CyberKnife Radiosurgery of Skull-base Tumors: A UK Center Experience
| Autor: | Amen Sibtain, Hannah C P Wilson, Patricia M Price, Christy Goldsmith, Andrew Edwards, Rhiannon Davies, Keyoumars Ashkan, Ronald Beaney, Timothy Cross, Nick P Plowman, Melanie M Green |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
tumors
STEREOTACTIC RADIOSURGERY medicine.medical_specialty intracranial fractionated radiotherapy medicine.medical_treatment treatment outcomes Schwannoma Radiosurgery Meningioma 03 medical and health sciences Medicine General & Internal 0302 clinical medicine LONG-TERM OUTCOMES Cyberknife General & Internal Medicine cyberknife Medicine Pathological Science & Technology business.industry General Engineering skull base radiosurgery medicine.disease Acute toxicity stereotactic Oncology 030220 oncology & carcinogenesis Toxicity MENINGIOMAS Radiation Oncology Radiology CyberKnife Radiosurgery GAMMA-KNIFE RADIOSURGERY business Life Sciences & Biomedicine 030217 neurology & neurosurgery |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| Popis: | The study aim was to evaluate patient individualized Cyberknife® treatment for heterogeneous skull-base tumors. Patients treated between 2009 and 2013 at The Harley Street Clinic were studied. In total, 66 patients received 15–30 Gy in 1–5 fractions to a median planning target volume (PTV) of 6.4 cc, including patients with secondary, multiple, residual and recurrent tumors, and those with tumors of uncertain pathological type. Outcome analysis was pragmatically restricted to 35 patients who had single, primary tumors treated with curative intent, and sufficient diagnostic and outcome information. Sixteen vestibular schwannoma patients with median PTV 3.8 cc (range 0.81–19.6) received 18–25 Gy in 3–5 fractions: 81% showed no acute toxicity, 50% reported no late toxicity, 71% of symptoms were stable/improved and local control was 100% at 11.4 months median follow-up. Twelve meningioma patients with median PTV of 5.5 cc (range 0.68–22.3) received 17–30 Gy in 1–5 fractions: 83% experienced no acute toxicity, 33% reported no late toxicity, 88% of symptoms were stable/improved and local control was 100% at 22.1 months median follow-up. Seven patients with other tumor types with median PTV of 24.3 cc (range 7.6–100.5) received 15–28.5 Gy in 1–5 fractions: 57% experienced no acute toxicity, 57% reported no late toxicities, 66% of symptoms were stable and local control was 43% at 14.9 months median follow-up. When tumor types were considered together, smaller tumors (PTV < 6.4 cc) showed reduced acute toxicity (p = 0.01). Overall, smaller benign tumors showed low acute toxicity, excellent local control, and good symptom management: a focus on enhanced neurological preservation may refine outcomes. For other tumor types outcome was encouraging: a focus on optimal dose and fractionation scheduling may reduce toxicity and improve local control. Individual patient experiences are detailed where valuable lessons were gained for optimizing local control and minimizing toxicity. |
| Databáze: | OpenAIRE |
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