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Naokatsu Saeki - One of the best experts on this subject based on the ideXlab platform.
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Gamma knife surgery for 1–10 Brain metastases without prophylactic whole-Brain Radiation therapy: analysis of cases meeting the Japanese prospective multi-institute study (JLGK0901) inclusion criteria
Journal of Neuro-Oncology, 2010Co-Authors: Toru Serizawa, Yoshinori Higuchi, Shinji Matsuda, Osamu Nagano, Tatsuo Hirai, Naokatsu SaekiAbstract:We evaluated the results of stereotactic radiosurgery (SRS) alone using gamma knife (GK) for selected patients with 1–10 Brain metastases without prophylactic whole-Brain Radiation therapy (WBRT) among JLGK0901-eligible cases. Seven hundred seventy-eight consecutive cases meeting the following JLGK0901 study inclusion criteria were analyzed: (1) newly diagnosed Brain metastases, (2) 1–10 Brain lesions, (3) less than 10 cm^3 volume of the largest tumor, (4) less than 15 cm^3 total tumor volume, (5) no magnetic resonance (MR) findings of cerebrospinal fluid (CSF) dissemination, and (6) no impaired activity of daily living [
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Gamma Knife® Radiosurgery Alone for One to Four Brain Metastases. Is Prophylactic Whole-Brain Radiation Therapy Really Necessary?
Radiosurgery, 2010Co-Authors: Toru Serizawa, Yoshinori Higuchi, Shinji Matsuda, Osamu Nagano, Naokatsu SaekiAbstract:Objective: We evaluated the effectiveness of stereotactic radiosurgery alone for patients with 1–4 Brain metastases without prophylactic whole-Brain Radiation therapy (WBRT).
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Gamma Knife Surgery for Metastatic Brain Tumors from Lung Cancer without Prophylactic Whole Brain Radiation Therapy
Radiosurgery, 2006Co-Authors: Toru Serizawa, Yoshinori Higuchi, Shinji Matsuda, Toshihiko Iuchi, Osamu Nagano, Naokatsu SaekiAbstract:Objective: We retrospectively analyzed the effectiveness of Gamma Knife surgery (GKS) for metastatic Brain tumors from lung cancer without prophylactic whole Brain Radiation therapy. Methods: Six hu
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Gamma knife treatment for multiple metastatic Brain tumors compared with whole-Brain Radiation therapy
Journal of Neurosurgery, 2000Co-Authors: Toru Serizawa, Toshihiko Iuchi, Naokatsu Saeki, Katsunobu Osato, Masaru Odaki, Osamu Ushikubo, Shinji Hirai, Motoki Sato, Shinji MatsudaAbstract:Object. The purpose of this retrospective study was to compare the effectiveness of gamma knife radiosurgery (GKS) for multiple cerebral metastases with that of whole-Brain Radiation therapy (WBRT). Methods. Ninety-six consecutive patients with cerebral metastases from nonsmall cell lung cancer were treated between 1990 and 1999. The entry criteria were the presence of between one and 10 multiple Brain lesions at initial diagnosis, no surgically inaccessible tumors with more than a 30-mm diameter, no carcinomatous meningitis, and more than 2 months of life expectancy. The patients were divided into two groups: the GKS group (62 patients) and the WBRT group (34 patients). In the GKS group, large lesions (> 30 mm) were removed surgically and all other small lesions (≤ 30 mm) were treated by GKS. New distant lesions were treated by repeated GKS without prophylactic WBRT. In the WBRT group, the patients were treated by the traditional combined therapy of WBRT and surgery. In both groups, chemotherapy was admi...
Helen A. Shih - One of the best experts on this subject based on the ideXlab platform.
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Early experience with hippocampal avoidance whole Brain Radiation therapy and simultaneous integrated boost for Brain metastases
Journal of Neuro-Oncology, 2020Co-Authors: Emily S. Lebow, William L. Hwang, Stephen Zieminski, Yi Wang, Andrzej Niemierko, William A. Mehan, Kevin S. Oh, Melin Khandekar, Henning Willers, Helen A. ShihAbstract:Purpose Cranial irRadiation results in cognitive decline, which is hypothesized to be partially attributable to hippocampal injury and stem cell loss. Recent advances allow for targeted reduction of Radiation dose to the hippocampi while maintaining adequate dose coverage to the Brain parenchyma and additional increasing dose to Brain metastases, a approach called hippocampal avoidance whole Brain Radiation therapy with a simultaneous integrated boost (HA-WBRT + SIB.) We review our early clinical experience with HA-WBRT + SIB. Materials and methods We evaluated treatments and clinical outcomes for patients treated with HA-WBRT + SIB between 2014 and 2018. Results A total of 32 patients (median age, 63.5 years, range 45.3–78.8 years) completed HA-WBRT + SIB. Median follow-up for patients alive at the time of analysis was 11.3 months. The most common histology was non-small cell lung cancer (n = 22). Most patients (n = 25) were prescribed with WBRT dose of 30 Gy with SIB to 37.5 Gy in 15 fractions. Volumetric modulated arc therapy reduced treatment time (p
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early experience with hippocampal avoidance whole Brain Radiation therapy and simultaneous integrated boost for Brain metastases
Journal of Neuro-oncology, 2020Co-Authors: Emily S. Lebow, William L. Hwang, Stephen Zieminski, Yi Wang, Andrzej Niemierko, William A. Mehan, Kevin S. Oh, Melin Khandekar, Henning Willers, Helen A. ShihAbstract:PURPOSE: Cranial irRadiation results in cognitive decline, which is hypothesized to be partially attributable to hippocampal injury and stem cell loss. Recent advances allow for targeted reduction of Radiation dose to the hippocampi while maintaining adequate dose coverage to the Brain parenchyma and additional increasing dose to Brain metastases, a approach called hippocampal avoidance whole Brain Radiation therapy with a simultaneous integrated boost (HA-WBRT + SIB.) We review our early clinical experience with HA-WBRT + SIB. MATERIALS AND METHODS: We evaluated treatments and clinical outcomes for patients treated with HA-WBRT + SIB between 2014 and 2018. RESULTS: A total of 32 patients (median age, 63.5 years, range 45.3-78.8 years) completed HA-WBRT + SIB. Median follow-up for patients alive at the time of analysis was 11.3 months. The most common histology was non-small cell lung cancer (n = 22). Most patients (n = 25) were prescribed with WBRT dose of 30 Gy with SIB to 37.5 Gy in 15 fractions. Volumetric modulated arc therapy reduced treatment time (p < 0.0001). Median freedom from intracranial progression and overall survival from completion of treatment were 11.4 months and 19.6 months, respectively. Karnofsky Performance Status was associated with improved survival (p = 0.008). The most common toxicities were alopecia, fatigue, and nausea. Five patients developed cognitive impairment, including grade 1 (n = 3), grade 2 (n = 1), and grade 3 (n = 1). CONCLUSION: HA-WBRT + SIB demonstrated durable intracranial disease control with modest side effects and merits further investigation as a means of WBRT toxicity reduction while improving long-term locoregional control in the Brain.
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NTCT-03CEREBRAL MICROBLEEDS AFTER WHOLE Brain Radiation THERAPY IN MEDULLOBLASTOMA PATIENTS
Neuro-oncology, 2015Co-Authors: Duangnapa Roongpiboonsopit, Helen A. Shih, Lily L. Alstein, Hugo J. Kuijf, Andreas Charidimou, Li Xiong, Anastasia Vashkevich, Sergi Martinez-ramirez, Anand Viswanathan, Jorg DietrichAbstract:BACKGROUND: Radiation therapy is part of the standard treatment for medulloblastoma patients. The pattern and incidence of neurovascular toxicities, such as cerebral microbleeds (CMBs) following whole Brain Radiation therapy (WBRT) is poorly characterized in long-term survivors. The aim of this study is to determine the temporal and spatial pattern of CMBs after WBRT in medulloblastoma patients. METHODS: We retrospectively identified medulloblastoma patients treated with WBRT at the Massachusetts General Hospital between 1999 and 2014. Longitudinal magnetic resonance imaging data was reviewed, and the incidence, prevalence and spatial pattern of CMBs were characterized over time. RESULTS: We identified 27 patients previously treated with WBRT for medulloblastoma and who had complete longitudinal imaging datasets available for review, including GRE, T1 and T2 imaging sequences. CMBs were found in >65% (18/27) of patients when followed for a median time of at least 4 years. Incidence of CMBs was increasing with each year from time of WBRT, and was more likely in patients treated at age of
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A phase I study of cediranib plus whole-Brain Radiation therapy in patients with Brain metastases from non-small cell lung cancer.
Journal of Clinical Oncology, 2010Co-Authors: April F. Eichler, Helen A. Shih, Lecia V. Sequist, Rakesh K. Jain, A. G. Sorensen, Tracy T BatchelorAbstract:TPS177 Background: Brain metastases (BM) are common in patients with non-small cell lung cancer (NSCLC), and whole-Brain Radiation therapy (WBRT) is associated with only modest benefit in many pati...
Toru Serizawa - One of the best experts on this subject based on the ideXlab platform.
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Gamma knife surgery for 1–10 Brain metastases without prophylactic whole-Brain Radiation therapy: analysis of cases meeting the Japanese prospective multi-institute study (JLGK0901) inclusion criteria
Journal of Neuro-Oncology, 2010Co-Authors: Toru Serizawa, Yoshinori Higuchi, Shinji Matsuda, Osamu Nagano, Tatsuo Hirai, Naokatsu SaekiAbstract:We evaluated the results of stereotactic radiosurgery (SRS) alone using gamma knife (GK) for selected patients with 1–10 Brain metastases without prophylactic whole-Brain Radiation therapy (WBRT) among JLGK0901-eligible cases. Seven hundred seventy-eight consecutive cases meeting the following JLGK0901 study inclusion criteria were analyzed: (1) newly diagnosed Brain metastases, (2) 1–10 Brain lesions, (3) less than 10 cm^3 volume of the largest tumor, (4) less than 15 cm^3 total tumor volume, (5) no magnetic resonance (MR) findings of cerebrospinal fluid (CSF) dissemination, and (6) no impaired activity of daily living [
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Gamma Knife® Radiosurgery Alone for One to Four Brain Metastases. Is Prophylactic Whole-Brain Radiation Therapy Really Necessary?
Radiosurgery, 2010Co-Authors: Toru Serizawa, Yoshinori Higuchi, Shinji Matsuda, Osamu Nagano, Naokatsu SaekiAbstract:Objective: We evaluated the effectiveness of stereotactic radiosurgery alone for patients with 1–4 Brain metastases without prophylactic whole-Brain Radiation therapy (WBRT).
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Gamma Knife Surgery for Metastatic Brain Tumors from Lung Cancer without Prophylactic Whole Brain Radiation Therapy
Radiosurgery, 2006Co-Authors: Toru Serizawa, Yoshinori Higuchi, Shinji Matsuda, Toshihiko Iuchi, Osamu Nagano, Naokatsu SaekiAbstract:Objective: We retrospectively analyzed the effectiveness of Gamma Knife surgery (GKS) for metastatic Brain tumors from lung cancer without prophylactic whole Brain Radiation therapy. Methods: Six hu
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Gamma knife treatment for multiple metastatic Brain tumors compared with whole-Brain Radiation therapy
Journal of Neurosurgery, 2000Co-Authors: Toru Serizawa, Toshihiko Iuchi, Naokatsu Saeki, Katsunobu Osato, Masaru Odaki, Osamu Ushikubo, Shinji Hirai, Motoki Sato, Shinji MatsudaAbstract:Object. The purpose of this retrospective study was to compare the effectiveness of gamma knife radiosurgery (GKS) for multiple cerebral metastases with that of whole-Brain Radiation therapy (WBRT). Methods. Ninety-six consecutive patients with cerebral metastases from nonsmall cell lung cancer were treated between 1990 and 1999. The entry criteria were the presence of between one and 10 multiple Brain lesions at initial diagnosis, no surgically inaccessible tumors with more than a 30-mm diameter, no carcinomatous meningitis, and more than 2 months of life expectancy. The patients were divided into two groups: the GKS group (62 patients) and the WBRT group (34 patients). In the GKS group, large lesions (> 30 mm) were removed surgically and all other small lesions (≤ 30 mm) were treated by GKS. New distant lesions were treated by repeated GKS without prophylactic WBRT. In the WBRT group, the patients were treated by the traditional combined therapy of WBRT and surgery. In both groups, chemotherapy was admi...
Jay S. Loeffler - One of the best experts on this subject based on the ideXlab platform.
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neurocognitive assessment following whole Brain Radiation therapy and radiosurgery for patients with cerebral metastases
Journal of Neurology Neurosurgery and Psychiatry, 2013Co-Authors: Susan G R Mcduff, Eric T. Wong, Jay S. Loeffler, Fred H Hochberg, Zachary J Taich, Joshua D Lawson, Parag Sanghvi, Fred G Barker, Peter C Warnke, Kevin T MurphyAbstract:The treatment of metastatic Brain lesions remains a central challenge in oncology. Because most chemotherapeutic agents do not effectively cross the blood–Brain barrier, it is widely accepted that Radiation remains the primary modality of treatment. The mode by which Radiation should be delivered has, however, become a source of intense controversy in recent years. The controversy involves whether patients with a limited number of Brain metastases should undergo whole Brain Radiation therapy (WBRT) or stereotactic radiosurgery (SRS) delivered only to the radiographically visible tumours. Survival is comparable for patients treated with either modality. Instead, the controversy involves the neurocognitive function (NCF) of radiating cerebrum that appeared radiographically normal relative to effects of the growth from micro-metastatic foci. A fundamental question in this debate involves quantifying the effect of WBRT in patients with cerebral metastasis. To disentangle the effects of WBRT on neurocognition from the effects inherent to the underlying disease, we analysed the results from randomised controlled studies of prophylactic cranial irRadiation in oncology patients as well as studies where patients with limited cerebral metastasis were randomised to SRS versus SRS+WBRT. In aggregate, these results suggest deleterious effects of WBRT in select neurocognitive domains. However, there are insufficient data to resolve the controversy of upfront WBRT versus SRS in the management of patients with limited cerebral metastases.
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results of whole Brain Radiation as salvage of methotrexate failure for immunocompetent patients with primary cns lymphoma
Journal of Clinical Oncology, 2005Co-Authors: Paul L Nguyen, Arnab Chakravarti, Dianne M Finkelstein, Fred H Hochberg, Tracy T Batchelor, Jay S. LoefflerAbstract:Purpose This study evaluates the efficacy and toxicity of whole-Brain Radiation therapy (WBRT) as salvage therapy for immunocompetent patients who failed initial high-dose methotrexate for primary CNS lymphoma (PCNSL).
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Can combined whole Brain Radiation therapy and radiosurgery improve the treatment of single Brain metastases
Nature Reviews Clinical Oncology, 2004Co-Authors: Jay S. LoefflerAbstract:Can combined whole Brain Radiation therapy and radiosurgery improve the treatment of single Brain metastases?
Shinji Matsuda - One of the best experts on this subject based on the ideXlab platform.
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Gamma knife surgery for 1–10 Brain metastases without prophylactic whole-Brain Radiation therapy: analysis of cases meeting the Japanese prospective multi-institute study (JLGK0901) inclusion criteria
Journal of Neuro-Oncology, 2010Co-Authors: Toru Serizawa, Yoshinori Higuchi, Shinji Matsuda, Osamu Nagano, Tatsuo Hirai, Naokatsu SaekiAbstract:We evaluated the results of stereotactic radiosurgery (SRS) alone using gamma knife (GK) for selected patients with 1–10 Brain metastases without prophylactic whole-Brain Radiation therapy (WBRT) among JLGK0901-eligible cases. Seven hundred seventy-eight consecutive cases meeting the following JLGK0901 study inclusion criteria were analyzed: (1) newly diagnosed Brain metastases, (2) 1–10 Brain lesions, (3) less than 10 cm^3 volume of the largest tumor, (4) less than 15 cm^3 total tumor volume, (5) no magnetic resonance (MR) findings of cerebrospinal fluid (CSF) dissemination, and (6) no impaired activity of daily living [
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Gamma Knife® Radiosurgery Alone for One to Four Brain Metastases. Is Prophylactic Whole-Brain Radiation Therapy Really Necessary?
Radiosurgery, 2010Co-Authors: Toru Serizawa, Yoshinori Higuchi, Shinji Matsuda, Osamu Nagano, Naokatsu SaekiAbstract:Objective: We evaluated the effectiveness of stereotactic radiosurgery alone for patients with 1–4 Brain metastases without prophylactic whole-Brain Radiation therapy (WBRT).
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Gamma Knife Surgery for Metastatic Brain Tumors from Lung Cancer without Prophylactic Whole Brain Radiation Therapy
Radiosurgery, 2006Co-Authors: Toru Serizawa, Yoshinori Higuchi, Shinji Matsuda, Toshihiko Iuchi, Osamu Nagano, Naokatsu SaekiAbstract:Objective: We retrospectively analyzed the effectiveness of Gamma Knife surgery (GKS) for metastatic Brain tumors from lung cancer without prophylactic whole Brain Radiation therapy. Methods: Six hu
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Gamma knife treatment for multiple metastatic Brain tumors compared with whole-Brain Radiation therapy
Journal of Neurosurgery, 2000Co-Authors: Toru Serizawa, Toshihiko Iuchi, Naokatsu Saeki, Katsunobu Osato, Masaru Odaki, Osamu Ushikubo, Shinji Hirai, Motoki Sato, Shinji MatsudaAbstract:Object. The purpose of this retrospective study was to compare the effectiveness of gamma knife radiosurgery (GKS) for multiple cerebral metastases with that of whole-Brain Radiation therapy (WBRT). Methods. Ninety-six consecutive patients with cerebral metastases from nonsmall cell lung cancer were treated between 1990 and 1999. The entry criteria were the presence of between one and 10 multiple Brain lesions at initial diagnosis, no surgically inaccessible tumors with more than a 30-mm diameter, no carcinomatous meningitis, and more than 2 months of life expectancy. The patients were divided into two groups: the GKS group (62 patients) and the WBRT group (34 patients). In the GKS group, large lesions (> 30 mm) were removed surgically and all other small lesions (≤ 30 mm) were treated by GKS. New distant lesions were treated by repeated GKS without prophylactic WBRT. In the WBRT group, the patients were treated by the traditional combined therapy of WBRT and surgery. In both groups, chemotherapy was admi...