Journal article
Preliminary experience with frameless stereotactic radiotherapy
International journal of radiation oncology, biology, physics, Vol.42(3), pp.591-599
1998
DOI: 10.1016/S0360-3016(98)00276-4
PMID: 9806519
Abstract
Purpose: To report initial clinical experience with a novel high-precision stereotactic radiotherapy system.
Methods and Materials: Sixty patients ranging in age from 2 to 82 years received a total of 1426 treatments with the University of Florida frameless stereotactic radiotherapy system. Of the total, 39 (65%) were treated with stereotactic radiotherapy (SRT) alone, and 21 (35%) received SRT as a component of radiotherapy. Pathologic diagnoses included meningiomas (15 patients), low-grade astrocytomas (11 patients), germinomas (9 patients), and craniopharyngiomas (5 patients). The technique was used as means of dose escalation in 11 patients (18%) with aggressive tumors. Treatment reproducibility was measured by comparing bite plate positioning registered by infrared light-emitting diodes (IRLEDs) with the stereotactic radiosurgery reference system, and with measurements from each treatment arc for the 1426 daily treatments (5808 positions). We chose 0.3 mm vector translation error and 0.3° rotation about each axis as the maximum tolerated misalignment before treating each arc.
Results: With a mean follow-up of 11 months, 3 patients had recurrence of malignant disease. Acute side effects were minimal. Of 11 patients with low grade astrocytomas, 4 (36%) had cerebral edema and increased enhancement on MR scans in the first year, and 2 required steroids. All had resolution and marked tumor involution on follow-up imaging. Bite plate reproducibility was as follows. Translational errors: anterior-posterior, 0.01 ± 0.10; lateral, 0.02 ± 0.07; axial, 0.01 ± 0.10. Rotational errors (degrees): anterior-posterior, 0.00 ± 0.03; lateral, 0.00 ± 0.06; axial, 0.01 ± 0.04. No patient treatment was delivered beyond the maximum tolerated misalignment. Daily treatment was delivered in approximately 15 min per patient.
Conclusion: Our initial experience with stereotactic radiotherapy using the infrared camera guidance system was good. Patient selection and treatment strategies are evolving rapidly. Treatment accuracy was the best reported, and the treatment approach was practical.
Details
- Title: Subtitle
- Preliminary experience with frameless stereotactic radiotherapy
- Creators
- John M Buatti - Radiation Oncology, University of Florida College of Medicine, Gainesville, FL 32610 USAFrancis J Bova - Radiation Oncology, University of Florida College of Medicine, Gainesville, FL 32610 USAWilliam A Friedman - Neurosurgery, University of Florida College of Medicine, Gainesville, FL 32610, USASanford L Meeks - Radiation Oncology, University of Florida College of Medicine, Gainesville, FL 32610 USARobert B Marcus - Radiation Oncology, University of Florida College of Medicine, Gainesville, FL 32610 USAJ.Parker Mickle - Neurosurgery, University of Florida College of Medicine, Gainesville, FL 32610, USAThomas L Ellis - Neurosurgery, University of Florida College of Medicine, Gainesville, FL 32610, USAWilliam M Mendenhall - Radiation Oncology, University of Florida College of Medicine, Gainesville, FL 32610 USA
- Resource Type
- Journal article
- Publication Details
- International journal of radiation oncology, biology, physics, Vol.42(3), pp.591-599
- DOI
- 10.1016/S0360-3016(98)00276-4
- PMID
- 9806519
- NLM abbreviation
- Int J Radiat Oncol Biol Phys
- ISSN
- 0360-3016
- eISSN
- 1879-355X
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 1998
- Academic Unit
- Radiation Oncology; Neurosurgery; Otolaryngology
- Record Identifier
- 9984040470902771
Metrics
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