The Cyberknife Robotic Radiosurgery System is used at the University of California at San Francisco to provide stereotactic treatments to a range of lesions throughout the body. Image guidance is an integral part of this system and is used in every treatment to provide adaptive control during the treatment. Clinical examples are given for various types of lesions using the different image guidance techniques that are available with this technology.
{"title":"The Cyberknife: practical experience with treatment planning and delivery.","authors":"Vernon Smith, Cynthia F Chuang","doi":"10.1159/000106033","DOIUrl":"https://doi.org/10.1159/000106033","url":null,"abstract":"<p><p>The Cyberknife Robotic Radiosurgery System is used at the University of California at San Francisco to provide stereotactic treatments to a range of lesions throughout the body. Image guidance is an integral part of this system and is used in every treatment to provide adaptive control during the treatment. Clinical examples are given for various types of lesions using the different image guidance techniques that are available with this technology.</p>","PeriodicalId":55140,"journal":{"name":"Frontiers of Radiation Therapy and Oncology","volume":"40 ","pages":"143-161"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000106033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26839078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Timmerman, R. Abdulrahman, B. Kavanagh, John L. Meyer
Primary and metastatic tumors to the lung have been principle targets for the noninvasive high-doseper- fraction treatment programs now officially called stereotactic body radiation therapy (SBRT). Highly focused treatment delivery to moving lung targets requires accurate assessment of tumor position throughout the respiratory cycle. Measures to account for this motion, either by tracking (chasing), gating, or inhibition (breath hold and abdominal compression) must be employed in order to avoid large margins of error that would expose uninvolved normal tissues. The treatments use image guidance and related treatment delivery technology for the purpose of escalating the radiation dose to the tumor itself with as little radiation dose to the surrounding normal tissues as possible. Clinical trials have demonstrated superior local control with SBRT as compared with conventionally fractionated radiotherapy. While late toxicity requires further careful assessment, acute and subacute toxicity are remarkably infrequent. Radiographic and local tissue effects consistent with bronchial damage and downstream collapse with fibrosis are common, especially with adequate doses capable of ablating tumor targets. As such, great care must be taken when employing SBRT near the serially functioning central chest structures including the esophagus and major airways. While mechanisms of this injury remain elusive, ongoing prospective trials offer the hope of finding the ideal application for SBRT in treating pulmonary targets.
{"title":"Lung cancer: a model for implementing stereotactic body radiation therapy into practice.","authors":"R. Timmerman, R. Abdulrahman, B. Kavanagh, John L. Meyer","doi":"10.1159/0000106047","DOIUrl":"https://doi.org/10.1159/0000106047","url":null,"abstract":"Primary and metastatic tumors to the lung have been principle targets for the noninvasive high-doseper- fraction treatment programs now officially called stereotactic body radiation therapy (SBRT). Highly focused treatment delivery to moving lung targets requires accurate assessment of tumor position throughout the respiratory cycle. Measures to account for this motion, either by tracking (chasing), gating, or inhibition (breath hold and abdominal compression) must be employed in order to avoid large margins of error that would expose uninvolved normal tissues. The treatments use image guidance and related treatment delivery technology for the purpose of escalating the radiation dose to the tumor itself with as little radiation dose to the surrounding normal tissues as possible. Clinical trials have demonstrated superior local control with SBRT as compared with conventionally fractionated radiotherapy. While late toxicity requires further careful assessment, acute and subacute toxicity are remarkably infrequent. Radiographic and local tissue effects consistent with bronchial damage and downstream collapse with fibrosis are common, especially with adequate doses capable of ablating tumor targets. As such, great care must be taken when employing SBRT near the serially functioning central chest structures including the esophagus and major airways. While mechanisms of this injury remain elusive, ongoing prospective trials offer the hope of finding the ideal application for SBRT in treating pulmonary targets.","PeriodicalId":55140,"journal":{"name":"Frontiers of Radiation Therapy and Oncology","volume":"40 1","pages":"368-85"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64391184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Malignant melanoma: PET/CT as a staging procedure.","authors":"Stefan P Müller","doi":"10.1159/000090860","DOIUrl":"https://doi.org/10.1159/000090860","url":null,"abstract":"","PeriodicalId":55140,"journal":{"name":"Frontiers of Radiation Therapy and Oncology","volume":"39 ","pages":"159-170"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000090860","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25785394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The skin represented the dose-limiting organ in radiotherapy over long periods of time. In the first third of the 20th century, radiotherapy was associated with deposition of significant radiation doses in the superficial compartments of the skin. Therefore, all major radiobiological principles, such as effects of fractionation on radiation sensitivity or volume/area effects, were initially based on observations in epidermal radiation reactions. The development of radiation sources producing mega-voltage X-rays resulted in translocation of dose maxima into the subcutaneous soft tissue. With this, and with the introduction of multiple-field irradiation techniques, severe radiation effects in the skin were almost completely prevented. However, skin reactions are still relevant to critical skin areas, such as intertriginous regions. Also, the treatment of skin tumours, which requires high skin doses, is associated with substantial skin effects. Combinations of radiotherapy, e.g. with chemotherapy or UV exposure, can significantly aggravate skin effects. Moreover, accidental radiation exposure is frequently associated with significant skin doses. Therefore, early and late reactions of the skin must still be considered clinically relevant.
{"title":"Skin and other reactions to radiotherapy--clinical presentation and radiobiology of skin reactions.","authors":"Wolfgang Dörr","doi":"10.1159/000090854","DOIUrl":"https://doi.org/10.1159/000090854","url":null,"abstract":"The skin represented the dose-limiting organ in radiotherapy over long periods of time. In the first third of the 20th century, radiotherapy was associated with deposition of significant radiation doses in the superficial compartments of the skin. Therefore, all major radiobiological principles, such as effects of fractionation on radiation sensitivity or volume/area effects, were initially based on observations in epidermal radiation reactions. The development of radiation sources producing mega-voltage X-rays resulted in translocation of dose maxima into the subcutaneous soft tissue. With this, and with the introduction of multiple-field irradiation techniques, severe radiation effects in the skin were almost completely prevented. However, skin reactions are still relevant to critical skin areas, such as intertriginous regions. Also, the treatment of skin tumours, which requires high skin doses, is associated with substantial skin effects. Combinations of radiotherapy, e.g. with chemotherapy or UV exposure, can significantly aggravate skin effects. Moreover, accidental radiation exposure is frequently associated with significant skin doses. Therefore, early and late reactions of the skin must still be considered clinically relevant.","PeriodicalId":55140,"journal":{"name":"Frontiers of Radiation Therapy and Oncology","volume":"39 ","pages":"96-101"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000090854","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25785388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The role of radiotherapy in the management of malignant melanoma.","authors":"S Marnitz","doi":"10.1159/000090858","DOIUrl":"https://doi.org/10.1159/000090858","url":null,"abstract":"","PeriodicalId":55140,"journal":{"name":"Frontiers of Radiation Therapy and Oncology","volume":"39 ","pages":"140-148"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000090858","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25785392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Potential of radiation therapy in the multimodal management of merkel cell carcinoma.","authors":"G Becker, D Bottke","doi":"10.1159/000090853","DOIUrl":"https://doi.org/10.1159/000090853","url":null,"abstract":"","PeriodicalId":55140,"journal":{"name":"Frontiers of Radiation Therapy and Oncology","volume":"39 ","pages":"87-95"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000090853","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25785387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Merkel cell carcinoma--clinical presentation and treatment.","authors":"Ingrid Moll","doi":"10.1159/000090806","DOIUrl":"https://doi.org/10.1159/000090806","url":null,"abstract":"","PeriodicalId":55140,"journal":{"name":"Frontiers of Radiation Therapy and Oncology","volume":"39 ","pages":"68-74"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000090806","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25785385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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