Radiation therapy for deep periocular cancer treatments when protons are unavailable: is combining electrons and orthovoltage therapy beneficial?

Deep periocular cancers can be difficult to plan and treat with radiation, given the difficulties in apposing bolus to skin, and the proximity to the retina and other optic structures. We sought to compare the combination of electrons and orthovoltage therapy (OBE) with existing modalities for these lesions. Four cases-a retro-orbital melanoma (Case 1) and basal cell carcinomas, extending across the eyelid (Case 2) or along the medial canthus (Cases 3-4)-were selected for comparison.

Survival was Significantly Better with Surgical/Medical/Radiation Co-interventions in a Single-Institution Practice Audit of Frameless Stereotactic Radiosurgery.

Purpose: To audit outcomes after introducing frameless stereotactic radiosurgery (SRS) for brain metastases, including co-interventions: neurosurgery, systemic therapy, and whole brain radiotherapy (WBRT). We report median overall survival (MS), local failure, and distant brain failure. We hypothesized patients treated with SRS would have clinically meaningful improved MS compared with historic institutional values.

The effect of contouring variability on dosimetric parameters for brain metastases treated with stereotactic radiosurgery.

Purpose: To quantify the effect of contouring variation on stereotactic radiosurgery plan quality metrics for brain metastases.

Methods And Materials: Fourteen metastases, each contoured by 8 physicians, formed the basis of this study. A template-based dynamic conformal 5-arc dose distribution was developed for each of the 112 contours, and each dose distribution was applied to the 7 other contours in each patient set.

Managing brain metastases patients with and without radiotherapy: initial lessonsfrom a team-based consult service through a multidisciplinary integrated palliative oncology clinic.

Purpose: A new ambulatory consultative clinic with integrated assessments by palliative care, radiation oncology, and allied health professionals was introduced to (1) assess patients with brain metastases at a regional comprehensive cancer center and (2) inform and guide patients on management strategies, including palliative radiotherapy, symptom control, and end-of-life care issues. We conducted a quality assurance study to inform clinical program development.

Methods: Between January 2011 and May 2012, 100 consecutive brain metastases patients referred and assessed through a multidisciplinary clinic were evaluated for baseline characteristics, radiotherapy use, and supportive care decisions.

Image-Guided Treatment of Fractionated Stereotactic Radiotherapy Patients: A Quantitative Analysis of Pre- and Post-Treatment Orthogonal kV Images of Patients Immobilized with Thermoplastic Masks.

Objectives: To measure setup and intrafraction variability for intracranial targets during treatment of patients immobilized with a Brainlab, Inc. thermoplastic head mask using ExacTrac© imaging on the treatment unit.

Patients And Methods: Between November 2007 and June 2008, 12 patients were treated with cranial fractionated stereotactic radiation therapy for 25-28 fractions.

Chest wall pain and rib fracture after stereotactic radiotherapy for peripheral non-small cell lung cancer.

Stereotactic body radiotherapy is an emerging treatment option for peripheral non-small cell lung cancer in medically inoperable patients. With high dose per fraction radiotherapy, late side effects are of possible concern. In our initial cohort of 42 patients treated with 54 to 60 Gy in three fractions, nine patients have rib fracture.

Prospective comparison of computed tomography and magnetic resonance imaging for liver cancer delineation using deformable image registration.

Purpose: The aim of this study was to compare magnetic resonance imaging (MRI) with computed tomography (CT) for liver cancer tumor definition for high-precision radiotherapy planning.

Methods And Materials: Diagnostic quality MRI scans and triphasic CT scans, with the liver immobilized in exhale, were obtained at the time of radiation planning for 26 patients with unresectable liver metastases (n = 8), hepatocellular carcinoma (n = 10), and cholangiocarcinoma (n = 8). On the CT and MRI series best demonstrating the tumor, the liver and gross tumor volumes (GTVs) were contoured, and intrahepatic anatomic reference points were identified.