Imperial College London
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ProfessorPatriciaPrice

Faculty of Medicine, Department of Surgery & Cancer

Visiting Professor
 
 
 
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Contact

 

p.price

 
 
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Location

 

BN1/24 B BlockHammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Wilson:2018:10.7759/cureus.2380,
author = {Wilson, HP and Price, PM and Ashkan, K and Edwards, A and Green, MM and Cross, T and Beaney, RP and Davies, R and Sibtain, A and Plowman, NP and Goldsmith, CD},
doi = {10.7759/cureus.2380},
journal = {Cureus},
title = {CyberKnife Radiosurgery of Skull-base Tumors: A UK Center Experience},
url = {http://dx.doi.org/10.7759/cureus.2380},
volume = {10},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - The study aim was to evaluate patient individualized Cyberknife(R) treatment for heterogeneous skull-base tumors. Patients treated between 2009 and 2013 at The Harley Street Clinic were studied. In total, 66 patients received 15-30 Gy in 1-5 fractions to a median planning target volume (PTV) of 6.4 cc, including patients with secondary, multiple, residual and recurrent tumors, and those with tumors of uncertain pathological type. Outcome analysis was pragmatically restricted to 35 patients who had single, primary tumors treated with curative intent, and sufficient diagnostic and outcome information. Sixteen vestibular schwannoma patients with median PTV 3.8 cc (range 0.81-19.6) received 18-25 Gy in 3-5 fractions: 81% showed no acute toxicity, 50% reported no late toxicity, 71% of symptoms were stable/improved and local control was 100% at 11.4 months median follow-up. Twelve meningioma patients with median PTV of 5.5 cc (range 0.68-22.3) received 17-30 Gy in 1-5 fractions: 83% experienced no acute toxicity, 33% reported no late toxicity, 88% of symptoms were stable/improved and local control was 100% at 22.1 months median follow-up. Seven patients with other tumor types with median PTV of 24.3 cc (range 7.6-100.5) received 15-28.5 Gy in 1-5 fractions: 57% experienced no acute toxicity, 57% reported no late toxicities, 66% of symptoms were stable and local control was 43% at 14.9 months median follow-up. When tumor types were considered together, smaller tumors (PTV < 6.4 cc) showed reduced acute toxicity (p = 0.01). Overall, smaller benign tumors showed low acute toxicity, excellent local control, and good symptom management: a focus on enhanced neurological preservation may refine outcomes. For other tumor types outcome was encouraging: a focus on optimal dose and fractionation scheduling may reduce toxicity and improve local control. Individual patient experiences are detailed where valuable lessons were gained for optimizing local control and minimizing toxici
AU  - Wilson,HP
AU  - Price,PM
AU  - Ashkan,K
AU  - Edwards,A
AU  - Green,MM
AU  - Cross,T
AU  - Beaney,RP
AU  - Davies,R
AU  - Sibtain,A
AU  - Plowman,NP
AU  - Goldsmith,CD
DO  - 10.7759/cureus.2380
PY  - 2018///
SN  - 2168-8184
TI  - CyberKnife Radiosurgery of Skull-base Tumors: A UK Center Experience
T2  - Cureus
UR  - http://dx.doi.org/10.7759/cureus.2380
UR  - https://www.ncbi.nlm.nih.gov/pubmed/29805949
UR  - http://hdl.handle.net/10044/1/70126
VL  - 10
ER  -
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