Single Institutional Experience of Stereotactic Radiosurgery Alone for First Brain Metastatic Event and Salvage of Second Brain Metastatic Event in a Community Setting with Review of the Literature.

Purpose: To document survival for patients treated with stereotactic radiosurgery (SRS) alone for brain metastases either at initial presentation or for salvage in conjunction with other known prognostic factors in a single institutional community setting with comparison to current literature.

Methods: All patients treated for brain metastases with SRS between October 2006 and October 2013 were reviewed. We identified 91 patients treated with SRS alone for first brain metastatic event (FBME) and 87 patients treated with SRS for second brain metastatic event (SBME).

Survival and Control Prognosticators of Recurrent Gynecological Malignancies of the Pelvis and Para-aortic Region Treated with Stereotactic Body Radiation Therapy.

Purpose: To define prognostic factors associated with improved survival and local control (LC) for gynecologic cancer recurrences limited to the pelvis and para-aortic (PA) region using stereotactic body radiation therapy (SBRT).

Methods: Between 2/2008 and 7/2014, 30 women (35 targets) with pelvic or PA recurrence of endometrioid ( = 12), cervical ( = 11), ovarian ( = 3), uterine-serous ( = 2), or carcinosarcoma ( = 2) cancer were treated with SBRT. Eleven recurrences were located in the central pelvis, 11 along the pelvic sidewall (PSW), and 13 in the PA region.

Benefit of Radiotherapy in Extraskeletal Myxoid Chondrosarcoma: A Propensity Score Weighted Population-based Analysis of the SEER Database.

Objectives: Extraskeletal myxoid chondrosarcoma (EMC) is a rare malignancy for which the role of radiotherapy is not well-defined. We examine the effect of external beam radiotherapy (EBRT) on cancer-specific survival (CSS) for patients with localized EMC, in a propensity score weighted, population-based analysis.

Materials And Methods: The Surveillance, Epidemiology, and End Results database (1973 to 2012) was queried for cases of localized EMC arising from soft connective tissues of the trunk and extremities treated with surgery and/or EBRT.

The Comparison of Stereotactic Body Radiation Therapy and Intensity-Modulated Radiation Therapy for Prostate Cancer by NCCN Risk Groups.

Objectives: The primary objective of this study is to compare freedom from biochemical failure (FFBF) between stereotactic body radiation therapy (SBRT) and intensity-modulated radiation therapy (IMRT) for patients with organ confined prostate cancer treated between 2007 through 2012 utilizing the 2015 National Comprehensive Cancer Network (NCCN) risk stratification guidelines. A secondary objective is to compare our updated toxicity at last follow-up compared with pretreatment with respect to bowel, bladder, sexual functioning, and need for invasive procedures between the two groups.

Methods: We retrospectively reviewed 270 consecutive men treated with either SBRT (n = 150) or IMRT (n = 120) at a community hospital with two distinct radiation departments and referral patterns.

Propensity score matched comparison of SBRT versus IMRT for the treatment of localized prostate cancer.

Objective: Stereotactic body radiation therapy (SBRT) is an attractive option for prostate cancer due to its short treatment duration and cost. In this report, we compare the efficacy and toxicity outcomes of prostate cancer patients treated with SBRT to those who received intensity-modulated radiation therapy (IMRT).

Methods: Two hundred sixty-three patients with localized prostate adenocarcinoma were included, ranging from clinically very low- to high-risk groups.

Definitive Treatment of Early-Stage Non-Small Cell Lung Cancer with Stereotactic Ablative Body Radiotherapy in a Community Cancer Center Setting.

Introduction: Stereotactic ablative body radiotherapy (SABR) provides a superior non-small cell lung cancer (NSCLC) treatment option when compared to conventional radiotherapy for patients deemed inoperable or refusing surgery. This study retrospectively analyzed the rates of tumor control and toxicity following SABR treatment (Cyberknife system) of primary early-stage NSCLC in a community setting.

Methods: One hundred patients were treated between 2007 and 2011.

Salvage Fractionated Stereotactic Radiotherapy with or without Chemotherapy and Immunotherapy for Recurrent Glioblastoma Multiforme: A Single Institution Experience.

Background: The current standard of care for salvage treatment of glioblastoma multiforme (GBM) is gross total resection and adjuvant chemoradiation for operable patients. Limited evidence exists to suggest that any particular treatment modality improves survival for recurrent GBM, especially if inoperable. We report our experience with fractionated stereotactic radiotherapy (fSRT) with and without chemo/immunotherapy, identifying prognostic factors associated with prolonged survival.

SBRT: An Opportunity to Improve Quality of Life for Oligometastatic Prostate Cancer.

Objective: Oligometastatic prostate cancer is a limited metastatic disease state in which potential long-term control is still possible with the use of targeted therapies such as surgery or stereotactic body radiation therapy (SBRT). SBRT may as well potentially prolong the time before the initiation of androgen deprivation therapy (ADT) and docetaxel chemotherapy for oligometastatic prostate cancer. The goal of this study is to outline prognostic factors associated with improved outcome with SBRT for metastatic prostate cancer and to quantify the effect of prior systemic treatments such as ADT and docetaxel on survival after SBRT.

Stereotactic body radiotherapy for re-irradiation of lung cancer recurrence with lower biological effective doses.

Objective: Few studies have evaluated re-irradiation of lung cancer recurrences with stereotactic body radiotherapy (SBRT). This study evaluates outcomes with SBRT re-irradiation for recurrent lung cancer.

Methods: Two hundred and seventy-eight patients treated with SBRT for lung cancer were retrospectively reviewed.

SBRT for the Primary Treatment of Localized Prostate Cancer: The Effect of Gleason Score, Dose and Heterogeneity of Intermediate Risk on Outcome Utilizing 2.2014 NCCN Risk Stratification Guidelines.

Purpose: To report an update of our previous experience using stereotactic body radiation therapy (SBRT) for the primary treatment of prostate cancer, risk stratified by the updated National Comprehensive Cancer Network (NCCN) version 2.2014, reporting efficacy and toxicity in a community hospital setting.

Methods: From 2007 to 2012, 142 localized prostate cancer patients were treated with SBRT using CyberKnife.

Stereotactic body radiation therapy for the primary treatment of localized prostate cancer.

Objective: The low alpha/beta ratio of prostate cancer suggests that hypofractionated schemes of dose-escalated radiotherapy should be advantageous. We report our experience using stereotactic body radiation therapy (SBRT) for the primary treatment of prostate cancer to assess efficacy and toxicity.

Methods: From 2007 to 2010, 70 patients (51 % low risk, 31 % intermediate risk, and 17 % high risk) with localized prostate cancer were treated with SBRT using the CyberKnife system.

Effect of fractionation in stereotactic body radiation therapy using the linear quadratic model.

Purpose: To examine the fractionation effect of stereotactic body radiation therapy with a heterogeneous dose distribution.

Methods: Derived from the linear quadratic formula with measurements from a hypothetical 2-cm radiosurgical tumor, the threshold percentage was defined as (α/β(tissue)/α/β(tumor)), the balance α/β ratio was defined as (prescription dose/tissue tolerance*α/β(tumor)), and the balance dose was defined as (tissue tolerance/threshold percentage).

Results: With increasing fractions and equivalent peripheral dose to the target, the biological equivalent dose of "hot spots" in a target decreases.

Stereotactic body radiation therapy for patients with heavily pretreated liver metastases and liver tumors.

We present our initial experience with CyberKnife stereotactic body radiation therapy (SBRT) in a heavily pretreated group of patients with liver metastases and primary liver tumors. From October 2007 to June 2009, 48 patients were treated at the Philadelphia CyberKnife Center for liver metastases or primary liver tumors. We report on 30 patients with 41 discrete lesions (1-4 tumors per patient) who received an ablative radiation dose (BED ≥ 79.

Hyperbaric oxygen therapy for radiation-induced cystitis and proctitis.

Purpose: To provide a retrospective analysis of the efficacy of hyperbaric oxygen therapy (HBOT) for treating hemorrhagic cystitis (HC) and proctitis secondary to pelvic- and prostate-only radiotherapy.

Methods And Materials: Nineteen patients were treated with HBOT for radiation-induced HC and proctitis. The median age at treatment was 66 years (range, 15-84 years).

Radiotherapy in the treatment of gastrointestinal stromal tumor.

Gastrointestinal stromal tumors (GISTs) are uncommon mesenchymal tumors of the gastrointestinal tract. Up to one-third of GISTs are malignant with a high rate of metastasis. Surgical resection is the mainstay of care for patients with resectable disease.

Tumor bed-to-skin distance using accelerated partial-breast irradiation with the strut-adjusted volume implant device.

Purpose: Because of the risk of skin toxicity with single dwell position, single-lumen brachytherapy devices are sometimes contraindicated for tumor cavities 5-7mm from the skin surface. We discuss the use of multicatheter device to treat patients with tumor bed-to-skin distances <7mm.

Methods And Materials: We treated 117 patients with accelerated partial-breast irradiation brachytherapy: 77 single-lumen and 40 multicatheter devices.

Chronic recurrent Gorham-Stout syndrome with cutaneous involvement.

Type IV osteolysis or Gorham-Stout syndrome is a rare condition characterized by recurrent vascular tumors that disrupt normal anatomical architecture. Gorham-Stout syndrome is most commonly associated with the skeletal system with resulting replacement of bone with scar tissue following tumor regression. The loss of entire bones has given Gorham-Stout syndrome the moniker vanishing bone disease.

Red shell: defining a high-risk zone of normal tissue damage in stereotactic body radiation therapy.

Purpose: To define a volume of tissue just outside of the clinical target volume (CTV) or planning target volume (PTV) in stereotactic body radiation therapy (SBRT) that receives doses appreciably above the tolerance level and in which other critical tissue structures must be avoided.

Methods And Materials: We define the tissue between the borders of the CTV and PTV as the Inner Red Shell. The tissue surrounding the PTV that receives higher than the local tissue tolerance is defined as the Outer Red Shell.

A Phase II study of anti-epidermal growth factor receptor radioimmunotherapy in the treatment of glioblastoma multiforme.

Object: This single-institution Phase II study tests the efficacy of adjuvant radioimmunotherapy with (125)I-labeled anti-epidermal growth factor receptor 425 murine monoclonal antibody ((125)I-mAb 425) in patients with newly diagnosed glioblastoma multiforme (GBM).

Methods: A total of 192 patients with GBM were treated with (125)I-mAb 425 over a course of 3 weekly intravenous injections of 1.8 GBq following surgery and radiation therapy.

Acute toxicity after cyberknife-delivered hypofractionated radiotherapy for treatment of prostate cancer.

Objective: To evaluate acute toxicity outcomes of prostate cancer patients treated with CyberKnife-delivered hypofractionated radiotherapy.

Methods: This study was a retrospective chart review analysis of the first 50 patients treated with CyberKnife radiotherapy for prostate cancer. Most patients were affected with early to intermediate stage prostate cancer.

Radioimmunotherapy as a novel treatment regimen: 125I-labeled monoclonal antibody 425 in the treatment of high-grade brain gliomas.

A Phase I/II clinical trial was undertaken between January 29, 1987 and January 25, 1997 to assess the efficacy of (125)I-labeled monoclonal antibody 425 ((125)I-MAb 425) in controlling high-grade brain gliomas. A total of 180 patients diagnosed with glioblastoma multiforme (GBM) and astrocytoma with anaplastic foci (AAF) were administered (125)I-MAb 425 as an adjuvant treatment. All underwent initial surgery followed by postoperative external beam radiation therapy and a cumulative dose of 140 mCi of (125)I-MAb 425.

Simultaneous radiotherapy and radioimmunotherapy of malignant gliomas with anti-EGFR antibody labelled with iodine 125. Preliminary results.

Background: In this paper we present the preliminary results of a prospective trial of the efficacy of simultaneous radiotherapy and anti-EGFR (125)I radioimmunotherapy of malignant gliomas with 2 years' total survival as the end-point, raising the question whether anti-EGFR (125)I radioimmunotherapy influences the disease-free survival in these patients.

Material And Methods: Patients with anaplastic astrocytoma or primary glioblastoma were previously treated by a macroscopically radical neurosurgical approach and randomized either to radiotherapy + radioimmunotherapy arm or treated by radiotherapy alone. Seven patients were included in the group with radioimmunotherapy, among them five with GBM and two with AA, and five patients in the control arm.