Helical TomoTherapy in the Treatment of Central Nervous System Metastasis
Helical TomoTherapy in the Treatment of Central Nervous System Metastasis
In this report the authors review the use of radiotherapy in the treatment of central nervous system (CNS) metastasis. They comment on different treatment methods for both intracranial and extracranial CNS metastasis and discuss some of the evidence supporting the use of radiotherapy in these settings. Recent advancements in radiation oncology technology are briefly reviewed with a focus on the advantages and disadvantages of helical TomoTherapy-based treatment strategies.
A review of pertinent current literature was performed. TomoTherapy research currently underway at the University of Virginia Health System is discussed and a representative case is presented.
Radiotherapy for CNS metastasis is an effective treatment that provides palliation of symptoms and confers a survival advantage on selected patients. Advances in radiotherapy techniques continue to improve the therapeutic ratio for patients with CNS metastases.
Helical TomoTherapy offers distinct advantages for patients with CNS metastatic disease by sparing normal tissue when intracranial or extracranial disease is targeted.
Metastatic lesions within the brain and CNS represent a significant clinical problem because of their dramatic impact on patients' quality of life. Each year in the US brain metastasis develops in approximately 250,000 to 300,000 patients. These patients face a median life expectancy of 6 months from diagnosis. If very aggressive treatment is used, a select cohort of patients with controlled systemic disease, a good performance status, and fewer than three brain metastatic lesions will survive 1 or more years. Treatment options for patients with brain metastases include surgery, chemotherapy, and radiation treatment. Current treatment strategies are evolving as a result of advancements in radiation delivery, including HT, which is capable of whole-brain irradiation with simultaneous high-dose targeting to metastatic lesions by using multiple-target differential dose-prescription strategies and highly conformal CSI.
Abstract and Introduction
Abstract
In this report the authors review the use of radiotherapy in the treatment of central nervous system (CNS) metastasis. They comment on different treatment methods for both intracranial and extracranial CNS metastasis and discuss some of the evidence supporting the use of radiotherapy in these settings. Recent advancements in radiation oncology technology are briefly reviewed with a focus on the advantages and disadvantages of helical TomoTherapy-based treatment strategies.
A review of pertinent current literature was performed. TomoTherapy research currently underway at the University of Virginia Health System is discussed and a representative case is presented.
Radiotherapy for CNS metastasis is an effective treatment that provides palliation of symptoms and confers a survival advantage on selected patients. Advances in radiotherapy techniques continue to improve the therapeutic ratio for patients with CNS metastases.
Helical TomoTherapy offers distinct advantages for patients with CNS metastatic disease by sparing normal tissue when intracranial or extracranial disease is targeted.
Introduction
Metastatic lesions within the brain and CNS represent a significant clinical problem because of their dramatic impact on patients' quality of life. Each year in the US brain metastasis develops in approximately 250,000 to 300,000 patients. These patients face a median life expectancy of 6 months from diagnosis. If very aggressive treatment is used, a select cohort of patients with controlled systemic disease, a good performance status, and fewer than three brain metastatic lesions will survive 1 or more years. Treatment options for patients with brain metastases include surgery, chemotherapy, and radiation treatment. Current treatment strategies are evolving as a result of advancements in radiation delivery, including HT, which is capable of whole-brain irradiation with simultaneous high-dose targeting to metastatic lesions by using multiple-target differential dose-prescription strategies and highly conformal CSI.
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