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    Clinical experience in the treatment of spinal cord tumors with cyberknife® fractionated stereotactic radiotherapy
    (2021) Guler Avci, Gulhan; Altinisik Inan, Gonca; Aytac Arslan, Suheyla; Guney, Yıldız; Coskun Breuneval, Mehtap
    Aim: The aim of the study is to evaluate the efficacy and safety of Cyberknife® fractionated stereotactic radiotherapy (FSRT) in spinal cord tumors. The secondary aim is to present short-term local control of the patients with spinal cord tumors.Materials and Methods: Ten patients with spinal cord tumors who underwent FSRT between January 2010 and May 2014 were retrospectively analyzed. FSRT was administered in a median dose of 20 Gy (range, 16-40 Gy) in a median 5 fractions (range, 4-6 fractions). Radiological / pathological diagnoses of the patients are meningioma (n = 3), schwannoma (n = 1), neurofibroma (n = 1), hemangioblastoma (n = 1), chordoma (n = 1), recurrent medulloblastoma (n = 1), recurrent ependymoma (n = 2). Results: The median age was 57 years (range, 22-84 years). The median tumor volume was 3.3 cm3 (range, 1.8- 74 cm3). Tumor localization was cervical in six cases, lumbar in three cases, and thoracic in one case. The median follow-up time was 13 months (range, 3-48 months). Clinical improvement was observed by FSRT in all patients except the three cases. Tumor control (no progression) was achieved in all cases. Radiologically, 6 patients were stable, 2 patients had complete and 1 patient had a partial response. No acute toxicity due to FSRT was observed in any cases.Conclusion: Stereotactic radiosurgery /radiotherapy provides acceptable toxicity and excellent local control results in patients with spinal cord tumors. However, well-designed studies with longer follow-up and a large number of patients are warranted.
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    Reirradiation with Cyberknife® fractionated stereotactic radiotherapy in adult recurrent low-grade gliomas
    (2020) Guler Avci, Gulhan; Aytac Arslan, Suheyla; Altinisik Inan, Gonca
    Aim: We aimed to present our clinical experience in patients with recurrent LGG who underwent the fractionated stereotactic radiotherapy (FSRT) with Cyberknife®. Material and Methods: Ten patients with recurrent low grade glioma who had previously irradiated were treated with FSRT as a salvage treatment. At the initial diagnosis, the histology of the tumor was grade II astrocytoma or oligodendroglioma. Four of 10 patients underwent surgery as the primary treatment for recurrence.Results: The median prescription dose was 24 Gy (range 21-25 Gy) with a median fractionation number of 4 (range, 3-5 fractions). No concurrent chemotherapy was administered except one with radiological tumor upgrading. The median interval between the first diagnosis and recurrence was 95 months (range, 45-191 months). From the time point of re-irradiation, median survival was 15 months (range, 1-30 months). CyberKnife® FSRT was well tolerated by all patients. No acute or late side effects were recorded. With a median follow-up of 17 months, 3 patients died. Seven patients were alive with local tumor control in 5 and tumor progression in 2 patients.Conclusion: Fractionated stereotactic radiotherapy is a safe and effective salvage treatment for recurrent LGG. FSRT in adult recurrent LGGs showed encouraging short term results in this small number of cases. Prospective studies are necessitated as further evaluation.