Daniel M. Trifiletti

Samuel T. Chao

Arjun Sahgal

Jason P. Sheehan

This new edition is a fully updated, comprehensive review of stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT): its physics, clinical evidence, indications, and future directions. The utilization of stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) is increasing internationally because of several factors. First, it offers patients a local treatment option that has demonstrated effectiveness similar to traditional surgery without the morbidity of general anesthesia and open surgical resection. Second, recent advancements in the quality of scientific evidence supporting a SRS or SBRT-containing approach in patients continues to evolve and demonstrate favorable disease-specific outcomes with little, if any, toxicity in various anatomic disease sites and for various conditions including cancer, benign tumors, and other psychiatric and neurologic conditions. Third, and most provocatively, is the notion that definitive local therapy (i.e. SRS or SBRT) in patients with cancer can boost the immune system to fight cancer in other sites throughout the body. While traditional medical knowledge would suggest that all patients with metastatic cancer are incurable, there is a mounting body of evidence that there is a subset of these patients that can be cured with definitive SRS or SBRT. This volume thus delves into each of these benefits and aspects of treatment, guiding physicians to the best treatment plan for their patients. Expert, international authors provide guidelines for SRS and SBRT use by clinicians. Chapters are divided into six main sections: Radiobiology of Radiosurgery and Stereotactic Body Radiation Therapy, Intracranial Radiosurgery Technique, Intracranial Radiosurgery by Indication, Stereotactic Body Radiation Therapy Technique, Stereotactic Body Radiation Therapy by Indication, The Future of Radiosurgery and SBRT. Overall physics are explained, as well as specific considerations for particular surgical tools (including the Leksell Gamma Knife and Accuray CyberKnife), techniques (including fractionated and charged particle radiosurgery), and anatomic sites (including brain metastases, pituitary tumors, and the prostate). Since the first edition published, the field has grown significantly. There is now significant new data to support preoperative radiosurgery, increased indications in metastatic cancers, as well as integration with new drug therapies and imaging techniques. Each chapter is thus fully updated with the latest in medical advancements and new scientific research. Detailed images and charts enhance the chapters. This book provides physicians with a single, practical resource incorporating both of these broad categories of treatment, SRS and SBRT, and better defines the current role and the direction of radiosurgery.

A Comprehensive Guide

Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy

Following recent developments in hypofractionated stereotactic radiation therapy (SRT) for brain and spine tumors, this new edition offers a fully updated and comprehensive "how-to" guidance on hypofractionated SRT for brain and spine metastases, glioma, benign tumors, and other tumor types. Presenting the state of the art of the technology and practice, this book: • Discusses the pros and cons of hypofractionated SRT compared to single-fraction radiosurgery, providing a deeper understanding of radiosurgery and radiobiology • Explains the toxicity and adverse effects of hypofractionated SRT including the dosage of 24 Gy in two spine SBRT fractionation schemes, aiding practitioners in communicating the risks and benefits of treatment and in obtaining consent from their patients • Outlines the current standards for safe practice, including checklists for implementation • Explores new technologies for brain and spine tumors including LITT, MR-guided focused ultrasound, and Zap technology, with chapters authored by well-recognized experts in the radiation, oncology, and neurosurgery communities; this book delivers a level of technological and clinical detail not available in journal papers This book is suitable for radiation oncologists, neurosurgeons, and medical physicists who specialize in brain and/or spine radiosurgery or want to start a program and need a comprehensive reference with key checklists for practice.

A Practical Approach to Guide Treatment of Brain and Spine Tumors

Image-Guided Hypofractionated Stereotactic Radiosurgery

Paul D. Brown

Simon S. Lo

Eric L. Chang

John H. Suh

This new edition elucidates the radiation therapy protocols and procedures for the management of adult patients presenting with primary benign and malignant central nervous system tumors. With the development of new treatment strategies and rapid advancement of radiation technology, it is crucial for radiation oncologists to maintain and refine their knowledge and skills. Dedicated exclusively to adult CNS radiation oncology, this textbook explores CNS tumors ranging from the common to the esoteric as well as secondary cancers of metastatic origin. The first half of the book is organized anatomically: tumors of the brain, spinal cord, leptomeninges, optic pathway, ocular choroid, and skull base. The second half covers primary CNS lymphoma, rare CNS tumors, metastatic brain disease, vascular conditions of the CNS, radiation-associated complications, and radiation modalities. This new edition is updated throughout and includes several new chapters, including: palliative radiation therapy for leptomeningeal disease, preoperative treatment for brain metastases, advanced neuroimaging for brain tumors, and MR-LINAC for brain tumors. Each chapter provides guidance on treatment field design, target delineation, and normal critical structure tolerance constraints in the context of the disease being treated. Learning objectives, case studies, and Maintenance of Certification Self-Assessment Continuing Medical Education-style questions and answers are incorporated throughout the book. This is an ideal guide for radiation oncologists, residents, and fellows, but medical students may also find value in the text.

Principles and Practice

Adult CNS Radiation Oncology

Lia M. Halasz

This book is a practical, up-to-date guide to the treatment of patients with brain and spinal tumors. Leading experts in the field explain treatment techniques in detail, highlighting key considerations in the use of external beam radiation therapy, intensity-modulated radiation therapy, particle therapy, radiosurgery, and stereotactic body radiation therapy. Specific recommendations are described for different tumor types, and helpful information provided on other important issues, such as the interaction of radiotherapy and systemic therapy and the avoidance of treatment complications. With the development of modern technology, highly conformal radiotherapy techniques have become more complicated, yet also more widely employed. This book will equip readers with the knowledge required to set up practices to deliver quality brain and spinal radiation therapy appropriate to each patient. It will be of benefit to radiation oncologists, clinical oncologists, medical physicists, medical dosimetrists, radiation therapists, and senior nurses as well as medical oncologists and surgical oncologists with an interest in radiotherapy.

A Practical Guide on Treatment Techniques

Intracranial and Spinal Radiotherapy

This book is a comprehensive review of stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT): its physics, clinical evidence, indications, and future directions. The utilization of stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) is increasing internationally because of several factors. First, it offers patients a local treatment option that has demonstrated effectiveness similar to traditional surgery without the morbidity of general anesthesia and open surgical resection. Second, recent advancements in the quality of scientific evidence supporting a SRS or SBRT-containing approach in patients continues to evolve and demonstrate favorable disease-specific outcomes with little, if any, toxicity in various anatomic disease sites and for various conditions including cancer, benign tumors, and other psychiatric and neurologic conditions. Third, and most provocatively, is the notion that definitive local therapy (i.e. SRS or SBRT) in patients with cancer can boost the immune system to fight cancer in other sites throughout the body. While traditional medical knowledge would suggest that all patients with metastatic cancer are incurable, there is a mounting body of evidence that there is a subset of these patients that can be cured with definitive SRS or SBRT. This volume thus delves into each of these benefits and aspects of treatment, guiding physicians to the best treatment plan for their patients. Expert, international authors provide guidelines for SRS and SBRT use by clinicians. Chapters are divided into six main sections: Radiobiology of Radiosurgery and Stereotactic Body Radiation Therapy, Intracranial Radiosurgery Technique, Intracranial Radiosurgery by Indication, Stereotactic Body Radiation Therapy Technique, Stereotactic Body Radiation Therapy by Indication, The Future of Radiosurgery and SBRT. Overall physics are explained, as well as specific considerations for particular surgical tools (including the Leksell Gamma Knife and Accuray CyberKnife), techniques (including fractionated and charged particle radiosurgery), and anatomic sites (including brain metastases, pituitary tumors, and the prostate). Detailed images and charts enhance the chapters. This book provides physicians with a single, practical resource incorporating both of these broad categories of treatment, SRS and SBRT, and better defines the current role and the direction of radiosurgery.

Arjun Sahgal

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