A Study of the Accuracy of Cyberknife Spinal Radiosurgery Using Skeletal Structure Tracking

Ho, Anthony K.; Fu, Dongshan; Cotrutz, C.; Hancock, Steven; Chang, Steven D.; Gibbs, Iris C.; Maurer, Calvin R.; Adler, John R.

doi:10.1227/01.neu.0000249248.55923.ec

Cited by 104 publications

(71 citation statements)

References 70 publications

(26 reference statements)

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“…A well-calibrated CyberKnife V R system typically performs static E2E tests on the level of 0.3-0.7 mm. 41,45,46 Since it is very time-consuming to perform E2E tests for all tracking modalities and path combinations every month, it is recommended that one intracranial and one extra-cranial E2E be performed at least monthly. These tests need to be cycled through each path and tracking method combination that is in clinical use.…”

Section: Iiic2 Isocentric End-to-end (E2e) Testmentioning

confidence: 99%

Report of AAPM TG 135: Quality assurance for robotic radiosurgery

et al. 2011

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The task group (TG) for quality assurance for robotic radiosurgery was formed by the American Association of Physicists in Medicine's Science Council under the direction of the Radiation Therapy Committee and the Quality Assurance (QA) Subcommittee. The task group (TG-135) had three main charges: (1) To make recommendations on a code of practice for Robotic Radiosurgery QA; (2) To make recommendations on quality assurance and dosimetric verification techniques, especially in regard to real-time respiratory motion tracking software; (3) To make recommendations on issues which require further research and development. This report provides a general functional overview of the only clinically implemented robotic radiosurgery device, the CyberKnife V R . This report includes sections on device components and their individual component QA recommendations, followed by a section on the QA requirements for integrated systems. Examples of checklists for daily, monthly, annual, and upgrade QA are given as guidance for medical physicists. Areas in which QA procedures are still under development are discussed.

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Section: Iiic2 Isocentric End-to-end (E2e) Testmentioning

confidence: 99%

Report of AAPM TG 135: Quality assurance for robotic radiosurgery

et al. 2011

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“…The SRS treatment procedure has been described in detail recently [15,[20][21][22]. The CyberKnife and the skeletal structure tracking software (X SIGHT , Accuray Inc.), were used for spinal radiosurgery in all patients.…”

Section: Methodsmentioning

confidence: 99%

“…The CyberKnife and the skeletal structure tracking software (X SIGHT , Accuray Inc.), were used for spinal radiosurgery in all patients. Previous studies have shown the feasibility and submillimetre accuracy of this fiducial-free, frameless method [15,20,21,23,24]. Planning and delivery of treatment were performed as outpatient procedures.…”

Section: Methodsmentioning

confidence: 99%

“…Consequently radiotherapy is considered to have only minimal effects in controlling RCC metastases [7]. Stereotactic radiosurgery (SRS) is well established as an effective therapeutic method in patients with brain metastases from renal cancer [8][9][10], and knowledge is accumulating that spinal lesions can be treated effectively with spinal SRS [11][12][13][14][15][16][17][18][19][20]. In the SRS series published to date, metastatic lesions from RCC have been included but little is known about the combination of antiangiogenic therapy and SRS in terms of toxicity and local tumour control in patients with advanced disease.…”

Section: Introductionmentioning

confidence: 99%

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Simultaneous anti‐angiogenic therapy and single‐fraction radiosurgery in clinically relevant metastases from renal cell carcinoma

Staehler¹,

Haseke²,

Nuhn³

et al. 2010

BJU International

104

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not alter the adverse effects of antiangiogenic therapy.• Local tumour control 15 months after SRS was 98% (95% confidence interval 89-99%). The median pain score before SRS was 5 (range 1-8) and was lowered to 0 (range 0-2, P < 0.01) after SRS. There were no treatment-related deaths or late complications after SRS.• Overall survival was 17.4 months in patients with spinal lesions and 11.1 month in patients with cerebral lesions ( P = 0.038). CONCLUSIONS• Simultaneous systemic anti-angiogenic therapy and SRS for selected patients with renal cell carcinoma who have spinal and cerebral metastases is safe and effective.• Single-fraction delivery allows for efficacious integration of focal radiation treatment into oncological treatment concepts without additional toxicity.• Further studies are needed to determine the limits of SRS for renal cell carcinoma metastases outside the brain and spine. KEYWORDSrenal cell cancer, cyberknife, sunitinib, sorafenib, stereotactic, robotic surgery, spinal tumours, cerebral metastasis What's known on the subject? and What does the study add? To date radiation therapy has had no oncological implication in renal cell carcinoma. Its use was limited to palliation in painful bone lesions. Radiation therapy was considered ineffective as renal cell cancer is resistant to the commonly used doses of radiotherapy. Side effects in combination with systemic therapy were not known, but heavy skin toxicities were expected. Only a few cases of combined radiation with systemic therapy were published. This is the only series where consecutive patients have been treated simultaneously with sunitnib and hypo-fractionated high-dose radiotherapy. Side effects were similar to those expected with systemic therapy or radiation therapy alone. Oncological results are extremely encouraging.Study Type -Therapy (case series) Level of Evidence 4 OBJECTIVE• To analyse the safety and efficacy of simultaneous standard anti-angiogenic therapy and stereotactic radiosurgery (SRS) in patients with spinal and cerebral metastases from renal cell carcinoma. PATIENTS AND METHODS• In all, 106 patients with spinal ( n = 55) or cerebral ( n = 51) metastatic lesions and an Eastern Cooperative Oncology Group status of 0 or 1 were treated with sorafenib or sunitinib and simultaneous SRS.• The primary endpoint was local control.• Secondary endpoints were toxicity and overall survival.

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“…The Xsight spine tracking system [8] matches stereoscopic live images of the spinal region of interest (ROI) with synthetic reference images (digitally reconstructed radiographs -DRRs) to determine the position of the spinal target. The ROI typically includes three to four adjacent vertebrae.…”

Section: Xsight Spine Tracking (Xst)mentioning

confidence: 99%

Feasibility of fiducial-free prone-position treatments with CyberKnife for lower lumbar/sacral spine lesions

Fürweger¹,

Drexler²,

Kufeld³

et al. 2011

Cureus

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A Study of the Accuracy of Cyberknife Spinal Radiosurgery Using Skeletal Structure Tracking

Abstract: The Xsight spine tracking system is practically important because it is accurate and eliminates the use of implanted fiducials. Experience has shown this technology to be robust under a wide range of clinical circumstances.

Cited by 104 publications

References 70 publications

Report of AAPM TG 135: Quality assurance for robotic radiosurgery

Report of AAPM TG 135: Quality assurance for robotic radiosurgery

Simultaneous anti‐angiogenic therapy and single‐fraction radiosurgery in clinically relevant metastases from renal cell carcinoma

Feasibility of fiducial-free prone-position treatments with CyberKnife for lower lumbar/sacral spine lesions

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