Radiotherapy in Managing Brain Metastases: A Case-Based Approach

375 Pages·2020·21.402 MB·English

by  Yoshiya Yamada, Eric Chang, John B. Fiveash, Jonathan Knisely

Radiotherapy in
Managing Brain
Metastases
A Case-Based Approach
Yoshiya Yamada
Eric Chang
John B. Fiveash
Jonathan Knisely
Editors
123
Radiotherapy in Managing Brain
Metastases
Yoshiya Yamada • Eric Chang
John B. Fiveash • Jonathan Knisely
Editors
Radiotherapy in
Managing Brain
Metastases
A Case-Based Approach
Editors
Yoshiya Yamada Eric Chang
Department of Radiation Oncology Department of Radiation Oncology
Memorial Sloan Kettering Cancer University of Southern
Center California
New York, NY Los Angeles, CA
USA USA
John B. Fiveash Jonathan Knisely
Department of Radiation Oncology Weill Cornell Medicine
University of Alabama at Birmingham NewYork–Presbyterian Hospital
Birmingham, AL New York, NY
USA USA
ISBN 978-3-030-43739-8 ISBN 978-3-030-43740-4 (eBook)
https://doi.org/10.1007/978-3-030-43740-4
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Foreword
Galileo and Michelangelo. Hippocrates and the Beatles. There is science and
there is art. There are scientists and there are artists. This textbook is the best
of both. Much of the science is new, and the integrated application of that
science is the art. The focus of their science and art is one of the most rapidly
evolving topics in oncology today – brain metastases. This topic transcends
any one type of cancer. While in the past this diagnosis was under-researched
because of the incorrect conventional wisdom that all such patients held the
same dismal prognosis, we now understand the vast heterogeneity among this
patient population. We are now able to peek over the horizon at the dawn of a
new era in which this heterogeneity holds clues that will lead us far beyond
local control of an individual tumor to a future in which a systemic response
may be ignited by the application of modern therapies in proper sequence and
intensity.
This textbook is unique because of the case-based nature of each chapter
which not only offers the reader practical guidance on the optimal manage-
ment of patients today but also reveals trending topics of tomorrow within
this burgeoning field. The editors and authors are the best in the world on
their assigned topics and should be congratulated on this excellent textbook.
It is an honor and a privilege to review this textbook. I have the utmost confi-
dence that the students of this discipline will find this textbook an essential
reference for years to come.
Minneapolis, MN, USA Paul W. Sperduto, MD, MPP, FASTRO
v
Preface
If one were asked, “What is the most efficacious treatment in radiation oncol-
ogy?”, her answer might be stereotactic radiosurgery. If one were to assess a
treatment by weighing the potential benefit against the potential harms, it
would be difficult to find a treatment as effective in tumor control and safe in
terms of the low incidence of treatment toxicity as stereotactic radiosurgery
for brain metastases.
The consequences of uncontrolled brain metastases are devastating.
Radiosurgery can be performed as a painless, minimally invasive, highly
effective treatment that maintains quality of life, with minimal impact upon
neurocognition, even when multiple brain metastases are present.
The evolution of advanced neuroimaging and sophisticated treatment
planning has allowed highly conformal radiation to be coupled with image-
guided treatment delivery ushering in high-precision radiation treatment into
the modern era. The result is a powerful yet safe and effective tool that can
successfully treat an otherwise vexing clinical problem. As technology
advances and our understanding of the biology of metastatic brain disease
evolves, radiosurgical treatment will continue to adapt and complement sys-
temic targeted therapies and immune checkpoint inhibitors.
This book is designed to be a very practical, case-based approach to the
modern management of brain metastases from the point of view of a radiation
oncologist. Clinical cases are presented to illustrate clinically based chapters,
while key points are provided at the end of each chapter.
We dedicate this book to our families; without their support, none of this
would have been possible.
Los Angeles, CA, USA Eric Chang
Birmingham, AL, USA John B. Fiveash
New York, NY, USA Jonathan Knisely
Yoshiya Yamada
vii
Contents
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Eric Chang, John B. Fiveash, Jonathan Knisely,
and Yoshiya Yamada
Part I C linical Overview: Brain Metastases
2 Brain Metastases: Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Mihir Naik, Joycelin F. Canavan, and Samuel T. Chao
3 Radiobiology of Stereotactic Radiosurgery . . . . . . . . . . . . . . . . . 21
Anuradha Thiagarajan and Yoshiya Yamada
4 Supportive Medical Management of Brain Metastases Patients
Including Treatment Complications . . . . . . . . . . . . . . . . . . . . . . . 31
Peter C. Pan, Laura E. Donovan, and Rajiv S. Magge
5 Neuroimaging of Brain Metastases . . . . . . . . . . . . . . . . . . . . . . . . 53
Mira A. Patel, Eric Lis, and Yoshiya Yamada
6 The Evolution of Combination Therapies Involving Surgery
and Radiosurgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
David Peters, Roshan Prabhu, Stuart Burri, and Anthony
Asher
7 Laser Interstitial Thermal Therapy for Brain Metastasis . . . . . 85
Ahmet F. Atik, Krishna C. Joshi, Alireza Mohammad
Mohammadi, and Gene H. Barnett
8 Integrating Systemic Therapy into the Management of Brain
Metastases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
John B. Fiveash, Anatoly Nikolaev, and Robert M. Conry
9 Indications for Stereotactic Radiosurgery: Multiple Brain
Metastases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Anurag Saraf and Tony J. C. Wang
10 Hypofractionated Stereotactic Radiosurgery for Intact
and Resected Brain Metastases . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
Erqi L. Pollom, Siyu Shi, and Scott G. Soltys
ix
x Contents
11 Target Delineation for Radiosurgery (Including Postoperative
Cavity Radiosurgery) in Brain Metastases . . . . . . . . . . . . . . . . . . 143
Balamurugan A. Vellayappan, Mei Chin Lim, Clement Yong,
Kejia Teo, Shawn Malone, and Simon Lo
12 Indications for Whole-Brain Radiation Therapy . . . . . . . . . . . . . 165
Michael Huo, Fabio Ynoe de Moraes, Matthew Foote, Mark
B. Pinkham, Gustavo N. Marta, and John H. Suh
13 Particle Therapy for the Treatment of Brain Metastases . . . . . . 185
Jeremy Brownstein, Hooney D. Min, Marc Bussiere, and
Helen A. Shih
14 Special Topics in Brain Metastases Management . . . . . . . . . . . . 197
James Byrne, Kevin S. Oh, and Nancy Wang
15 Salvage/Reirradiation/Retreatment . . . . . . . . . . . . . . . . . . . . . . . 217
David Roberge
Part II T echnical: Treatment Planning and Delivery
16 General Techniques for Radiosurgery . . . . . . . . . . . . . . . . . . . . . 231
Mark Ruschin, Arjun Sahgal, Lijun Ma, Lei Wang, Ermias
Gete, and Alan Nichol
17 Single-Isocenter, Multiple Metastasis Treatment Planning . . . . . 249
Evan M. Thomas, Richard A. Popple, Elizabeth Covington,
and John B. Fiveash
18 Dose Tolerances in Brain Metastasis Management . . . . . . . . . . . 281
Giuseppe Minniti, Claudia Scaringi, and Barbara Tolu
19 Evaluation of the Quality of a Radiosurgery Plan . . . . . . . . . . . . 297
Evan M. Thomas, Richard A. Popple, and John B. Fiveash
20 Image Guidance for Frameless Radiosurgery Including
Surface Mapping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311
Guang Li, Yoshiya Yamada, and Åse Ballangrud
21 Safety Procedures and Checklists for Radiosurgery . . . . . . . . . . 323
Richard A. Popple
22 Quality Assurance for Small Fields . . . . . . . . . . . . . . . . . . . . . . . . 335
Richard A. Popple
23 Techniques of Whole Brain Radiation Therapy Including
Hippocampal Avoidance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347
Sean S. Mahase, Diana A. R. Julie, and Jonathan Knisely
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369
Contributors
Anthony Asher, MD Department of Neurosurgery, Carolina Neurosurgery
and Spine Associates, Charlotte, NC, USA
Ahmet F. Atik, MD Department of Neurosurgery, Rose Ella Burkhardt
Neuro-Oncology Center, Cleveland Clinic Foundation, Cleveland, OH, USA
Åse Ballangrud, PhD Department of Medical Physics, Memorial Sloan
Kettering Cancer Center, New York, NY, USA
Gene H. Barnett, MD Department of Neurosurgery, Rose Ella Burkhardt
Neuro-Oncology Center, Cleveland Clinic Foundation, Cleveland, OH, USA
Cleveland Clinic Lerner College of Medicine of Case Western Reserve
University, Cleveland, OH, USA
Jeremy  Brownstein, MD, MSc Department of Radiation Oncology,
Massachusetts General Hospital, Boston, MA, USA
Stuart  Burri, MD Department of Radiation Oncology, Levine Cancer
Institute, Carolinas Medical Center, Southeast Radiation Oncology Group,
Charlotte, NC, USA
Marc  Bussiere, MSc Stereotactic Physics, Department of Radiation
Oncology, Massachusetts General Hospital, Boston, MA, USA
James  Byrne, MD, PhD Department of Radiation Oncology, Harvard
Radiation Oncology Program, Boston, MA, USA
Joycelin F. Canavan, MD, FRCPC Department of Radiation Oncology,
Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
Eric Chang, MD Department of Radiation Oncology, University of Southern
California, Los Angeles, CA, USA
Samuel  T.  Chao, MD Department of Radiation Oncology, Rose Ella
Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic,
Cleveland, OH, USA
Mei  Chin  Lim, MBBS Department of Diagnostic Imaging, National
University Hospital, National University Health System, Singapore,
Singapore
xi
xii Contributors
Robert M. Conry, MD Division of Hematology & Oncology, University of
Alabama at Birmingham, Birmingham, AL, USA
Elizabeth L. Covington, PhD Department of Radiation Oncology, The
University of Alabama at Birmingham, Birmingham, AL, USA
Fabio Ynoe de Moraes, MD Department of Oncology, Division of Radiation
Oncology, Kingston General Hospital, Queens University, Kingston, ON,
Canada
Laura E. Donovan, MD Department of Neurology, Columbia University
Irving Medical Center, New York, NY, USA
John B. Fiveash, MD Department of Radiation Oncology, University of
Alabama at Birmingham, Birmingham, AL, USA
Matthew Foote, BSc, MBBS (Hons) FRANZCR School of Medicine, The
University of Queensland, Brisbane, QLD, Australia
Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane,
Australia
Ermias  Gete, PhD Medical Physics, BC Cancer, Vancouver Centre,
Vancouver, BC, Canada
Michael Huo, MBBS, FRANZCR Radiation Medicine Program, Princess
Margaret Cancer Centre, Toronto, ON, Canada
Department of Radiation Oncology, University of Toronto, Toronto, ON,
Canada
School of Medicine, The University of Queensland, Brisbane, QLD, Australia
Krishna C. Joshi, MD Department of Neurosurgery, Rose Ella Burkhardt
Neuro-Oncology Center, Cleveland Clinic Foundation, Cleveland, OH, USA
Diana  A.  R.  Julie, MD, MPH Department of Radiation Oncology,
NewYork-Presbyterian Hospital, Weill Cornell Medicine, New York, NY,
USA
Kejia  Teo, MBBS Department of Neurosurgery, National University
Hospital, National University Health System, Singapore, Singapore
Jonathan Knisely, MD, FASTRO Department of Radiation Oncology, Weill
Cornell Medicine, NewYork–Presbyterian Hospital, New York, NY, USA
Guang Li, PhD Department of Medical Physics, Memorial Sloan Kettering
Cancer Center, New York, NY, USA
Eric Lis, MD Department of Radiology, Memorial Sloan Kettering Cancer
Center, New York, NY, USA
Simon Lo, MBChB, FACR, FASTRO Department of Radiation Oncology,
University of Washington School of Medicine, Seattle, WA, USA
Rajiv S. Magge, MD Department of Neurology, Weill Cornell Medicine,
NewYork-Presbyterian Hospital, New York, NY, USA