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Anthes VB, Schwartz M, Cusimano MD, Radovanovic I, Kulkarni AV, Laperriere NJ, Payne D, Heaton RK, van Prooijen M, Das S, Tsang DSC. Effect of Cobalt-60 Calibration Dose-Rate on Arteriovenous Malformation Obliteration after Stereotactic Radiosurgery. Int J Radiat Oncol Biol Phys 2023; 117:e83-e84. [PMID: 37786194 DOI: 10.1016/j.ijrobp.2023.06.833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Stereotactic radiosurgery (SRS) dose rate - how old the cobalt-60 sources are - is known to influence outcomes for some neurologic conditions and benign tumors, but it is not known if SRS dose rate influences arteriovenous malformation (AVM) obliteration. The objective of this study is to determine the association between cobalt-60 calibration dose rate and cerebral AVM obliteration in patients treated with SRS. Our hypothesis is that higher SRS dose rates are associated with increased incidence of cerebral AVM obliteration. MATERIALS/METHODS We performed a retrospective study of 361 patients undergoing 411 AVM-directed SRS treatments between 2005 and 2019 at a single institution. Obliteration was confirmed with digital subtraction angiogram or MRI (if patient refused angiography). Lesion characteristics, SRS treatment details, and post-treatment obliteration and toxicities were recorded. Univariate and multivariate proportional hazards regression models of AVM outcomes with regard to SRS dose rate were performed, controlling for factors such as Spetzler-Martin Grade, maximum AVM extent, prior hemorrhage and prior embolization. RESULTS At 10 years post-SRS, 68% of AVMs were obliterated on follow-up imaging. Dose rates >2.9 Gy/min were found to be significantly associated with AVM obliteration compared to those <2.1 Gy/min (p = 0.034, Gray's test). AVM size or Spetzler-Martin grade were also associated with obliteration, with obliteration more likely for smaller lesions, particularly those <3 cm in maximal diameter, or with lower Spetzler-Martin grade. Higher dose rates were not associated with development of post-SRS radiologic or symptomatic edema, though larger AVM volume was associated with both types of edema. CONCLUSION Patients with cerebral AVMs treated with higher SRS dose rates (from fresh cobalt-60 sources) experience higher incidences of obliteration, without a significant change in the risk of post-treatment edema. These findings suggest that clinics offering SRS for AVMs should regularly renew cobalt-60 radiation sources to maintain high therapeutic dose rates.
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Affiliation(s)
- V B Anthes
- Radiation Medicine Program, Princess Margaret Cancer Centre and Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - M Schwartz
- Division of Neurosurgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - M D Cusimano
- Division of Neurosurgery, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - I Radovanovic
- Division of Neurosurgery, University Health Network, Toronto, ON, Canada
| | - A V Kulkarni
- Division of Neurosurgery, The Hospital for Sick Children, Toronto, ON, Canada
| | - N J Laperriere
- Radiation Medicine Program, Princess Margaret Cancer Centre and Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - D Payne
- Radiation Medicine Program, Princess Margaret Cancer Centre and Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - R K Heaton
- Radiation Medicine Program, Princess Margaret Cancer Centre and Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - M van Prooijen
- Radiation Medicine Program, Princess Margaret Cancer Centre and Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - S Das
- Division of Neurosurgery, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, ON, Canada
| | - D S C Tsang
- Radiation Medicine Program, Princess Margaret Cancer Centre and Toronto Western Hospital, University Health Network, Toronto, ON, Canada
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Abstract
To enhance PEG uptake for radiation therapy, a peptide containing an integrin binding domain (RGD) was conjugated to PEG. Nanoparticles functionalized with both the RGD peptide and PEG had a higher uptake than NPs functionalized with PEG alone.
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Affiliation(s)
- C. Cruje
- Dept. of Physics
- Ryerson University
- Toronto
- Canada
| | - C. Yang
- Dept. of Physics
- Ryerson University
- Toronto
- Canada
| | | | | | - B. D. Chithrani
- Dept. of Physics
- Ryerson University
- Toronto
- Canada
- Keenan Research Centre
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Stanescu T, Chung C, Simeonov A, van Prooijen M, Millar B, Menard C. Quantification of the Magnetic Susceptibility Effects During MRI Guided Radiosurgery of Hemorrhagic Brain Metastases. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.2209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Tsang R, Pebdani H, Patil N, Edem I, Albert-Green A, van Prooijen M, Heydarian M, Ladak S, Zadeh G. PO-0639 EXCELLENT CLINICAL OUTCOME FOR PITUITARY ADENOMAS TREATED WITH STEREOTACTIC RADIOTHERAPY USING A NARROW MARGIN. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70972-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Barnett E, Moseley D, Comsa D, Abbas A, van Prooijen M, Yeung I. SU-E-T-145: Patient Specific Quality Assurance - Not Just Stamp Collecting. Med Phys 2011. [DOI: 10.1118/1.3612096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Lamey M, Carlone M, Alasti H, Bissonnette J, Borg J, Breen S, Coolens C, Heaton R, Islam M, Sharpe M, Stanescu T, van Prooijen M, Jaffray D. SU-E-T-252: Safety Systems and Failure Modes and Effects Analysis for a Linear Accelerator - Magnetic Resonance Imager - Brachytherapy System. Med Phys 2011. [DOI: 10.1118/1.3612203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Comsa D, Barnett E, Moseley D, van Prooijen M. SU-E-T-445: Use of MAPPHAN for Patient Specific VMAT Plan Verification. Med Phys 2011. [DOI: 10.1118/1.3612399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Patil N, Brierley J, van Prooijen M, Heydarian M, Mckinnon S, Ladak S, Fung S, Tsang R. Excellent Clinical Outcome is Maintained for Pituitary Adenomas Treated with Stereotactic Radiotherapy using a Narrow Margin. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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van Prooijen M, Islam M, Heaton R. SU-FF-T-578: Assessment and Management of Dose Perturbations Due to the Treatment Couch. Med Phys 2009. [DOI: 10.1118/1.3182076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Heaton R, Smale J, Norrlinger B, Wang Y, van Prooijen M, Islam M. Poster - Thurs Eve-31: Clinical implementation and experience with EPID-based precision isocentre localization. Med Phys 2008; 35:3407. [DOI: 10.1118/1.2965950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Cho Y, van Prooijen M, Jaffray D, Islam M. SU-EE-A2-02: Verification of Source and Collimator Configuration for Gamma-Knife® Perfexion TM using Panormaric Imaging. Med Phys 2008. [DOI: 10.1118/1.2961381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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La Macchia N, Tsang R, Parent A, Heaton R, Cheung F, van Prooijen M, Amin N, Islam M. The Development of a Segmented Intensity Modulated Beam Technique for Total Body Irradiation Prior to Hematologic Stem Cell Transplantation. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Heaton R, van Prooijen M, Cheung F, Islam M, La Macchia N, Amin M, Tsang R, Millar B, Hodgson D. TH-C-M100E-07: A CT Based Total Body Irradiation Technique Using Intensity Modulated Beams. Med Phys 2007. [DOI: 10.1118/1.2761675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Amin M, Heaton R, van Prooijen M, Norrlinger B, Cheung F, Islam M. SU-FF-T-184: Dosimetric Verification of a Novel TBI Technique Using Segmented Radiation Fields. Med Phys 2007. [DOI: 10.1118/1.2760843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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van Prooijen M, Heaton R, Norrlinger B, Hunter S, Islam M. SU-FF-T-343: Peripheral Dose Variations with Different IMRT Delivery Systems. Med Phys 2007. [DOI: 10.1118/1.2761007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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