Update on management of metastatic brain disease. Peter Hoskin Mount Vernon Cancer Centre Northwood UK
|
|
- Joseph Tyler
- 5 years ago
- Views:
Transcription
1 Update on management of metastatic brain disease Peter Hoskin Mount Vernon Cancer Centre Northwood UK
2 Incidence 15-30% of patients with solid tumours will develop brain metastases Most common primary sites are: Lung Breast Melanoma Renal Colorectal
3 Changing pattern of brain metastases Lung 52% 40% Melanoma 5% 9% Breast 17% 17% Renal/ Colorectal8% 24% Neider et al 2011
4 Diagnosis of brain metastases CT scan: screening Will detect lesions 3-4mm Oedema may be prominent with midline shift Lung and breast often similar to normal brain Most enhance with IV contrast On CT approximately 50% will be solitary MR scan: definitive More sensitive 10% have haemorrhage Gadolinium enhanced MR will identify multiple metastases in 2-11% of CT defined solitary mets Functional MR may have a role
5
6
7 Management of brain metastases
8 Suspicious symptoms radiological diagnosis Known primary YES?STEROIDS?ANTICONVULSANT ANALGESICS NO CT CAP BIOPSY OTHER HISTOLOGY?GCT OR LYMPHOMA?SURGERY?RADIOTHERAPY?BSC CHEMOTHERAPY
9 Management of brain metastases SOLITARY (1-4) MULTIPLE OPERABLE INOPERABLE ASSESS RPA SURGERY SRS RPA I or II RPA III POST OP RT WBRT BSC RECURRENCE?RETREAT? REOP?SRS
10 Solitary metastases Surgery alone Surgery + post op radiotherapy + WBRT + SRS RT alone Whole brain radiotherapy Radiosurgery
11 Surgery + post op radiotherapy
12 Surgery + post op radiotherapy
13 Radiosurgery or Surgery for 1-3 metastases
14 Global Physical Cognitive Emotional Role Fatigue
15 Solitary metastases Surgery alone Surgery + post op radiotherapy RT alone Whole brain radiotherapy Radiosurgery
16 Gammaknife Solitary brain metastases: RadioSurgery Stereotactic linear accelerator techniques
17
18
19
20 Surgery vs SRS No RCT: three retrospective analyses Muacevic Schoggl McNeil n=108 n=133 n=97 All subject to selection bias No difference for survival or Local control shown
21 Randomised trials of SRS vs WBRT + SRS
22 Local control Survival
23 Probability of significant neurocognitive decline
24 et al N=97 Verbal memory Median survival :7.7mo 1yr survival: 30% Pre SRS: 53% below expected in at least 1 domain Compliance: 84% at 6months Attention Visual memory Executive functioning
25
26 Solitary brain metastases Operable single lesions: surgery Postop radiotherapy recommended SRS Inoperable 1-4 lesions: SRS alone
27
28 Multiple brain metastases Radiotherapy Dose fractionation Patient selection Chemotherapy Patient selection
29 Dose >30Gy/10f vs 30Gy/10f control SURVIVAL Dose <30Gy/10f vs 30Gy/10f control
30 Dose >30Gy/10f vs 30Gy/10f control NEUROLOGICAL FUNCTION Dose <30Gy/10f vs 30Gy/10f control
31
32 Hippocampal sparing
33 Hippocampal sparing
34
35 Chemotherapy for brain metastases Highly chemosensitive tumours: Germ cell, Lymphoma Moderate chemosensitive tumour: SCLC Breast
36 Chemotherapy for brain metastases: Choriocarcinoma Rustin et al 25 patients: 22 on CT (18 solitary) 3 raised CSF HCG EMA CO: 18 primary presentation: 13/18 CR 7 recurrences: 2/7 CR
37 Chemotherapy for brain metastases: Germ cell Fossa et al: 56 45% CSS Bokemeyer et al: 18 33% survived Lester et al: 5 80% survival Rustin et al: 10 80% survival
38 Breast Lung
39 Melanoma Lung Renal
40
41 25 case reports! Ipilimumab 13 open trials 15 published Venmurafenib
42 Multiple brain metastases Radiotherapy Dose fractionation Patient selection Chemotherapy Patient selection
43
44 Zindler et al
45 Recursive partitioning of prognostic factors in RTOG trial 1200 patients
46 Recursive partitioning of prognostic factors in RTOG trial 1200 patients
47 Recursive partitioning of prognostic factors in RTOG trial 1200 patients
48
49 Zindler et al
50
51 et al
52 If the only tool you have is a hammer then you tend to see every problem as a nail Abraham Maslow
53
54 Supportive care management of brain metastases: what is known and what we need to know [Tsao et al 2003] the optimal management of brain metastases remains elusive. The magnitude of benefit of using WBRT above supportive care alone is uncertain
55 Symptom response after palliative radiotherapy for patients with brain metastases [Bezjak et al 2002] Neurological symptom response at 1 month Resolved mproved Stable Worse Deceased
56 Symptom response after palliative radiotherapy for patients with brain metastases [Bezjak et al 2002]
57 Symptom response after palliative radiotherapy for patients with brain metastases [Bezjak et al 2002]
58
59
60 Cochrane meta-analysis 2007 & 2012 Supportive care versus whole brain radiotherapy There is a lack of high quality randomized evidence to clarify the value of WBRT versus supportive care alone Supportive care alone is an option (for example, for patients with poor performance status or widely disseminated cancer based on short life expectancy). There is lack of contemporary high quality trials to guide practitioners as to which subsets of patients with brain metastases should be managed with supportive care alone without whole brain radiotherapy.
61 Management of brain metastases SOLITARY (1-4) MULTIPLE OPERABLE INOPERABLE ASSESS RPA SURGERY SRS RPA I or II RPA III POST OP RT WBRT BSC RECURRENCE?RETREAT? REOP?SRS
62 Management of brain metastases SOLITARY (1-4) MULTIPLE OPERABLE INOPERABLE ASSESS RPA SURGERY SRS RPA I or II RPA III POST OP RT WBRT BSC RECURRENCE?RETREAT? REOP?SRS
63 SOLITARY (1-4) Conclusion SURGERY + SRS SRS alone MULTIPLE CHEMOTHERAPY for GCT, LYMPHOMA?breast, SCLC,??ALK+ve NSCLC, B-RAF+ve melanoma WBRT RPA I/II BSC RPA III
Optimal Management of Isolated HER2+ve Brain Metastases
Optimal Management of Isolated HER2+ve Brain Metastases Eliot Sims November 2013 Background Her2+ve patients 15% of all breast cancer Even with adjuvant trastuzumab 10-15% relapse Trastuzumab does not
More informationTreatment of Brain Metastases
1 Treatment of Brain Metastases An Overview and Pending Research Questions To Answer Olav E. Yri, MD, PhD www.ntnu.no/prc European Palliative Care Research Centre (PRC) The brain metastases diagnosis Outline
More informationA Population-Based Study on the Uptake and Utilization of Stereotactic Radiosurgery (SRS) for Brain Metastasis in Nova Scotia
A Population-Based Study on the Uptake and Utilization of Stereotactic Radiosurgery (SRS) for Brain Metastasis in Nova Scotia Gaurav Bahl, Karl Tennessen, Ashraf Mahmoud-Ahmed, Dorianne Rheaume, Ian Fleetwood,
More informationThe Role of Radiation Therapy in the Treatment of Brain Metastases. Matthew Cavey, M.D.
The Role of Radiation Therapy in the Treatment of Brain Metastases Matthew Cavey, M.D. Objectives Provide information about the prospective trials that are driving the treatment of patients with brain
More informationCollection of Recorded Radiotherapy Seminars
IAEA Human Health Campus Collection of Recorded Radiotherapy Seminars http://humanhealth.iaea.org The Management of Brain Metastases Dr. Luis Souhami Professor Department of Radiation Oncology University,
More informationMinesh Mehta, Northwestern University. Chicago, IL
* Minesh Mehta, Northwestern University Chicago, IL Consultant: Adnexus, Bayer, Merck, Tomotherapy Stock Options: Colby, Pharmacyclics, Procertus, Stemina, Tomotherapy Board of Directors: Pharmacyclics
More informationRadiotherapy and Brain Metastases. Dr. K Van Beek Radiation-Oncologist BSMO annual Meeting Diegem
Radiotherapy and Brain Metastases Dr. K Van Beek Radiation-Oncologist BSMO annual Meeting Diegem 24-02-2017 Possible strategies Watchful waiting Surgery Postop RT to resection cavity or WBRT postop SRS
More informationManagement of single brain metastasis: a practice guideline
PRACTICE GUIDELINE SERIES Management of single brain metastasis: a practice guideline A. Mintz MD,* J. Perry MD, K. Spithoff BHSc, A. Chambers MA, and N. Laperriere MD on behalf of the Neuro-oncology Disease
More informationStereotactic Radiosurgery for Brain Metastasis: Changing Treatment Paradigms. Overall Clinical Significance 8/3/13
Stereotactic Radiosurgery for Brain Metastasis: Changing Treatment Paradigms Jason Sheehan, MD, PhD Departments of Neurosurgery and Radiation Oncology University of Virginia, Charlottesville, VA USA Overall
More informationPalliative radiotherapy in lung cancer
New concepts and insights regarding the role of radiation therapy in metastatic disease Umberto Ricardi University of Turin Department of Oncology Radiation Oncology Palliative radiotherapy in lung cancer
More informationVINCENT KHOO. 8 th EIKCS Symposium: May 2013
8 th EIKCS Symposium: May 2013 VINCENT KHOO Royal Marsden NHS Foundation Trust & Institute of Cancer Research St George s Hospital & University of London Austin Health & University of Melbourne Disclosures
More informationHong Kong Hospital Authority Convention 2018
Hong Kong Hospital Authority Convention 2018 Stereotactic Radiosurgery in Brain Metastases - Development of the New Treatment Paradigm in HA, Patients Profiles and Their Clinical Outcomes 8 May 2018 Dr
More informationPalliative radiotherapy near the end of life for brain metastases from lung cancer: a populationbased
Palliative radiotherapy near the end of life for brain metastases from lung cancer: a populationbased analysis Roel Schlijper Fellow Radiation Oncology BC Cancer, Prince George Disclosures No conflicts
More informationMetastasi cerebrali La Radioterapia: tecnica, frazionamento, radiosensibilizzanti
Metastasi cerebrali La Radioterapia: tecnica, frazionamento, radiosensibilizzanti Brain Metastases Radiation Therapy of multiple brain metastases Is treatment appropriate? - Survival - QoL Brain Metastases
More informationAlleinige Radiochirurgie und alleinige Systemtherapie zwei «extreme» Entwicklungen in der Behandlung von Hirnmetastasen?
Department of Radiation Oncology Chairman: Prof. Dr. Matthias Guckenberger Alleinige Radiochirurgie und alleinige Systemtherapie zwei «extreme» Entwicklungen in der Behandlung von Hirnmetastasen? Matthias
More informationCNS Metastases in Breast Cancer
Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer CNS Metastases in Breast Cancer CNS Metastases in Breast Cancer Version 2006: Maass / Junkermann Version 2007 2009: Bischoff
More informationARROCase Brain Metastases
ARROCase Brain Metastases Colin Hill*, Daniel M. Trifiletti*, Timothy N. Showalter*, Jason P. Sheehan Radiation Oncology* and Neurosurgery University of Virginia Charlottesville, VA Case: HPI 64 year old
More informationCME. Special Article. Received 27 October 2011; revised 9 December 2011; accepted 15 December Practical Radiation Oncology (2012) 2,
Practical Radiation Oncology (2012) 2, 210 225 CME www.practicalradonc.org Special Article Radiotherapeutic and surgical management for newly diagnosed brain metastasis(es): An American Society for Radiation
More informationProphylactic Cranial Irradiation and Thoracic Radiotherapy in Extensive Stage Small-Cell Lung Cancer
Prophylactic Cranial Irradiation and Thoracic Radiotherapy in Extensive Stage Small-Cell Lung Cancer Dr Neil Bayman Consultant Clinical Oncology ESMO-Christie Preceptorship Programme in Lung Cancer, March
More informationOutline. WBRT field. Brain Metastases. Whole Brain RT Prophylactic WBRT Stereotactic radiosurgery (SRS) 1 fraction Stereotactic frame
Radiation Therapy for Advanced NSC Lung Ca Alexander Gottschalk, M.D., Ph.D. Associate Professor Director of CyberKnife Radiosurgery Department of Radiation Oncology University of California San Francisco
More informationTania Kaprealian, M.D. Assistant Professor UCLA Department of Radiation Oncology August 22, 2015
Tania Kaprealian, M.D. Assistant Professor UCLA Department of Radiation Oncology August 22, 2015 Most common brain tumor, affecting 8.5-15% of cancer patients. Treatment options: Whole brain radiation
More informationSurvival and Intracranial Control of Patients With 5 or More Brain Metastases Treated With Gamma Knife Stereotactic Radiosurgery
ORIGINAL ARTICLE Survival and Intracranial Control of Patients With 5 or More Brain Metastases Treated With Gamma Knife Stereotactic Radiosurgery Ann C. Raldow, BS,* Veronica L. Chiang, MD,w Jonathan P.
More informationOutcomes after Reirradiation for Brain Metastases
Original Article PROGRESS in MEDICAL PHYSICS Vol. 26, No. 3, September, 2015 http://dx.doi.org/10.14316/pmp.2015.26.3.137 Outcomes after Reirradiation for Brain Metastases Jesang Yu, Ji Hoon Choi, Sun
More informationCONTINUING PROFESSIONAL DEVELOPMENT
23/09/15 POSTGRADUATE SCHOOL OF MEDICINE BRAIN METASTASES Prof M Brada and Dr John Green MDSC156/199: Acute Clinical Oncology A MEMBER OF THE RUSSELL GROUP CONTINUING PROFESSIONAL DEVELOPMENT Brain Metastases
More informationClinical Study Does Time between Imaging Diagnosis and Initiation of Radiotherapy Impact Survival after Whole-Brain Radiotherapy for Brain Metastases?
ISRN Oncology Volume 2013, Article ID 214304, 4 pages http://dx.doi.org/10.1155/2013/214304 Clinical Study Does Time between Imaging Diagnosis and Initiation of Radiotherapy Impact Survival after Whole-Brain
More informationCollection of Recorded Radiotherapy Seminars
IAEA Human Health Campus Collection of Recorded Radiotherapy Seminars http://humanhealth.iaea.org The Role of Radiosurgery in the Treatment of Gliomas Luis Souhami, MD Professor Department of Radiation
More informationSelecting the Optimal Treatment for Brain Metastases
Selecting the Optimal Treatment for Brain Metastases Clinical Practice Today CME Co-provided by Learning Objectives Upon completion, participants should be able to: Understand the benefits, limitations,
More informationRadiotherapy for Brain Metastases
Radiotherapy for Brain Metastases Robert B. Den, MD a, David W. Andrews, MD b, * KEYWORDS Brain metastases Treatment approaches SRS WBRT The optimal treatment of brain metastases remains controversial.
More informationJefferson Digital Commons. Thomas Jefferson University. Mark E Linskey Department of Neurosurgery, University of California-Irvine Medical Center
Thomas Jefferson University Jefferson Digital Commons Department of Neurosurgery Faculty Papers Department of Neurosurgery 1-1-2010 The role of stereotactic radiosurgery in the management of patients with
More informationOncological Management of Brain Tumours. Anna Maria Shiarli SpR in Clinical Oncology 15 th July 2013
Oncological Management of Brain Tumours Anna Maria Shiarli SpR in Clinical Oncology 15 th July 2013 Outline General considerations of Primary Brain Tumours: epidemiology, pathology, presentation. Diagnosis
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 4,100 116,000 120M Open access books available International authors and editors Downloads Our
More informationSergio Bracarda MD. Head, Medical Oncology Department of Oncology AUSL-8 Istituto Toscano Tumori (ITT) San Donato Hospital Arezzo, Italy
Sergio Bracarda MD Head, Medical Oncology Department of Oncology AUSL-8 Istituto Toscano Tumori (ITT) San Donato Hospital Arezzo, Italy Ninth European International Kidney Cancer Symposium Dublin 25-26
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES CENTRAL NERVOUS SYSTEM BRAIN METASTASES CNS Site Group Brain Metastases Author: Dr. Norm Laperriere Date: February 20, 2018 1. INTRODUCTION
More informationManagement of Single Brain Metastases Practice Guideline Report #9-1
Management of Single Brain Metastases Practice Guideline Report #9-1 A.P. Mintz, J. Perry, G. Cairncross, A. Chambers and members of the Neuro-oncology Disease Site Group Report Date: August 17, 2004 SUMMARY
More informationLaboratory data from the 1970s first showed that malignant melanoma
2265 Survival by Radiation Therapy Oncology Group Recursive Partitioning Analysis Class and Treatment Modality in Patients with Brain Metastases from Malignant Melanoma A Retrospective Study Jeffrey C.
More informationWe have previously reported good clinical results
J Neurosurg 113:48 52, 2010 Gamma Knife surgery as sole treatment for multiple brain metastases: 2-center retrospective review of 1508 cases meeting the inclusion criteria of the JLGK0901 multi-institutional
More informationEvidence Based Medicine for Gamma Knife Radiosurgery. Metastatic Disease GAMMA KNIFE SURGERY
GAMMA KNIFE SURGERY Metastatic Disease Evidence Based Medicine for Gamma Knife Radiosurgery Photos courtesy of Jean Régis, Timone University Hospital, Marseille, France Brain Metastases The first report
More informationProtocolos de consenso: MTS Cerebrales Resumen ASTRO. Javier Aristu y Germán Valtueña Servicio Oncología Rad. Depart.
Protocolos de consenso: MTS Cerebrales Resumen ASTRO Javier Aristu y Germán Valtueña Servicio Oncología Rad. Depart. ASTRO 2013 Brain met SRS Abstracts 97. Comparative Effectiveness of SRS versus WBRT
More informationMehmet Ufuk ABACIOĞLU Neolife Medical Center, İstanbul, Turkey
Updated Oncology 2015: State of the Art News & Challenging Topics CURRENT STATUS OF STEREOTACTIC RADIOSURGERY IN BRAIN METASTASES Mehmet Ufuk ABACIOĞLU Neolife Medical Center, İstanbul, Turkey Bucharest,
More informationBrain metastases and meningitis carcinomatosa: Prof. Rafal Dziadziuszko Medical University of Gdańsk, Poland
Brain metastases and meningitis carcinomatosa: a palliative situation? Prof. Rafal Dziadziuszko Medical University of Gdańsk, Poland SAMO, Lucerne, February 1-2, 2013 Treatment options for NSCLC patients
More informationCONGRESS OF NEUROLOGICAL SURGEONS SYSTEMATIC REVIEW AND
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 CONGRESS OF NEUROLOGICAL SURGEONS SYSTEMATIC REVIEW AND EVIDENCE-BASED GUIDELINES ON THE USE OF STEREOTACTIC RADIOSURGERY IN THE
More informationChemotherapy for Urological Cancers
Chemotherapy for Urologic Cancers Matthew Rettig, MD Associate Professor Department of Medicine Division of Hematology-Oncology Department of Urology Medical Director, Prostate Cancer Program Institute
More informationRole of Prophylactic Cranial Irradiation in Small Cell Lung Cancer
Role of Prophylactic Cranial Irradiation in Small Cell Lung Cancer Kazi S. Manir MD,DNB,ECMO,PDCR Clinical Tutor Department of Radiotherapy R. G. Kar Medical College and Hospital, Kolkata SCLC 15% of lung
More informationTargeted Therapies in the Management of Non-Small Cell Lung Cancer. A Multi-Disciplinary Approach
Targeted Therapies in the Management of Non-Small Cell Lung Cancer A Multi-Disciplinary Approach Course Faculty Medical Oncologists: Dr. Barb Melosky British Columbia Cancer Agency, Vancouver, BC Dr. Jeff
More informationTreatment of Recurrent Brain Metastases
Treatment of Recurrent Brain Metastases Penny K. Sneed, M.D. Dept. of Radiation Oncology University of California San Francisco Background Brain metastases occur in 8.5-15% of cancer pts in population-
More informationThe Role of Radiotherapy in Metastatic Breast Cancer. Shilpen Patel MD, FACRO Associate Professor Departments of Radiation Oncology and Global Health
The Role of Radiotherapy in Metastatic Breast Cancer Shilpen Patel MD, FACRO Associate Professor Departments of Radiation Oncology and Global Health Indications for Palliative Pain Control Radiation Bone
More information肺癌放射治療新進展 Recent Advance in Radiation Oncology in Lung Cancer 許峰銘成佳憲國立台灣大學醫學院附設醫院腫瘤醫學部
肺癌放射治療新進展 Recent Advance in Radiation Oncology in Lung Cancer 許峰銘成佳憲國立台灣大學醫學院附設醫院腫瘤醫學部 Outline Current status of radiation oncology in lung cancer Focused on stage III non-small cell lung cancer Radiation
More informationIs it cost-effective to treat brain metastasis with advanced technology?
Is it cost-effective to treat brain metastasis with advanced technology? Cost-effectiveness analysis of whole brain RT, stereotactic radiosurgery and craniotomy in HA setting Lam, Tai-Chung, Choi CW Horace,
More informationRadiotherapy Protocols
Radiotherapy Protocols Cranial Irradiation for Palliative Whole Brain for Metastases and Prophylactic Whole Brain for SCLC Prepared by: Dr C Blesing, Dr N Warner, Dr D Cutter, Ms R Watson, Ms L Drummond,
More informationAdvances in Radiation Therapy
Advances in Radiation Therapy 2017 Recent Advances in Oncology Michelle Alonso-Basanta, MD PhD Helene Blum Assistant Professor Associate Chief of Clinical Operations Director of Quality Assurance Chief,
More informationGamma Knife Radiosurgery A tool for treating intracranial conditions. CNSA Annual Congress 2016 Radiation Oncology Pre-congress Workshop
Gamma Knife Radiosurgery A tool for treating intracranial conditions CNSA Annual Congress 2016 Radiation Oncology Pre-congress Workshop ANGELA McBEAN Gamma Knife CNC State-wide Care Coordinator Gamma Knife
More informationComparative Analysis of Efficacy and Safety of Multisession Radiosurgery to Single Dose Radiosurgery for Metastatic Brain Tumors
ORIGINAL ARTICLE Brain Tumor Res Treat 2015;3(2):95-102 / pissn 2288-2405 / eissn 2288-2413 http://dx.doi.org/10.14791/btrt.2015.3.2.95 Comparative Analysis of Efficacy and Safety of Multisession Radiosurgery
More informationBenefits of Radiation Therapy in the Palliative Cancer Patient
Benefits of Radiation Therapy in the Palliative Cancer Patient Dr Joshua Sappiatzer Radiation Oncologist Page 1 Overview Why we should aim for better palliative radiotherapy treatment Bone metastases Rapid
More informationLeptomeningeal metastasis: management and guidelines. Emilie Le Rhun Lille, FR Zurich, CH
Leptomeningeal metastasis: management and guidelines Emilie Le Rhun Lille, FR Zurich, CH Definition of LM LM is defined as the spread of tumor cells within the leptomeninges and the subarachnoid space
More informationWhere are we with radiotherapy for biliary tract cancers?
Where are we with radiotherapy for biliary tract cancers? Professor Maria A. Hawkins Associate Professor in Clinical Oncology MRC Group Leader/Honorary Consultant Clinical Oncologist CRUK MRC Oxford Institute
More informationImmunotherapy for the Treatment of Brain Metastases
Society for Immunotherapy of Cancer (SITC) Immunotherapy for the Treatment of Brain Metastases Lawrence G. Lum, MD, DSc Karmanos Cancer Institute and Wayne State University Advances in Cancer Immunotherapy
More informationImmune Checkpoint Inhibitors: The New Breakout Stars in Cancer Treatment
Immune Checkpoint Inhibitors: The New Breakout Stars in Cancer Treatment 1 Introductions Peter Langecker, MD, PhD Executive Medical Director, Global Oncology Clinipace Worldwide Mark Shapiro Vice President
More informationSBRT for lung metastases: Case report
SBRT for lung metastases: Case report Guillermo de Velasco MD, PhD University Hospital 12 de Octubre @H12O_GUCancer @g_develasco Case report 71 years old man Smoker DM 2005 Right radical nephrectomy Histology:
More informationRadiotherapy for Rectal Cancer. Kevin Palumbo Adelaide Radiotherapy Centre
Radiotherapy for Rectal Cancer Kevin Palumbo Adelaide Radiotherapy Centre Overview CRC are common (3 rd commonest cancer) rectal Ca approx 25-30% of all CRC. Presentation PR bleeding: beware attributing
More informationES-SCLC Joint Case Conference. Anthony Paravati Adam Yock
ES-SCLC Joint Case Conference Anthony Paravati Adam Yock Case 57 yo woman with 35 pack year smoking history presented with persistent cough and rash Chest x-ray showed a large left upper lobe/left hilar
More informationTreating Multiple. Brain Metastases (BM)
ESTRO 36 5-9 May 2017, Vienna Austria, Accuray Symposium Treating Multiple Brain Metastases (BM) with CyberKnife System Frederic Dhermain MD PhD, Radiation Oncologist Gustave Roussy University Hospital,
More informationBrain metastases: changing visions
Brain metastases: changing visions Roberto Spiegelmann, MD Baiona, 2014 Head, Stereotactic Radiosurgery Unit Dept of Neurosurgery, Chaim Sheba Medical Center Tel Hashomer, Israel The best current estimate
More informationRadiotherapy symptoms control in bone mets. Francesco Cellini GemelliART. Ernesto Maranzano,MD. Session 5: Symptoms management
Session 5: Symptoms management Radiotherapy symptoms control in bone mets Francesco Cellini GemelliART Ernesto Maranzano,MD Director of Oncology Department Chief of Radiation Oncology Centre S. Maria Hospital
More informationTreating Brain Metastases in the Changing World of Oncology: Matthew Ewend, MD Kay and Van Weatherspoon Professor Chair, Department of Neurosurgery
Treating Brain Metastases in the Changing World of Oncology: Matthew Ewend, MD Kay and Van Weatherspoon Professor Chair, Department of Neurosurgery Disclosures Consultant: None Stock Holdings: None Paid
More informationManagement of Brain Metastases Sanjiv S. Agarwala, MD
Management of Brain Metastases Sanjiv S. Agarwala, MD Professor of Medicine Temple University School of Medicine Chief, Oncology & Hematology St. Luke s Cancer Center, Bethlehem, PA, USA Incidence (US):
More informationPlace of tumor bed radiosurgery and focal radiotherapy following resec7on of brain metastases: A new paradigm Lucyna Kepka
Place of tumor bed radiosurgery and focal radiotherapy following resec7on of brain metastases: A new paradigm Lucyna Kepka Department of Radia7on Oncology; M. Sklodowska- Curie Memorial Cancer Center and
More informationBrain metastases are common brain malignant neoplasms
J Neurosurg (Suppl) 117:49 56, 2012 Hypofractionated stereotactic radiotherapy with or without whole-brain radiotherapy for patients with newly diagnosed brain metastases from non small cell lung cancer
More informationResearch Article Have Changes in Systemic Treatment Improved Survival in Patients with Breast Cancer Metastatic to the Brain?
Oncology Volume 2008, Article ID 417137, 5 pages doi:10.1155/2008/417137 Research Article Have Changes in Systemic Treatment Improved Survival in Patients with Breast Cancer Metastatic to the Brain? Carsten
More informationRecognition & Treatment of Malignant Spinal Cord Compression Study Day
Recognition & Treatment of Malignant Spinal Cord Compression Study Day 11 th May 2017 Dr Bernie Foran Consultant Clinical Oncologist & Honorary Senior Lecturer Weston Park Hospital Outline of Talk Clinical
More informationSurgical Management of Pulmonary Metastases. Dr AG Jacobs Principal Specialist Dept Cardiothoracic Surgery Steve Biko Academic Hospital
Surgical Management of Pulmonary Metastases Dr AG Jacobs Principal Specialist Dept Cardiothoracic Surgery Steve Biko Academic Hospital Introduction Lungs 2 nd most common site of metastatic deposition
More informationSociety for Immunotherapy of Cancer (SITC) Immunotherapy for the Treatment of Brain Metastases
Society for Immunotherapy of Cancer (SITC) Immunotherapy for the Treatment of Brain Metastases Geoffrey T. Gibney, MD Georgetown-Lombardi Comprehensive Cancer Center Medstar-Georgetown University Hospital
More informationOriginal Article Value of Adding Boost to Whole Brain Radiotherapy after Surgical Resection of Limited Brain Metastases
Egyptian Journal of Neurosurgery Volume 29 / No. 4 / October - December 2014 39-44 Original Article Value of Adding Boost to Whole Brain Radiotherapy after Surgical Resection of Limited Brain Metastases
More informationWhen is local surgery indicated in metastatic breast cancer?
When is local surgery indicated in metastatic breast cancer? NICOLA ROCHE THE ROYAL MARSDEN HOSPITAL IBCS 2018 Stage at diagnosis 2014 Survival with Stage IV breast cancer Hypothesis Surgical removal of
More informationA prognostic index that predicts outcome following palliative whole brain radiotherapy for patients with metastatic malignant melanoma
British Journal of Cancer (4) 91, 829 833 All rights reserved 7 9/4 $3. www.bjcancer.com A prognostic index that predicts outcome following palliative whole brain radiotherapy for patients with metastatic
More informationPalliative RT. Jiraporn Setakornnukul, M.D. Radiation Oncology Division Siriraj Hospital, Mahidol University
Palliative RT Jiraporn Setakornnukul, M.D. Radiation Oncology Division Siriraj Hospital, Mahidol University Scope Brain metastasis Metastasis epidural spinal cord compression SVC obstruction Bone pain
More informationClinical Commissioning Policy: Stereotactic Radiosurgery / Radiotherapy For Cerebral Metastases. December Reference : NHSCB/D5/1
Clinical Commissioning Policy: Stereotactic Radiosurgery / Radiotherapy For Cerebral Metastases December 2012 Reference : NHSCB/D5/1 NHS Commissioning Board Clinical Commissioning Policy: Stereotactic
More informationNews Briefing New Developments in Pediatric & Adult CNS Malignancies
News Briefing New Developments in Pediatric & Adult CNS Malignancies Tuesday, Sept. 24, 2013 2:45 p.m. Daphne Haas-Kogan, MD University of California, San Francisco Cost-effectiveness of Proton Therapy
More informationSan Antonio Breast Cancer Symposium 2010 Highlights Radiotherapy
San Antonio Breast Cancer Symposium 2010 Highlights Radiotherapy Kathleen C. Horst, M.D. Assistant Professor Department of Radiation Oncology Stanford University The Optimal SEquencing of Adjuvant Chemotherapy
More informationStereotactic radiotherapy
Stereotactic radiotherapy Influence of patient positioning and fixation on treatment planning - clinical results Frank Zimmermann Institut für Radioonkologie Universitätsspital Basel Petersgraben 4 CH
More informationCHEMO-RADIOTHERAPY FOR BLADDER CANCER. Dr Darren Mitchell Consultant Clinical Oncologist Northern Ireland Cancer Centre
CHEMO-RADIOTHERAPY FOR BLADDER CANCER Dr Darren Mitchell Consultant Clinical Oncologist Northern Ireland Cancer Centre AIMS Muscle invasive disease Current Gold-Standard Rationale behind Chemo-Radiotherapy
More informationPlace of surgery in diagnos1c and therapeu1c strategies: New challenges
Place of surgery in diagnos1c and therapeu1c strategies: New challenges Philippe Métellus M.D., Ph.D. Department of Neurosurgery, CHU Timone, Marseille, France Place of surgery in diagnos1c and therapeu1c
More informationRadiotherapy of Brain Metastases and Carcinomatous Meningitis
Universitätsspital Basel Radiotherapy of Brain Metastases and Carcinomatous Meningitis Dr. J. Winkler 16.01.2009 1 in 4 cancer patients develop brain metastases In 1/3-1/2 of these patients brain metastasis
More informationLung Cancer Radiotherapy
Lung Cancer Radiotherapy Indications, Outcomes, and Impact on Survivorship Care Malcolm Mattes, MD Assistant Professor WVU Department of Radiation Oncology When people think about radiation, they think
More informationDepartment of Oncology and Palliative Medicine, Nordland Hospital, 8092 Bodø, Norway 2
The Scientific World Journal Volume 212, Article ID 69323, 5 pages doi:1.11/212/69323 The cientificworldjournal Clinical Study Towards Improved Prognostic Scores Predicting Survival in Patients with Brain
More informationBr a i n metastases occur in 20 40% of all patients. The results of resection after stereotactic radiosurgery for brain metastases.
J Neurosurg 111:825 831, 2009 The results of resection after stereotactic radiosurgery for brain metastases Clinical article Hi d e y u k i Ka n o, M.D., Ph.D., 1,3 Do u g l a s Ko n d z i o l k a, M.D.,
More informationUpdate on Limited Small Cell Lung Cancer. Laurie E Gaspar MD, MBA Prof/Chair Radiation Oncology University of Colorado Denver
Update on Limited Small Cell Lung Cancer Laurie E Gaspar MD, MBA Prof/Chair Radiation Oncology University of Colorado Denver Objectives - Limited Radiation Dose Radiation Timing Radiation Volume PCI Neurotoxicity
More informationQuality of life in brain metastases radiation trials: a literature review
RADIATION ONCOLOGY Quality of life in brain metastases radiation trials: a literature review J. Wong,* A. Hird,* A. Kirou Mauro,* J. Napolskikh BSc,* and E. Chow MBBS* ABSTRACT Background An estimated
More informationSUCCESSFUL TREATMENT OF METASTATIC BRAIN TUMOR BY CYBERKNIFE: A CASE REPORT
SUCCESSFUL TREATMENT OF METASTATIC BRAIN TUMOR BY CYBERKNIFE: A CASE REPORT Cheng-Ta Hsieh, 1 Cheng-Fu Chang, 1 Ming-Ying Liu, 1 Li-Ping Chang, 2 Dueng-Yuan Hueng, 3 Steven D. Chang, 4 and Da-Tong Ju 1
More information3.3 SRS / neurochirurgische resectie met of zonder WBRT I Study ID II Method III Patient
1. Andrews DW et al, Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial,
More informationCécile Le Péchoux Department of Radiation Oncology, Institut Gustave Roussy, Villejuif France Amsterdam 2010
Prophylactic Cranial Irradiation in Lung Cancer Cécile Le Péchoux Department of Radiation Oncology, Institut Gustave Roussy, Villejuif France Amsterdam 2010 Prophylactic cranial irradiation PCI was introduced
More informationOncologist. The. Neuro-Oncology. Multidisciplinary Management of Brain Metastases. The Oncologist 2007;12:
The Oncologist Neuro-Oncology Multidisciplinary Management of Brain Metastases APRIL F. EICHLER, a,b,d JAY S. LOEFFLER, a,c,d a Pappas Center for Neuro-Oncology, Departments of b Neurology and c Radiation
More informationTHORACIC MALIGNANCIES
THORACIC MALIGNANCIES Summary for Malignant Malignancies. Lung Ca 1 Lung Cancer Non-Small Cell Lung Cancer Diagnostic Evaluation for Non-Small Lung Cancer 1. History and Physical examination. 2. CBCDE,
More informationThoracic Recurrences. Soft tissue recurrence
Stereotactic body radiotherapy for thoracic and soft malignancies Alexander Gottschalk, M.D., Ph.D. Associate Professor Director of CyberKnife Radiosurgery Department of Radiation Oncology University of
More informationTherapy of Non-Operable early stage NSCLC
SBRT Stage I NSCLC Therapy of Non-Operable early stage NSCLC Dr. Adnan Al-Hebshi MD, FRCR(UK), FRCP(C), ABR King Faisal Specialist Hospital & Research Centre This is our territory Early Stages NSCLC Surgical
More informationUPDATE ON RADIOTHERAPY
1 Miriam Kleiter UPDATE ON RADIOTHERAPY Department for Companion Animals and Horses, Plattform Radiooncology and Nuclear Medicine, University of Veterinary Medicine Vienna Introduction Radiotherapy has
More informationClinical Case Conference
Clinical Case Conference Palliative radiation therapy for bone metastasis Jeff Burkeen, MD, PGY2 7/20/2015 1 Overview Epidemiology Pathophysiology Common presentations and symptoms Imaging Surgery Radiation
More informationUtility of 18 F-FDG PET/CT in metabolic response assessment after CyberKnife radiosurgery for early stage non-small cell lung cancer
Utility of F-FDG PET/CT in metabolic response assessment after CyberKnife radiosurgery for early stage non-small cell lung cancer Ngoc Ha Le 1*, Hong Son Mai 1, Van Nguyen Le 2, Quang Bieu Bui 2 1 Department
More informationRadiation Therapy and Immunotherapy: New Frontiers
Radiation Therapy and Immunotherapy: New Frontiers May 12 th, 2017 Anshu K. Jain, MD Radiation Oncologist, Ashland-Bellefonte and Logan Regional Cancer Centers Assistant Professor of Therapeutic Radiology,
More informationThe 7th Edition of TNM in Lung Cancer.
10th European Conference Perspectives in Lung Cancer. Brussels, March 2009. The 7th Edition of TNM in Lung Cancer. Peter Goldstraw, Consultant Thoracic Surgeon, Royal Brompton Hospital, Professor of Thoracic
More informationTargeted/Immunotherapy & Molecular Profiling State-of-the-art in Cancer Care
Targeted/Immunotherapy & Molecular Profiling State-of-the-art in Cancer Care Manmeet Ahluwalia, MD, FACP Miller Family Endowed Chair in Neuro-Oncology Director Brain Metastasis Research Program Cleveland
More information