radiation-induced optic neuropathy?

Purpose: To analyze the parameters that influence the risk of radiation-induced optic neuropathy (RION) after radiotherapy for head-and-neck tumors.

Methods And Materials: Between 1964 and 2000, 273 patients with tumors of the nasopharynx, paranasal sinuses, nasal cavity, and hard palate adenoid cystic carcinomas were treated with curative intent and had radiation fields that included the optic nerves and/or chiasm. Patients were followed for at least 1 year after radiotherapy.

Preventing radiation retinopathy with hyperfractionation.

Purpose: The purpose of this study was to determine factors associated with the development of radiation retinopathy in a large series of patients with head-and-neck cancer. In particular, we addressed whether the use of hyperfractionated radiation therapy was effective in reducing the risk of retinopathy.

Methods And Materials: One hundred eighty-six patients received a significant dose to the retina as part of curative radiotherapy.

Tracheobronchial amyloidosis: a case report of successful treatment with external beam radiation therapy.

Tracheobronchial amyloidosis (TBA) refers to the deposition of localized amyloid deposits within the upper airways. Treatments have historically focused on bronchoscopic techniques including debridement, laser ablation, balloon dilation, and stent placement. Local excisions often prove temporarily effective, with multiple local recurrences and progressive compromise pulmonary function occurring frequently.

Radiation therapy for esthesioneuroblastoma: rationale for elective neck irradiation.

Purpose: Esthesioneuroblastoma is an uncommon malignancy of neural crest origin arising in the upper nasal cavity. We describe the University of Florida experience using radiation therapy (RT) in the treatment of this neoplasm, particularly the use of elective nodal irradiation.

Materials And Methods: Between May 1972 and August 1998, 22 patients received RT for esthesioneuroblastoma.

Angiosarcoma after breast-conserving therapy.

Background: Angiosarcoma arising in the irradiated breast after breast-conserving therapy is being reported with increasing frequency. As more women undergo breast-conserving therapy, the incidence can be expected to increase. Surgeons, medical oncologists, and radiation oncologists will be faced with difficult management decisions for this aggressive disease.