The Role of CT and MR Imaging in Stereotactic Body Radiotherapy of the Spine: From Patient Selection and Treatment Planning to Post-Treatment Monitoring.

Spine metastases (SMs) are common, arising in 70% of the cases of the most prevalent malignancies in males (prostate cancer) and females (breast cancer). Stereotactic body radiotherapy, or SBRT, has been incorporated into clinical treatment algorithms over the past decade. SBRT has shown promising rates of local control for oligometastatic spinal lesions with low radiation dose to adjacent critical tissues, particularly the spinal cord.

Patient reported outcomes and short-term adjustment trajectories following gamma knife radiosurgery for benign brain tumor.

Purpose: Patient reported outcomes (PROs) in the context of Gamma Knife Stereotactic Radiosurgery (GKSRS) for benign brain tumor have been under-researched. This study examined changes in PROs and adjustment trajectories post-GKSRS.

Method: 50 adults (54% female) aged on average 53.

Radiosurgery Society Case-Based Guide to Stereotactic Body Radiation Therapy for Challenging Cases of Spinal Metastases.

Purpose: Spinal stereotactic body radiation therapy (SBRT) has become the standard of care in management of patients with limited sites of metastatic disease, radioresistant histologies, painful vertebral metastases with long life expectancy and cases of reirradiation. Our case-based guidelines aim to assist radiation oncologists in the appropriate utilization of SBRT for common, yet challenging, cases of spinal metastases.

Methods And Materials: Cases were selected to include scenarios of large volume sacral disease with nerve entrapment, medically inoperable disease abutting the thecal sac, and local failure after prior SBRT.

Utility of 68Ga-DOTATATE PET-MRI for Gamma Knife® stereotactic radiosurgery treatment planning for meningioma.

Objectives: To investigate the impact of adding 68Ga-DOTATATE PET/MRI to standard MRI for target volume delineation in Gamma Knife® stereotactic radiosurgery (GKSRS) for meningioma.

Methods: Seventeen patients with 18 lesions undergoing GKSRS for WHO grade 1 meningioma were enrolled in a prospective study. All patients underwent pre-treatment 68Ga-DOTATATE PET/MRI examination in addition to standard procedures.

Repurposing traditional U-Net predictions for sparse SAM prompting in medical image segmentation.

Automated medical image segmentation (MIS) using deep learning has traditionally relied on models built and trained from scratch, or at least fine-tuned on a target dataset. The Segment Anything Model (SAM) by Meta challenges this paradigm by providing zero-shot generalisation capabilities. This study aims to develop and compare methods for refining traditional U-Net segmentations by repurposing them for automated SAM prompting.

Cost-utility analysis of a telehealth psychological support intervention for people with primary brain tumor: Telehealth Making Sense of brain tumor.

Objective: To undertake an economic evaluation of a telehealth psychological support intervention for patients with primary brain tumor (PBT).

Methods: A within-trial cost-utility analysis over 6 months was performed comparing a tailored telehealth-psychological support intervention with standard care (SC) in a randomized control trial. Data were sourced from the Telehealth Making Sense of Brain Tumor (Tele-MAST) trial survey data, project records, and administrative healthcare claims.

Emergent radiotherapy for spinal cord compression/impingement-a narrative review.

Background And Objective: Malignant epidural spinal cord compression (MESCC), often presenting with back pain and motor/sensory deficits, is associated with poor survival, particularly when there is loss of ambulation. The purpose of this review is to evaluate the literature and discuss appropriate workup and management of MESCC, specifically in the emergent setting.

Methods: A PubMed search was conducted on "spinal cord compression" and "radiation therapy.

Outcomes for oligometastatic head and neck cancer treated with stereotactic body radiotherapy: Results from an international multi-institutional consortium.

Background: We report the results of an international multi-institutional cohort of oligometastatic (OMD) head and neck cancer (HNC) patients treated with SBRT.

Methods: Patients with OMD HNC (≤5 metastases) treated with SBRT between 2008 and 2016 at six institutions were included. Treated metastasis control (TMC), progression-free survival (PFS), and overall survival (OS) were analyzed by multivariable analysis (MVA).

Emergent radiotherapy for brain and leptomeningeal metastases: a narrative review.

Background And Objective: As novel systemic therapies allow patients to live longer with cancer, the risk of developing central nervous system (CNS) metastases increases and providers will more frequently encounter emergent presentation of brain metastases (BM) and leptomeningeal metastases (LM). Management of these metastases requires appropriate work-up and well-coordinated multidisciplinary care. We set out to perform a review of emergent radiotherapy (RT) for CNS metastases, specifically focusing on BM and LM.

Evaluation of the telehealth making sense of brain tumor psychological support intervention for people with primary brain tumor and their caregivers: A randomized controlled trial.

Objective: This pragmatic randomized control trial aimed to evaluate clinical efficacy of the Making Sense of Brain Tumour program delivered via videoconferencing (Tele-MAST) for improving mental health and quality of life (QoL) relative to standard care in individuals with primary brain tumor (PBT).

Method: Adults with PBT experiencing at least mild distress (Distress Thermometer ≥4) and caregivers were randomly allocated to the 10-session Tele-MAST program or standard care. Mental health and QoL were assessed pre-intervention, post-intervention (primary endpoint), and 6-weeks and 6-months follow-up.

The impact of local control on widespread progression and survival in oligometastasis-directed SBRT: Results from a large international database.

Purpose: We investigated the impact of local control (LC) on widespread progression (WSP) and overall survival (OS) in patients treated to all extracranial oligometastases (OMs) at presentation to SBRT in this retrospective review across 6 international centers.

Materials/methods: Relationships between LC status of SBRT-directed OMs and OS and WSP (>5 new active/untreated lesions) were explored using Cox and Fine-Gray regression models, adjusting for radioresistant histology and pre-SBRT systemic therapy receipt. The association between LC and dosimetric predictors was analyzed with competing risk regression using death as a competing risk and across a wide range of simulated α/βratios.

The safety, feasibility, and efficacy of an 18-week exercise intervention for adults with primary brain cancer - the BRACE study.

Purpose: To determine the safety, feasibility, and potential effect of an 18-week exercise intervention for adults with primary brain cancer.

Materials And Methods: Eligible patients were 12-26-weeks post-radiotherapy for brain cancer. The individually-prescribed weekly exercise was ≥150-minutes of moderate-intensity exercise, including two resistance-training sessions.

Individuals' perceptions of health and well-being in the context of stereotactic radiosurgery for benign brain tumour: A longitudinal qualitative investigation.

Background And Objectives: Treatment-related outcomes after Gamma Knife Stereotactic Radiosurgery (GKSRS) for benign brain tumour are well-established; yet patient reported outcomes have been largely overlooked. This study explored individuals' perspectives of their health and well-being prior to and following GKSRS.

Method: Twenty adults (65% female) aged 24-71 years with benign brain tumour were recruited from a major metropolitan hospital and assessed approximately one week prior to, two weeks after, and at three months following GKSRS.

Gamma Knife® stereotactic radiosurgery for intracranial cavernous malformations.

Introduction: Gamma Knife® stereotactic radiosurgery (GKSRS) is a non-invasive alternative to surgical resection for cerebral cavernous malformations (CCMs), especially in eloquent locations.

Methodology: A retrospective review was performed on an Australian cohort of patients receiving GKSRS for CCMs at a single institution. All patients exhibited symptoms and/or radiological evidence of haemorrhage before therapy.

Conditional Survival of Patients With Extracranial Oligometastatic Treated With Stereotactic Body Radiation Therapy: An International Consortium Study.

Purpose: Prolonged survivorship is increasingly observed in patients with oligometastases (OM) treated with stereotactic body radiation therapy (SBRT). The purpose of this study was to study the conditional survival of patients with OM, which can provide more detailed prognostic information over time by considering time already survived.

Methods And Materials: A multi-institutional database consisting of 1033 patients with OM (≤5 metastases) treated with SBRT between 2006 and 2017 was analyzed.

Stereotactic radiosurgery for melanoma brain metastases: Concurrent immune checkpoint inhibitor therapy associated with superior clinicoradiological response outcomes.

Introduction/purpose: This study assessed long-term clinical and radiological outcomes following treatment with combination stereotactic radiosurgery (SRS) and immunotherapy (IT) for melanoma brain metastases (BM).

Methods: A retrospective review was performed in a contemporary cohort of patients with melanoma BM at a single tertiary institution receiving Gamma Knife SRS for melanoma BM. Multivariate Cox proportional-hazards modelling was performed with a P <0.

"Hey, I'm still here!": Maintaining, managing and rebuilding social connections after brain tumour.

It is well recognized that social networks can buffer the adverse effects of chronic illness on psychological wellbeing. However, the functional impairments associated with brain tumour often affect social participation, which may reduce people's capacity to draw upon their social capital for support. This qualitative phenomenological study aimed to understand how brain tumour influences people's ability to manage, maintain, and rebuild their social networks.

The optimal management of brain metastases from gestational trophoblastic neoplasia.

Introduction: Gestational trophoblastic diseases and neoplasias (GTDs and GTNs) comprise a spectrum of diseases arising from abnormally proliferating placental/trophoblastic tissue following an antecedent molar or non-molar pregnancy. These can spread to the brain hematogenously in about 10% of patients, mostly in high-risk disease. The optimal management of patients with brain metastases from GTN is unclear, with multiple systemic regimens under use and an uncertain role for radiotherapy.

Current status of intra-cranial stereotactic radiotherapy and stereotactic radiosurgery in Australia and New Zealand: key considerations from a workshop and surveys.

Recently, there has been increased interest worldwide in the use of conventional linear accelerator (linac)-based systems for delivery of stereotactic radiosurgery/radiotherapy (SRS/SRT) contrasting with historical delivery in specialised clinics with dedicated equipment. In order to gain an understanding and define the current status of SRS/SRT delivery in Australia and New Zealand (ANZ) we conducted surveys and provided a single-day workshop. Prior to the workshop ANZ medical physicists were invited to complete two surveys: a departmental survey regarding SRS/SRT practises and equipment; and an individual survey regarding opinions on current and future SRS/SRT practices.

An analysis of a large multi-institutional database reveals important associations between treatment parameters and clinical outcomes for stereotactic body radiotherapy (SBRT) of oligometastatic colorectal cancer.

Purpose: In recent years, stereotactic body radiotherapy (SBRT) has emerged as an effective treatment for oligometastatic cancers. Here, we report radiation treatment parameters and clinical outcomes for patients with oligometastatic colorectal cancer (CRC) treated with SBRT using a large multi-institutional database.

Methods: Patients with extra-cranial oligometastatic CRC (≤5 lesions) treated with SBRT at six large academic cancer centers were included.

Development of a Prognostic Model for Overall Survival in Patients With Extracranial Oligometastatic Disease Treated With Stereotactic Body Radiation Therapy.

Purpose: Patients with oligometastatic disease (OMD) can experience durable disease control with ablative therapy to all sites of disease. Stereotactic body radiation therapy (SBRT) is an important modality in the management of OMD, although a validated prognostic model for OMD treated with SBRT is currently lacking. The purpose of this study was to develop a prognostic model for overall survival (OS) in patients with OMD treated with SBRT.

Volumetric burden of metastatic lesions drives outcomes in patients with extracranial oligometastatic disease.

Background: We hypothesized that the total volume of metastases at initial oligometastatic (OM) presentation to stereotactic body radiation therapy (SBRT) is an important prognostic factor that can refine the definition of OM disease.

Methods: Patients with extracranial oligometastatic cancer (≤5 lesions) treated with SBRT were included in an international multi-institutional database. Multivariable Cox and competing risks regression models were used to determine the relationship between distant progression-free survival (DPFS), widespread progression (WSP), and overall survival (OS) with the total planning target volume (PTV) at initial OM presentation to SBRT.

Use of GammaPlan convolution algorithm for dose calculation on CT and cone-beam CT images.

Purpose: The aim of this study was to assess the suitability of using cone-beam computed tomography images (CBCTs) produced in a Leksell Gamma Knife (LGK) Icon system to generate electron density information for the convolution algorithm in Leksell GammaPlan (LGP) Treatment Planning System (TPS).

Materials And Methods: A retrospective set of 30 LGK treatment plans generated for patients with multiple metastases was selected in this study. Both CBCTs and fan-beam CTs were used to provide electron density data for the convolution algorithm.