Spatially fractionated radiotherapy (GRID) using helical tomotherapy.

Spatially fractionated radiotherapy (GRID) was designed to treat large tumors while sparing skin, and it is usually delivered with a linear accelerator using a commercially available block or multileaf collimator (LINAC-GRID). For deep-seated (skin to tumor distance (> 8 cm)) tumors, it is always a challenge to achieve adequate tumor dose coverage. A novel method to perform GRID treatment using helical tomotherapy (HT-GRID) was developed at our institution.

Dosimetric effect on pediatric conformal treatment plans using dynamic jaw with Tomotherapy HDA.

It is important to minimize the radiation dose delivered to healthy tissues in pediatric cancer treatment because of the risk of secondary malignancies. Tomotherapy HDA provides a dynamic jaw (DJ) delivery mode that creates a sharper penumbra at the craniocaudal ends of a target in addition to a fixed jaw (FJ) delivery mode. The purpose of this study was to evaluate its dosimetric effect on the pediatric cancer cases.

Multi-institutional feasibility study of a fast patient localization method in total marrow irradiation with helical tomotherapy: a global health initiative by the international consortium of total marrow irradiation.

Purpose: To develop, characterize, and implement a fast patient localization method for total marrow irradiation.

Methods And Materials: Topographic images were acquired using megavoltage computed tomography (MVCT) detector data by delivering static orthogonal beams while the couch traversed through the gantry. Geometric and detector response corrections were performed to generate a megavoltage topogram (MVtopo).

Voxel-based dose reconstruction for total body irradiation with helical tomotherapy.

Purpose: We have developed a megavoltage CT (MVCT)-based dose reconstruction strategy for total body irradiation (TBI) with helical TomoTherapy (HT) using a deformable registration model to account for the patient's interfraction changes. The proposed technique serves as an efficient tool for delivered dose verification and, potentially, plan adaptation.

Methods And Materials: Four patients with acute myelogenous leukemia treated with TBI using HT were selected for this study.

Dosimetric comparison of helical tomotherapy and linac-IMRT treatment plans for head and neck cancer patients.

The rapid development and clinical implementation of external beam radiation treatment technologies continues. The existence of various commercially available technologies for intensity-modulated radiation therapy (IMRT) has stimulated interest in exploring the differential potential advantage one may have compared with another. Two such technologies, Hi-Art Helical Tomotherapy (HT) and conventional medical linear accelerator-based IMRT (LIMRT) have been shown to be particularly suitable for the treatment of head and neck cancers.

Evaluation of spatially fractionated radiotherapy (GRID) and definitive chemoradiotherapy with curative intent for locally advanced squamous cell carcinoma of the head and neck: initial response rates and toxicity.

Purpose: To present results and acute toxicity in 14 patients with bulky (>or=6 cm) tumors from locally advanced squamous cell carcinoma of the head and neck who received spatially fractionated radiotherapy (GRID) therapy to the bulky mass followed by concomitant chemoradiotherapy using simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT).

Methods And Materials: GRID therapy to the GTV was delivered by creating one treatment field with a checkerboard pattern composed of open-closed areas using a multileaf collimator. The GRID prescription was 20 Gy in one fraction.

Spatially fractionated (GRID) therapy for large and bulky tumors.

Avanced bulky tumors warrant aggressive therapy to attempt to maximize local control of the disease. Spatially fractionated radiation therapy (GRID) delivers a single-fraction of high dose radiation to these tumors with a curative or palliative goal. GRID therapy may be combined with fractionated radiation therapy or used in a therapeutic multi-modality setting to achieve control of the bulky disease.

Pediatric craniospinal axis irradiation with helical tomotherapy: patient outcome and lack of acute pulmonary toxicity.

Purpose: To present the patient outcomes and risk of symptomatic acute radiation pneumonitis (ARP) in 18 pediatric patients treated with helical tomotherapy to their craniospinal axis for a variety of neoplasms.

Methods And Materials: A total of 18 patients received craniospinal axis irradiation with helical tomotherapy. The median age was 12 years (range, 2.

Therapeutic guidelines for the treatment of bone metastasis: a report from the American College of Radiology Appropriateness Criteria Expert Panel on Radiation Oncology.

Bone metastases remain a therapeutic challenge because of the diversity of the problems they cause, the relative paucity of data regarding their treatment, and the necessity for management by a multidisciplinary palliative care team. The American College of Radiology convened an Appropriateness Criteria Expert Panel on Radiation Oncology for the treatment of bone metastasis to create representative clinical case scenarios and then rank the appropriate use of treatment modalities as well as the most reasonable radiotherapy dose schema and treatment planning methods. Here we present both the resulting Appropriateness Criteria and the rationale for making these decisions.

A prospective cohort study of microvascular decompression and Gamma Knife surgery in patients with trigeminal neuralgia.

Object: The aim of this study was to analyze 1 surgeon's 4-year experience with microvascular decompression ([MVD], 36 patients) and Gamma Knife surgery ([GKS], 44 patients) in 80 consecutive patients with trigeminal neuralgia (TN).

Methods: The authors conducted a prospective cohort study from March 1999 to December 2003 with an independent clinical assessment of the results and serial patient satisfaction surveys. All patients completed a 2004 patient satisfaction survey (0.

Retrospective evaluation of pediatric cranio-spinal axis irradiation plans with the Hi-ART tomotherapy system.

Helical tomotherapy (HT) can be used for the delivery of cranio-spinal axis irradiation (CSAI) without the need for beam matching of conventional linac-based external beam irradiation. The aim of this study is to retrospectively evaluate HT plans used for treatment in nine patients treated with CSAI. Helical tomotherapy cranio-spinal axis irradiation (HT-CSAI) plans were created for each patient.

Dosimetric comparison of helical tomotherapy and Gamma Knife stereotactic radiosurgery for single brain metastasis.

Background: Helical Tomotherapy (HT) integrates linear accelerator and computerized tomography (CT) technology to deliver IMRT. Targets are localized (i.e.

Fast radiographic film calibration procedure for helical tomotherapy intensity modulated radiation therapy dose verification.

Film dosimetry offers an advantageous in-phantom planar dose verification tool in terms of spatial resolution and ease of handling for quality assurance (QA) of intensity modulated radiation therapy (IMRT) plans. A critical step in the success of such a technique is that the film calibration be appropriately conducted. This paper presents a fast and efficient film calibration method for a helical tomotherapy unit using a single sheet of film.

Feasibility of cranio-spinal axis radiation with the Hi-Art tomotherapy system.

Background And Purpose: Helical tomotherapy can eliminate the need for junction lines. The goal of this study is to evaluate tomotherapy in the delivery of CSA radiation and measurement of plan quality using physical parameters in comparing conventional (CSA-RT) and helical tomotherapy (CSA-TOMO) plans.

Patients And Methods: CSA-TOMO and CSA-RT plans were created for dosimetric comparison.

Relative roles of microsurgery and stereotactic radiosurgery for the treatment of patients with cranial meningiomas: a single-surgeon 4-year integrated experience with both modalities.

Object: The authors sought to assess the respective roles of microsurgery and gamma knife surgery (GKS) in the treatment of patients with meningiomas.

Methods: The authors culled from a 4-year prospective database data on 74 cases of meningiomas. Thirty-eight were treated with GKS and 35 with microsurgery.

Accelerated cerebral vasculopathy after radiation therapy to the brain.

Brain irradiation is commonly used for many primary brain malignancies. We will present two cases of post-radiation vasculopathy of large arteries of patients who received radiation therapy to the brain as part of their tumor management. We will underscore the significance of this condition and suggest the overall management of patients receiving brain radiation at an early age.

Intensity-modulated radiation therapy reduces the dose to normal tissue in T2N0M0 squamous cell carcinoma of the glottic larynx.

The purpose of this paper was to compare intensity-modulated radiation therapy (IMRT) and conventional planning for T2N0M0 squamous cell carcinoma (SQCC) of the glottic larynx. Three patients with T2N0M0 SQCC are presented who were treated with IMRT. Conventional plans were also generated for comparison purposes.

Application of intensity-modulated radiation therapy for pediatric malignancies.

Novel radiation therapy delivery techniques have moved very slowly in the field of pediatric oncology. Some collaborative groups allow new radiation therapy delivery techniques in their trials. In many instances, the option of using these techniques is not addressed.