Mask-based immobilization in Gamma Knife stereotactic radiosurgery
Autor: | Stephen J. Ko, Steven Herchko, Laura A. Vallow, Daniel M. Trifiletti, Henry Ruiz-Garcia, Aaron Bush, Jennifer L. Peterson, B.C. May, Ronald Reimer |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male medicine.medical_treatment Small target Gamma knife Radiosurgery Large target 03 medical and health sciences Motion 0302 clinical medicine Physiology (medical) medicine Meningeal Neoplasms Humans Primary Brain Tumors Aged Retrospective Studies Aged 80 and over business.industry Brain Neoplasms General Medicine Cone-Beam Computed Tomography Middle Aged Treatment characteristics Patient tolerance Treatment Outcome Neurology 030220 oncology & carcinogenesis Intrafraction motion Surgery Female Neurology (clinical) Dose Fractionation Radiation business Nuclear medicine Meningioma 030217 neurology & neurosurgery |
Zdroj: | Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 83 |
ISSN: | 1532-2653 |
Popis: | The Gamma Knife Icon (Elekta AB, Stockholm) is a cobalt-based stereotactic radiosurgery (SRS) unit to support the use of a thermoplastic mask in lieu of a rigid frame, using an onboard cone-beam CT (CBCT) and an intrafraction motion management system (IFMM). We retrospectively reviewed 124 patients treated with Gamma Knife SRS from January 2018 to December 2019 at our institution using a mask-based immobilization system. Patient and treatment characteristics were collected and summarized as well as interfraction shifts and treatment-related outcomes. This dataset includes 124 patients with an associated 358 intracranial tumors. Twenty-four patients presented with primary brain tumors, which included 14 meningiomas and 10 other histologies, with 100 patients having brain metastases. Sixty tumors were post-operative, while 298 were intact. The median dose for primary tumors was 25 Gy in 5 fractions. Median doses to metastases were 20 Gy in 1 fraction, 27 Gy in 3 fractions, and 25 Gy in 5 fractions. Median interfraction CBCT shifts were submillimeter. Median patient follow-up was 6.28 months. 91% of patients with metastases maintained local control. Our early clinical experience has demonstrated limited toxicity profiles and high patient tolerance, which suggests that mask-based Gamma Knife SRS provides a safe alternative option for frameless SRS. Patients with large target volumes where fractionation is preferred or with small target volumes in non-eloquent areas can be considered for this approach. Response rates are encouraging, and continued follow-up is necessary to investigate long-term control and survival. |
Databáze: | OpenAIRE |
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