ArticleRadiation oncology (London, England)2011
Frameless linac-based stereotactic radiosurgery (SRS) for brain metastases: analysis of patient repositioning using a mask fixation system and clinical outcomes.
Article in Radiation oncology (London, England), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
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41 citing papers in PubMed, 87 citations in OpenAlex.
- A phase II clinical trial of frameless, fractionated stereotactic radiation therapy for brain metastases.JNCI cancer spectrum · 2023Trial
- Effects of intrafractional motion on targeting accuracy in frameless single-isocenter multi-target stereotactic radiosurgery.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Comparison of 3 vs 5 Fraction Single Isocenter Radiosurgery for Brain Metastases.Advances in radiation oncology · 2026Article
- To shift or not to shift: identifying and correcting patient motion after couch rotations in non-coplanar intracranial radiosurgery with stereoscopic X-ray imaging.Journal of applied clinical medical physics · 2026Article
- Accuracy and workflow efficiency of surface-guided open-face vs. closed-face masks in SRT/SRS for brain metastases.Technical innovations & patient support in radiation oncology · 2026Article
- Control-point-specific plan robustness in volumetric modulated arc therapy-based cranial radiotherapy.Journal of applied clinical medical physics · 2026Article
- Hypofractionated frameless gamma knife radiosurgery for glomus jugulare tumors: A single-center experience.Neurosurgical review · 2025Article
- Evaluation of the system accuracy of frameless stereotactic radiosurgery using a combination of cone beam CT, six degrees of freedom couch, and surface image-guided systems.Journal of applied clinical medical physics · 2025Article
- A multi-institutional trial evaluating the use of an integrated quality assurance phantom for frameless single-isocenter multitarget stereotactic radiosurgery.Frontiers in oncology · 2024Article
- Stereotactic Radiosurgery of Multiple Brain Metastases: A Review of Treatment Techniques.Cancers · 2023Review
- A comprehensive evaluation of advanced dose calculation algorithms for brain stereotactic radiosurgery.Journal of applied clinical medical physics · 2023Article
- Region-of-interest intra-arc MV imaging to facilitate sub-mm positional accuracy with minimal imaging dose during treatment deliveries of small cranial lesions.Journal of applied clinical medical physics · 2022Article
- Initial clinical experience of surface guided stereotactic radiation therapy with open-face mask immobilization for improving setup accuracy: a retrospective study.Radiation oncology (London, England) · 2022Article
- Comparison of dosimetric impact of intra-fractional setup discrepancy between multiple- and single-isocenter approaches in linac-based stereotactic radiotherapy of multiple brain metastases.Journal of applied clinical medical physics · 2022Article
- Brain Linac-Based Radiation Therapy: "Test Drive" of New Immobilization Solution and Surface Guided Radiation Therapy.Journal of personalized medicine · 2021Article
- Dose-Response Effect and Dose-Toxicity in Stereotactic Radiotherapy for Brain Metastases: A Review.Cancers · 2021Review
- Surgical management of anterior clinoidal meningiomas: consensus statement on behalf of the EANS skull base section.Acta neurochirurgica · 2021Article
- Accuracy of dose-volume metric calculation for small-volume radiosurgery targets.Medical physics · 2021Article
- Intra-fractional patient motion when using the Qfix Encompass immobilization system during HyperArc treatment of patients with brain metastases.Journal of applied clinical medical physics · 2021Article
- Performance assessment of two motion management systems for frameless stereotactic radiosurgery.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2021Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo assess the accuracy of patient repositioning and clinical outcomes of frameless stereotactic radiosurgery (SRS) for brain metastases using a stereotactic mask fixation system. PATIENTS AND
methodsOne hundred two patients treated consecutively with frameless SRS as primary treatment at University of Rome Sapienza Sant'Andrea Hospital between October 2008 and April 2010 and followed prospectively were involved in the study. A commercial stereotactic mask fixation system (BrainLab) was used for patient immobilization. A computerized tomography (CT) scan obtained immediately before SRS was used to evaluate the accuracy of patient repositioning in the mask by comparing the isocenter position to the isocenter position established in the planning CT. Deviations of isocenter coordinates in each direction and 3D displacement were calculated. Overall survival, brain control, and local control were estimated using the Kaplan-Meier method calculated from the time of SRS.
resultsThe mean measured isocenter displacements were 0.12 mm (SD 0.35 mm) in the lateral direction, 0.2 mm (SD 0.4 mm) in the anteroposterior, and 0.4 mm (SD 0.6 mm) in craniocaudal direction. The maximum displacement of 2.1 mm was seen in craniocaudal direction. The mean 3D displacement was 0.5 mm (SD 0.7 mm), being maximum 2.9 mm. The median survival was 15.5 months, and 1-year and 2-year survival rates were 58% and 24%, respectively. Nine patients recurred locally after SRS, with 1-year and 2-year local control rates of 91% and 82%, respectively. Stable extracranial disease (P = 0.001) and KPS > 70 (P = 0.01) were independent predictors of survival.
conclusionsFrameless SRS is an effective treatment in the management of patients with brain metastases. The presented non-invasive mask-based fixation stereotactic system is associated with a high degree of patient repositioning accuracy; however, a careful evaluation is essential since occasional errors up to 3 mm may occur.
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