Lung Metastases Treated with Image-guided Stereotactic Body Radiation Therapy.

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Lung Metastases Treated with Image-guided Stereotactic Body Radiation Therapy.

Clin Oncol (R Coll Radiol). 2013 Apr;25(4):236-41

Authors: Baschnagel AM, Mangona VS, Robertson JM, Welsh RJ, Kestin LL, Grills IS

Abstract
AIMS: To evaluate outcomes after treatment with image-guided stereotactic body radiation therapy (SBRT) using daily online cone beam computed tomography for malignancies metastatic to the lung.
MATERIALS AND METHODS: Forty-seven lung metastases in 32 patients were treated with volumetrically guided SBRT. The median age was 62 years (21-87). Primaries included colorectal (n = 10), sarcoma (n = 4), head and neck (n = 4), melanoma (n = 3), bladder (n = 2), non-small cell lung cancer (n = 2), renal cell (n = 2), thymoma (n = 2), thyroid (n = 1), endometrial (n = 1) and oesophageal (n = 1). The number of lung metastases per patient ranged from one to three (68% single lesions). SBRT was prescribed to the edge of the target volume to a median dose of 60 Gy (48-65 Gy) in a median of four fractions (four to 10). Most lesions were treated using 12 Gy fractions (92%) to 48 or 60 Gy.
RESULTS: The median follow-up was 27.6 months (7.6-57.1 months). The 1, 2 and 3 year actuarial local control rates for all treated lesions were 97, 92 and 85%, respectively. Two patients with colorectal primaries (four lesions in total) had local failure. The median overall survival was 40 months. The 1, 2 and 3 year overall survival from the time of SBRT completion was 83, 76 and 63%, respectively. There were no grade 4 or 5 toxicities. Grade 3 toxicities (one instance of each) included pneumonitis, dyspnoea, cough, rib fracture and pain.
CONCLUSION: SBRT with daily online cone beam computed tomography for lung metastases achieved excellent local tumour control with low toxicity and encouraging 2 and 3 year survival.

PMID: 23352916 [PubMed – in process]

The Isadora syndrome: a case report of cervical, oesophageal and tracheal transection in a go-karting accident.

The Isadora syndrome: a case report of cervical, oesophageal and tracheal transection in a go-karting accident.

Br J Neurosurg. 2011 Apr;25(2):310-2

Authors: Ahmad M, Sinha P, Al-Tamimi YZ, Sylvester D, Dezso A, Timothy J

We report a case of cervical spine, tracheal and oesophageal trauma from a go-karting injury caused by the patient’s scarf catching in the vehicle’s wheel. We discuss the significance of the pre-hospital and operative management of this potentially life-threatening injury by a multi-specialty surgical team. The importance of health and safety issues in recreational sports is highlighted in view of the increasing incidence of cervical spine trauma over past two decades.

PMID: 21545330 [PubMed – in process]