Stereotactic Body Radiotherapy (SBRT) of Pancreatic Cancer-A Critical Review and Practical Consideration.

Pancreatic cancer is the third leading cause of cancer death in the developed world and is predicted to become the second by 2030. A cure may be achieved only with surgical resection of an early diagnosed disease. Surgery for more advanced disease is challenging and can be contraindicated for many reasons.

Preoperative Chemoradiotherapy for Gastroesophageal Junction Adenocarcinoma Modified by PET/CT: Results of Virtual Planning Study.

: The treatment of gastroesophageal junction (GEJ) adenocarcinoma consists of either perioperative chemotherapy or preoperative chemoradiotherapy. Radiotherapy (RT) in the neoadjuvant setting is associated with a higher probability of resections with negative margins (R0) and better tumor regression rate, which might be enhanced by incrementing RT dose with potential impact on treatment results. This virtual planning study demonstrates the feasibility of increasing the dose to GEJ tumor and involved nodes using PET/CT imaging.

Stereotactic Body Radiotherapy for Lymph Node Oligometastases: Real-World Evidence From 90 Consecutive Patients.

Aims: To evaluate the efficacy and toxicity of extracranial stereotactic body radiotherapy (SBRT) in the treatment of oligometastatic lymph node involvement in the mediastinum, retroperitoneum, or pelvis, in a consecutive group of patients from real clinical practice outside clinical trials.

Methods: A retrospective analysis of 90 patients with a maximum of four oligometastases and various primary tumors (the most common being colorectal cancers). The endpoints were local control of treated metastases (LC), freedom from widespread dissemination (FFWD), progression-free survival (PFS), overall survival (OS), and freedom from systemic treatment (FFST).

Targeted Radiotherapy of the Tumor Cavity after Surgical Resection of Aggressive Recurrent Brain Metastasis: A Case Report.

Postoperative management of patients with brain metastases is controversial. Besides local control, cognitive function and quality of life are the most important outcomes of postoperative radiotherapy. In this case report, we introduce a patient with aggressive recurred solid metastasis treated with repeated surgery and an individual radiotherapy approach in order to highlight that close mutual collaboration leads to a clear benefit for our patients.

Stereotactic Body Radiotherapy of Lymph Node Oligometastases.

Background: The aim of this retrospective study is to evaluate the efficacy and toxicity of extracranial stereotactic radiotherapy for the treatment of oligometastatic lymph node involvement in the mediastinum, retroperitoneum, and pelvis in a consecutive group of patients from real clinical practice.

Material And Methods: Of a total of 50 patients treated between 2011 and 2017, 29 were men and 21 were women, and the mean age was 62 years (median 66 years, range 25-81 years). Patients were most often irradiated in five fractions; the dose was selected according to dose-volume histograms of organs-at-risk in proximity to the planning target volume.

In silico study of pseudoprogression in glioblastoma: collaboration of radiologists and radiation oncologists in the estimation of extent of high dose RT region.

Background And Aim: Oncologists play a vital role in the interpretation of radiographic results in glioblastoma patients. Molecular pathology and information on radiation treatment protocols among others are all important for accurate interpretation of radiology images. One important issue that may arise in interpreting such images is the phenomenon of tumor "pseudoprogression"; oncologists need to be able to distinguish this effect from true disease progression.

Stereotactic Body Radiotherapy - Current Indications.

Background: Stereotactic body radiotherapy (SBRT) is used to treat localized tumor lesions and consists of applying high doses of radiation to a small number of fractions using specially equipped linear accelerators, modern immobilization devices, and imaging methods, which are considered special, advanced techniques in modern day radiotherapy. SBRT is a very well tolerated, non-invasive, short-term treatment that does not require hospitalization or any complicated preparation. Compared to standard radiotherapy techniques, SBRT allows, due to its precision, significantly higher doses to be applied to the target with less damage to surrounding healthy tissues.

Ablative dose stereotactic body radiation therapy for oligometastatic disease: a prospective single institution study.

Localized, metastasis-directed stereotactic body radiation therapy (SBRT) of oligometastatic disease (OD) is currently rapidly evolving standard of care in many institutions. Further reports of outcomes are required to strengthen the level of evidence in the absence of comparative trials evaluating different practical procedures. The aim of this prospective single institutional study is to analyse, in unselected cohort of patients from real-world clinical practice, the long-term survival, tumor control outcomes and safety of SBRT in OD (radical ablative radiotherapy with biological equivalent dose BED10>100 Gy).

Physiological and fitness differences between cytotypes vary with stress in a grassland perennial herb.

Background And Aims: Understanding the consequences of polyploidization is a major step towards assessing the importance of this mode of speciation. Most previous studies comparing different cytotypes, however, did so only within a single environment and considered only one group of traits. To take a step further, we need to explore multiple environments and a wide range of traits.

Left hippocampus sparing whole brain radiotherapy (WBRT): A planning study.

Aims: Unilateral sparing of the dominant (left) hippocampus during whole brain radiotherapy (WBRT) could mitigate cognitive decline, especially verbal memory, similar to the widely investigated bilateral hippocampus avoidance (HA-WBRT). The aim of this planning study is dosimetrical comparison of HA-WBRT with only left hippocampus sparing (LHA-WBRT) plans.

Methods: HA-WBRT plans for 10 patients were prepared in accordance with RTOG 0933 trial and served as baseline for comparisons with several LHA-WBRT plans prepared with an effort: 1) to maintain the same left hippocampus dosimetry ("BEST PTV") and 2) to maintain same dosimetry in planning target volume as in HA-WBRT ("BEST LH").

Utilization of Prognostic Indexes for Patients with Brain Metastases in Daily Radiotherapy Routine - is the Complexity and Intricacy Still an Issue?

Background: Many prognostic indexes are available for patients with brain metastases in order to estimate remaining lifetime before selection of appropriate treatment including palliative radiotherapy. Their routine utilization is often deprecated for their complexity. We developed a practical tool based on widely available spreadsheet editors for facilitation of daily clinical use of selected indexes (RPA, GPA and WBRT 30) and evaluated its usage for retrospective single institutional survival analysis of patients irradiated for brain metastases.

Volumetric modulated arc therapy for hippocampal-sparing radiotherapy in transformed low-grade glioma: A treatment planning case report.

Timing of radiotherapy for low-grade gliomas is still controversial due to concerns of possible adverse late effects. Prevention of possible late cognitive sequelae by hippocampal avoidance has shown promise in phase II trials. A patient with progressive low-grade glioma with gradual dedifferentiation into anaplastic astrocytoma is presented along with description of radiotherapy planning process attempting to spare the hippocampus.

Why and how to spare the hippocampus during brain radiotherapy: the developing role of hippocampal avoidance in cranial radiotherapy.

The goal of this review is to summarize the rationale for and feasibility of hippocampal sparing techniques during brain irradiation. Radiotherapy is the most effective non-surgical treatment of brain tumors and with the improvement in overall survival for these patients over the last few decades, there is an effort to minimize potential adverse effects leading to possible worsening in quality of life, especially worsening of neurocognitive function. The hippocampus and associated limbic system have long been known to be important in memory formation and pre-clinical models show loss of hippocampal stem cells with radiation as well as changes in architecture and function of mature neurons.

Cytotype distribution at a diploid-hexaploid contact zone in Aster amellus (Asteraceae).

Background And Aims: The present study aims to assess the diversity and distribution of cytotypes of Aster amellus in central and eastern Europe, contributing with data to improve understanding of the evolutionary dynamics of the contact zone between diploids and hexaploids of this polyploid complex.

Methods: Large-scale cytotype screening of 4720 individuals collected in 229 populations was performed using 4',6-diamidino-2-phenylindole (DAPI) flow cytometry. Fine-scale cytotype screening was performed in the mixed-ploidy population.

Stereotactic radiofrequency amygdalohippocampectomy for the treatment of temporal lobe epilepsy: do good neuropsychological and seizure outcomes correlate with hippocampal volume reduction?

Temporal lobe surgery bears the risk of a decline of neuropsychological functions. Stereotactic radiofrequency amygdalohippocampectomy (SAHE) represents an alternative to mesial temporal lobe epilepsy (MTLE) surgery. This study compared neuropsychological results with MRI volumetry of the residual hippocampus.

Cognitive outcome after stereotactic amygdalohippocampectomy.

Purpose: We sought to determine the neuropsychological outcome after stereotactic radiofrequency amygdalohippocampectomy performed for intractable mesial temporal lobe epilepsy.

Methods: The article describes the cases of 31 patients who were evaluated using the Wechsler Adult Intelligence Scale-Revised and the Wechsler Memory Scale-Revised prior to, and one year after, surgery.

Key Findings: Patients showed increases in their mean Full Scale, Verbal and Performance IQ scores of 4, 3 and 4 IQ points respectively (p<.

Stereotactic body radiation therapy for colorectal cancer liver metastases; early results.

Background: Stereotactic body radiation therapy (SBRT) is well feasible and effective method for treatment of colorectal cancer liver metastases.

Materials And Methods: From September 2009 to December 2011, 11 patients with 15 inoperable liver metastases of colorectal cancer were treated by SBRT using Varian Clinac iX linear accelerator. We treated 6 men and 5 women of age from 51 to 81 years (median 68).

[Contemporary pharmacotherapy of epilepsy].

The epilepsies are a frequent group of neurologic disorders. We have witnessed significant advances in their medical treatment recently. About 70 % of newly diagnosed patients are rendered seizure-free.

[Nonconvulsive status epilepticus].

The article summarizes basic facts about classification, clinical presentation, EEG diagnostics and treatment of nonconvulsive status epilepticus.

[Temporal lobe epilepsy in adults and possibilities of neurosurgical treatment: the role of magnetic resonance].

Temporal lobe epilepsy is the most common type of focal epilepsy diagnosed in adult patients. According to the location of seizure generation it is classified as mesial temporal lobe epilepsy and neocortical lateral lobe epilepsy. Diagnosis of temporal lobe epilepsy can be proved by the combination of the clinical manifestation of partial complex seizures, scalp-video EEG monitoring, results of magnetic resonance imaging (MRI) and imaging of interictal fluoro-deoxy-glucose positron emission tomography.

Stereotactic radiofrequency amygdalohippocampectomy: does reduction of entorhinal and perirhinal cortices influence good clinical seizure outcome?

Purpose: Stereotactic radiofrequency amygdalohippocampectomy (SAHE) has been modified recently in our center for the therapy of mesial temporal epilepsy (MTLE). It has promising clinical results comparable with microsurgical amygdalohippocampectomy despite smaller volume reduction of the hippocampus. We hypothesized that the extent of perirhinal and entorhinal cortex (PRC, EC) reduction could explain the clinical outcome.

Stereotactic radiofrequency amygdalohippocampectomy in the treatment of mesial temporal lobe epilepsy.

Purpose: Minimally invasive percutaneous single trajectory stereotactic radiofrequency amygdalohippocampectomy was used to treat mesial temporal lobe epilepsy (MTLE). The aim of the study was to evaluate complications and effectiveness of this procedure.

Materials And Methods: A group of 51 patients with MTLE was treated using stereotactic thermo-lesion of amygdalohippocampal complex under local anaesthesia.

Microsurgical and stereotactic radiofrequency amygdalohippocampectomy for the treatment of mesial temporal lobe epilepsy: different volume reduction, similar clinical seizure control.

We compared stereotactic radiofrequency amygdalohippocampectomy (SAHE) with microsurgical amygdalohippocampectomy (AHE) in a group of 33 patients with mesial temporal lobe epilepsy in terms of hippocampal and amygdalar volume reductions and clinical outcome. In 23 subjects treated by SAHE, the hippocampal volume decreased by 58.0% (20.

Highly unstable sequence interruptions of the CTG repeat in the myotonic dystrophy gene.

Myotonic dystrophy type 1 is caused by the expansion of a CTG repeat in the 3' UTR of the DMPK gene. A length exceeding 50 CTG triplets is pathogenic. Intermediate alleles with 35-49 triplets are not disease-causing but show instability in intergenerational transmissions.