Review
Oncology
Felix Ehret, David Kaul, Volker Budach, Laura-Nanna Lohkamp
Summary: This systematic review summarizes the current experience and evidence for robotic radiosurgery (RRS) and robotic stereotactic radiotherapy (RSRT) in pediatric neuro-oncology. The results indicate that both treatment modalities are infrequently used and primarily employed in specific situations, with encouraging treatment outcomes but a lack of high-quality studies. Prospective studies are needed to determine the actual utility of RRS and RSRT in pediatric neuro-oncology.
Article
Medicine, General & Internal
Pritsana Punyawai, Nicha Radomsutthikul, Mantana Dhanachai, Chai Kobkitsuksakul, Ake Hansasuta
Summary: This study reported long-term outcomes of frameless robotic stereotactic radiosurgery for brain arteriovenous malformation at Ramathibodi Hospital. The majority of patients achieved an excellent outcome with minimal adverse effects, despite some cases experiencing AVM rupture or new neurological deficits during the follow-up period.
Article
Oncology
Felix Ehret, Markus Kufeld, Christoph Furweger, Alfred Haidenberger, Paul Windisch, Carolin Senger, Melina Kord, Malte Trager, David Kaul, Christian Schichor, Jorg-Christian Tonn, Alexander Muacevic
Summary: The study reports treatment outcomes of spinal ependymomas using robotic radiosurgery (RRS) from two institutions, showing that RRS is a safe and efficient treatment modality for managing primary and secondary spinal ependymal tumors in patients with multiple lesions and local recurrences.
FRONTIERS IN ONCOLOGY
(2021)
Article
Oncology
Felix Ehret, Carolin Senger, Markus Kufeld, Christoph Fuerweger, Melina Kord, Alfred Haidenberger, Paul Windisch, Daniel Ruess, David Kaul, Maximilian Ruge, Christian Schichor, Joerg-Christian Tonn, Alexander Muacevic
Summary: Robotic radiosurgery (RRS) is a safe, time-saving, and effective treatment modality for intramedullary metastases, especially for patients with unresectable lesions. Many symptoms improve or remain stable after treatment, and most treated lesions are controlled until death. These findings can guide further palliative care for affected patients.
Article
Oncology
Felix Ehret, Lucas Mose, Markus Kufeld, Christoph Fuerweger, Paul Windisch, Alfred Haidenberger, Christian Schichor, Joerg-Christian Tonn, Alexander Muacevic
Summary: This study investigated the efficacy and safety of single-session robotic radiosurgery for spinal metastasis recurrences occurring in the same initial location due to advancements in medical technology. The results showed that this treatment modality is safe, time-saving, and effective, with outcomes comparable to reirradiated metastases in boundary areas.
FRONTIERS IN ONCOLOGY
(2021)
Article
Multidisciplinary Sciences
Franziska Loebel, Antonio Pontoriero, Anne Kluge, Giuseppe Iati, Gueliz Acker, Markus Kufeld, Alberto Cacciola, Stefano Pergolizzi, Sergio Vinci, Sara Lillo, Ran Xu, Carmen Stromberger, Volker Budach, Peter Vajkoczy, Carolin Senger, Alfredo Conti
Summary: Robotic radiosurgery is an effective approach for treating cerebral arteriovenous malformations (AVMs) of all Spetzler-Martin grades, with satisfactory obliteration rates, low toxicity, and a relatively rare incidence of rebleeding. Embolization before treatment can downstage the lesions and improve treatment outcomes.
Article
Oncology
Valentina Borzillo, Rossella Di Franco, Diana Giannarelli, Fabrizio Cammarota, Esmeralda Scipilliti, Emma D'Ippolito, Angela Petito, Marcello Serra, Sara Falivene, Antonio M. Grimaldi, Ester Simeone, Lucia Festino, Vito Vanella, Claudia Trojaniello, Maria Grazia Vitale, Gabriele Madonna, Paolo A. Ascierto, Paolo Muto
Summary: Combining ipilimumab with stereotactic radiotherapy/radiosurgery could improve local control in patients with melanoma brain metastases. However, the impact and timing of these two methods on patients' outcomes are still unclear.
Article
Radiology, Nuclear Medicine & Medical Imaging
Suhong Yu, Huijun Xu, Yin Zhang, Xin Zhang, Michael Dyer, Ariel Hirsch, Minh Tam Truong, Heming Zhen
Summary: The study developed a knowledge-based planning (KBP) model for predicting dosimetric indices and facilitating planning in CyberKnife intracranial stereotactic radiosurgery/radiotherapy (SRS/SRT). The KBP model showed desirable predictability in terms of dose prediction and planning efficiency, demonstrating its ability to improve plan quality and efficiency.
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS
(2021)
Article
Multidisciplinary Sciences
Valerie Schmelter, Sarah Heidorn, Alexander Muacevic, Siegfried G. Priglinger, Paul Foerster, Raffael Liegl
Summary: Iris melanoma is a rare form of uveal melanoma, with treatment options including surgical resection, enucleation, or irradiation. This study analyzed the visual outcomes of eight patients with iris melanoma following robotic-assisted CyberKnife treatment, showing that robotic-assisted radiosurgery is a promising non-invasive treatment option.
SCIENTIFIC REPORTS
(2021)
Article
Oncology
Putipun Puataweepong, Mantana Dhanachai, Thiti Swangsilpa, Chomporn Sitathanee, Rawee Ruangkanchanasetr, Ake Hansasuta, Kumuthinee Pairat
Summary: The study aimed to evaluate the long-term clinical outcomes of patients with vestibular schwannoma treated with stereotactic radiosurgery (SRS) and hypofractionated stereotactic radiotherapy (HSRT) using CyberKnife(R) system. Results showed that both SRS and HSRT provided excellent long-term tumor control, with HSRT potentially resulting in acceptable hearing preservation rates.
ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY
(2022)
Article
Oncology
Tobias Greve, Felix Ehret, Theresa Hofmann, Jun Thorsteinsdottir, Franziska Dorn, Viktor Svigelj, Anita Resman-Gaspersic, Joerg-Christian Tonn, Christian Schichor, Alexander Muacevic
Summary: The study analyzed a large series of cerebral AVMs treated by the frameless CyberKnife stereotactic radiosurgery system. Most AVMs were classified as Spetzler-Martin grade I to III. The occurrence of new neurological deficits after treatment was 5.1%, with almost all patients recovering.
FRONTIERS IN ONCOLOGY
(2021)
Article
Oncology
Gueliz Acker, Marcel Nachbar, Nina Soffried, Bohdan Bodnar, Anastasia Janas, Kiril Krantchev, Goda Kalinauskaite, Anne Kluge, David Shultz, Alfredo Conti, David Kaul, Daniel Zips, Peter Vajkoczy, Carolin Senger
Summary: Neoadjuvant stereotactic radiosurgery (NaSRS) is becoming increasingly important in the treatment of brain metastases. Our analysis showed that there was no significant difference in tumor volume pre- and postoperatively, and smaller tumors had a higher risk of volume increase. However, contouring resection cavities remains a challenge.
FRONTIERS IN ONCOLOGY
(2023)
Article
Oncology
Carolin Senger, Anne Kluge, Melina Kord, Zoe Zimmermann, Alfredo Conti, Markus Kufeld, Anita Kreimeier, Franziska Loebel, Carmen Stromberger, Volker Budach, Peter Vajkoczy, Gueliz Acker
Summary: This study is the largest published series on robotic radiosurgery for ONSM so far and shows that robotic radiosurgery is a safe and effective treatment. 90.0% of patients had stable or improved visual acuity, and the overall local tumor control rate was 96.0%.
Review
Oncology
Felix Ehret, Markus Kufeld, Christoph Fuerweger, Alfred Haidenberger, Susanne Fichte, Ralph Lehrke, Carolin Senger, David Kaul, Martin Bleif, Gerd Becker, Daniel Ruess, Maximilian Ruge, Christian Schichor, Joerg-Christian Tonn, Alexander Muacevic
Summary: Meningiomas, especially foramen magnum meningiomas (FMMs) located near vital brain structures, pose a significant neurosurgical challenge. Stereotactic radiosurgery (SRS) has shown to be effective and safe, achieving high local tumor control with favorable outcomes for FMM patients, including those with tumor recurrence or remnants after surgery. SRS should be considered for selected patients, particularly those not suitable for surgery.
Article
Oncology
Sergej Telentschak, Daniel Ruess, Stefan Grau, Roland Goldbrunner, Niklas von Spreckelsen, Karolina Jablonska, Harald Treuer, Martin Kocher, Maximilian Ruge
Summary: The study retrospectively analyzed 34 patients treated with CK-hSRS, showing good treatment effectiveness with high local control rates but a 12% complication rate.
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
(2021)
Review
Oncology
R. Avgousti, C. Antypas, C. Armpilia, F. Simopoulou, P. Karaiskos, Z. Liakouli, V. Kouloulias, E. Kyrodimos, L. A. Moulopoulos, A. Zygogianni
Summary: The purpose of this study was to identify the optimal time for replanning and set thresholds for the process of replanning in radiotherapy. The study found that the most noticeable changes in radiotherapy occur in the middle fraction of the treatment, and the suggested optimal time for replanning is between the third and fourth week. Some thresholds, such as anatomical deviations > 1 cm, average weight loss > 10%, and violations in dose coverage of the targets > 5% and peripherals, lead to replanning. Adaptive radiotherapy may decrease toxicity and improve local control, but its benefits ultimately depend on each individual patient.
CANCER RADIOTHERAPIE
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
P. Kouris, A. Moutsatsos, E. P. Pappas, I Beli, P. Pantelakos, P. Karaiskos, E. Pantelis
Summary: The dose rate distributions delivered to prostate and head & neck cancer patients treated with a helical TomoTherapy system were analyzed. The analysis showed that treatment time and dose rate varied under different treatment planning conditions. Changing field width and pitch settings can affect dose rate and treatment time.
BIOMEDICAL PHYSICS & ENGINEERING EXPRESS
(2022)
Article
Engineering, Biomedical
Aristea Lekatou, Vasiliki Peppa, Pantelis Karaiskos, Evangelos Pantelis, Panagiotis Papagiannis
Summary: This study investigates the potential of 2D ion chamber arrays as a standalone tool for verifying source strength, positioning, and dwell time in Ir-192 high-dose rate brachytherapy device quality assurance. The results show that the ion chamber array can accurately track source movement and verify source air kerma strength within estimated method uncertainties. Furthermore, the development of a custom jig can improve testing accuracy and eliminate the need for source positioning correction in air kerma strength verification.
PHYSICS IN MEDICINE AND BIOLOGY
(2022)
Article
Oncology
Elena Vlastou, Evaggelos Pantelis, Efstathios P. Efstathopoulos, Pantelis Karaiskos, Vasileios Kouloulias, Kalliopi Platoni
Summary: This study investigates the dose enhancement effect of gold nanoparticles (AuNPs) under different irradiation conditions. The results suggest that a significant dose increase can be achieved, especially at close distances to AuNPs.
Article
Radiology, Nuclear Medicine & Medical Imaging
Georgia Prentou, Eleftherios P. Pappas, Eleni Prentou, Nikolaos Yakoumakis, Chryssa Paraskevopoulou, Efi Koutsouveli, Evaggelos Pantelis, Panagiotis Papagiannis, Pantelis Karaiskos
Summary: The impact of systematic MLC leaf positional uncertainties on the quality of intracranial single-isocenter multi-target VMAT-SRS treatment plans is studied in this research. The study attempts to estimate appropriate tolerance levels and finds that plan quality indices and dose-volume metrics are very sensitive to systematic sub-millimeter leaf positional inaccuracies. Tailoring acceptable and tolerance levels to VMAT-SRS spatial and dosimetric accuracy requirements is necessary.
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS
(2022)
Article
Engineering, Biomedical
A. Moutsatsos, P. Kouris, M. Zoros, O. Athanasiou, C. Koutsarnakis, P. Pantelakos, E. Pantelis
Summary: This study found that CyberKnife radiosurgery delivers highly inhomogeneous dose rate distributions in the temporo-spatial domain, and demonstrated the impact of treatment time on the biological effect. It was shown that each physical dose iso-surface is associated with a range of BEDslr values, which changes with increasing treatment time.
PHYSICS IN MEDICINE AND BIOLOGY
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Panagiotis Archontakis, Argyris Moutsatsos, Panagiotis Papagiannis, Ioannis Seimenis, Evaggelos Pantelis
Summary: In this study, the imaging dose and scattered radiation in CyberKnife radiosurgery applications were calculated and analyzed. The amount of scattered radiation reaching each detector was found to depend on the size of the imaged anatomical region. For head applications, the maximum organ dose at the nasal bones was 1.5 mGy, and the average dose to the eye lenses was 0.37 mGy. For extracranial applications, the entrance imaging dose was 0.4 mGy. Sequentially acquiring radiograph pairs instead of simultaneous acquisition can reduce scattered radiation. An estimated dose of 3.7 cGy to the eye lenses is assumed for 100 image pair exposures required for treatment completion.
PHYSICA MEDICA-EUROPEAN JOURNAL OF MEDICAL PHYSICS
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Evaggelos Pantelis, Andreas Logothetis, Emmanouil Zoros, Eleftherios P. Pappas, Panagiotis Papagiannis, Ian Paddick, Hakan Nordstrom, George Kollias, Pantelis Karaiskos
Summary: In this study, the accuracy of the LGP-Convolution algorithm was evaluated in scenarios involving bone and/or air inhomogeneities. The results demonstrated excellent agreement between LGP-Convolution calculations and experimental as well as Monte Carlo results of dose to medium. It was confirmed that the LGP-Convolution algorithm reports the dose to medium, and the air inhomogeneity was found to have no clinical significance.
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Vasiliki Margaroni, Eleftherios P. Pappas, Anastasios Episkopakis, Evaggelos Pantelis, Panagiotis Papagiannis, Nikolas Marinos, Pantelis Karaiskos
Summary: This study develops a Monte Carlo-based framework to determine correction factors for ionization chambers in MR-Linac dosimetry protocols and quality assurance checks. The study also investigates the dependencies of these factors on irradiation setup conditions and explores the impact of small asymmetrical air gaps on detector readings in solid phantoms.
Article
Oncology
Anastasia Stergioula, Evaggelos Pantelis, Theodoros Kormas, Georgios Agrogiannis
Summary: Differentiated thyroid carcinomas usually have slow progression and good long-term survival, but distant metastases can occur in locations such as cervical lymph nodes, lungs, and bones. However, skeletal muscle metastases are extremely rare. This report presents a case of a 42-year-old woman with follicular thyroid cancer who had a thigh mass that was initially misdiagnosed as synovial sarcoma. Further analysis confirmed the mass to be a skeletal muscle metastasis from thyroid cancer. This study aims to raise awareness that skeletal muscle metastases can occur in clinical settings, despite their low probability.
FRONTIERS IN ONCOLOGY
(2023)
Review
Oncology
Anastasia Stergioula, Panagiotis Pantelakos, Ioannis Varthalitis, Georgios Agrogiannis, Evaggelos Pantelis
Summary: Primary cardiac angiosarcomas (PCAs) are rare tumors that are typically found in the right atrium. Most patients present with unresectable tumors and a dismal prognosis. In this report, we present the successful management of an unresectable PCA using weekly paclitaxel combined with radiotherapy delivered by a helical TomoTherapy system. Follow-up imaging studies showed remarkable tumor regression, and the patient remains disease-free 12 months post treatment.
CLINICAL AND TRANSLATIONAL RADIATION ONCOLOGY
(2023)
Review
Oncology
Anastasia Stergioula, Stefania Kokkali, Evaggelos Pantelis
Summary: This systematic review examines the treatment outcome of primary cardiac angiosarcoma patients and finds that multimodality treatment including surgery and chemo-radiotherapy offers the greatest survival benefit.
CANCER TREATMENT REVIEWS
(2023)
Meeting Abstract
Oncology
P. Archontakis, P. Papagiannis, I. Seimenis, E. Pantelis
RADIOTHERAPY AND ONCOLOGY
(2022)
Article
Medicine, General & Internal
Nandan M. Shanbhag, Christos Antypas, Abdul K. Msaddi, Sinead Catherine Murphy, Teekendra T. Singh
Summary: This article reports a case of a 26-year-old premenopausal lady who was referred to the Department of Oncology with headaches and easy fatiguability. The patient had a previous unsuccessful attempt of excision for a right falcine space-occupying lesion (SOL). After discussing the case at a Multi-Disciplinary Tumor Board, it was decided to treat the patient with hypofractionated stereotactic radiotherapy using CyberKnife (R), which was effective and safe.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2022)
Meeting Abstract
Oncology
C. Antypas, N. Tzoumi, C. Armpilia, R. Avgousti, A. Zygogianni
RADIOTHERAPY AND ONCOLOGY
(2021)