Browsing by Author "Ansari, Shaheryar"

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    Brainstem metastases treated with Gamma Knife stereotactic radiosurgery: the Indiana University Health experience
    (Future Medicine:, 2018-01) Patel, Ajay; Mohammadi, Homan; Dong, Tuo; Shiue, Kevin Ren-Yeh; Frye, Douglas; Le, Yi; Ansari, Shaheryar; Watson, Gordon A.; Miller, James C.; Lautenschlaeger, Tim; Medicine, School of Medicine
    Brainstem metastases offer a unique challenge in cancer treatment, yet stereotactic radiosurgery (SRS) has proven to be an effective modality in treating these tumors. This report discusses the clinical outcomes of patients with brainstem metastases treated at Indiana University with Gamma Knife (GK) radiosurgery from 2008 to 2016. 19 brainstem metastases from 14 patients who had follow-up brain imaging were identified. Median tumor volume was 0.04 cc (range: 0.01-2.0 cc). Median prescribed dose was 17.5 Gy to the 50% isodose line (range: 14-22 Gy). Median survival after GK SRS treatment to brainstem lesion was 17.2 months (range: 2.8-45.6 months). The experience at Indiana University confirms the safety and efficacy of range of GK SRS prescription doses (14-22 Gy) to brainstem metastases.
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    Toxicity of Radiosurgery for Brainstem Metastases
    (Elsevier, 2018) Patel, Ajay; Dong, Tuo; Ansari, Shaheryar; Cohen-Gadol, Aaron; Watson, Gordon; de Moraes, Fabio Ynoe; Nakamura, Masaki; Murovic, Judith; Chang, Steven D.; Hatiboglu, Mustafa Aziz; Chung, Caroline; Miller, James; Lautenschlaeger, Tim; Radiation Oncology, School of Medicine
    Background Although stereotactic radiosurgery (SRS) is an effective modality in the treatment of brainstem metastases (BSM), radiation-induced toxicity remains a critical concern. To better understand how severe or life-threatening toxicity is affected by the location of lesions treated in the brainstem, a review of all available studies reporting SRS treatment for BSM was performed. Methods Twenty-nine retrospective studies investigating SRS for BSM were reviewed. Results The rates of grade 3 or greater toxicity, based on the Common Terminology Criteria for Adverse Events, varied from 0 to 9.5% (mean 3.4 ± 2.9%). Overall, the median time to toxicity after SRS was 3 months, with 90% of toxicities occurring before 9 months. A total of 1243 cases had toxicity and location data available. Toxicity rates for lesions located in the medulla were 0.8% (1/131), compared with midbrain and pons, respectively, 2.8% (8/288) and 3.0% (24/811). Conclusions Current data suggest that brainstem substructure location does not predict for toxicity and lesion volume within this cohort with median tumor volumes 0.04–2.8 cc does not predict for toxicity.