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Spinal Diseases: HELP
Articles by Ben J. Slotman
Based on 9 articles published since 2008
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Between 2008 and 2019, Ben Slotman wrote the following 9 articles about Spinal Diseases.
 
+ Citations + Abstracts
1 Guideline Reirradiation spine stereotactic body radiation therapy for spinal metastases: systematic review. 2017

Myrehaug, Sten / Sahgal, Arjun / Hayashi, Motohiro / Levivier, Marc / Ma, Lijun / Martinez, Roberto / Paddick, Ian / Régis, Jean / Ryu, Samuel / Slotman, Ben / De Salles, Antonio. ·Department of Radiation Oncology, University of Toronto, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada. · Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan. · Neurosurgery Service and Gamma Knife Center, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. · Division of Physics, Department of Radiation Oncology, University of California, San Francisco, California. · Department Neurosurgery, Ruber Internacional Hospital, Madrid, Spain. · National Hospital for Neurology & Neurosurgery, University College London, United Kingdom. · Department of Functional Neurosurgery, Timone University Hospital, Aix-Marseille University, Marseille, France. · Department of Radiation Oncology and Neurosurgery, Stony Brook University, Stony Brook, New York. · Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands; and. · Department of Neurosurgery, University of California, Los Angeles, California, and HCor Neuroscience, São Paulo, Brazil. ·J Neurosurg Spine · Pubmed #28708043.

ABSTRACT: OBJECTIVE Spinal metastases that recur after conventional palliative radiotherapy have historically been difficult to manage due to concerns of spinal cord toxicity in the retreatment setting. Spine stereotactic body radiation therapy (SBRT), also known as stereotactic radiosurgery, is emerging as an effective and safe means of delivering ablative doses to these recurrent tumors. The authors performed a systematic review of the literature to determine the clinical efficacy and safety of spine SBRT specific to previously irradiated spinal metastases. METHODS A systematic literature review was conducted, which was specific to SBRT to the spine, using MEDLINE, Embase, Cochrane Evidence-Based Medicine Database, National Guideline Clearinghouse, and CMA Infobase, with further bibliographic review of appropriate articles. Research questions included: 1) Is retreatment spine SBRT efficacious with respect to local control and symptom control? 2) Is retreatment spine SBRT safe? RESULTS The initial literature search retrieved 2263 articles. Of these articles, 160 were potentially relevant, 105 were selected for in-depth review, and 9 studies met all inclusion criteria for analysis. All studies were single-institution series, including 4 retrospective, 3 retrospective series of prospective databases, 1 prospective, and 1 Phase I/II prospective study (low- or very low-quality data). The results indicated that spine SBRT is effective, with a median 1-year local control rate of 76% (range 66%-90%). Improvement in patients' pain scores post-SBRT ranged from 65% to 81%. Treatment delivery was safe, with crude rates of vertebral body fracture of 12% (range 0%-22%) and radiation-induced myelopathy of 1.2%. CONCLUSIONS This systematic literature review suggests that SBRT to previously irradiated spinal metastases is safe and effective with respect to both local control and pain relief. Although the evidence is limited to low-quality data, SBRT can be a recommended treatment option for reirradiation.

2 Guideline Stereotactic body radiotherapy for de novo spinal metastases: systematic review. 2017

Husain, Zain A / Sahgal, Arjun / De Salles, Antonio / Funaro, Melissa / Glover, Janis / Hayashi, Motohiro / Hiraoka, Masahiro / Levivier, Marc / Ma, Lijun / Martínez-Alvarez, Roberto / Paddick, J Ian / Régis, Jean / Slotman, Ben J / Ryu, Samuel. ·Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut. · Department of Radiation Oncology, University of Toronto, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada. · Department of Neurosurgery, University of California, Los Angeles, California. · Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut. · Department of Neurosurgery, Tokyo Women's Medical University, Tokyo. · Department of Radiation Oncology, Kyoto University, Kyoto, Japan. · Neurosurgery Service and Gamma Knife Center, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. · Division of Physics, Department of Radiation Oncology, University of California, San Francisco, California. · Department of Neurosurgery, Ruber International Hospital, Madrid, Spain. · National Hospital for Neurology and Neurosurgery, London, United Kingdom. · Department of Functional Neurosurgery, Timone University Hospital, Aix-Marseille University, Marseille, France. · Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands; and. · Department of Radiation Oncology, Stony Brook University, Stony Brook, New York. ·J Neurosurg Spine · Pubmed #28598293.

ABSTRACT: OBJECTIVE The aim of this systematic review was to provide an objective summary of the published literature pertaining to the use of stereotactic body radiation therapy (SBRT) specific to previously untreated spinal metastases. METHODS The authors performed a systematic review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, of the literature found in a search of Medline, PubMed, Embase, and the Cochrane Library up to March 2015. The search strategy was limited to publications in the English language. RESULTS A total of 14 full-text articles were included in the analysis. All studies were retrospective except for 2 studies, which were prospective. A total of 1024 treated spinal lesions were analyzed. The median follow-up time ranged from 9 to 49 months. A range of dose-fractionation schemes was used, the most common of which were 16-24 Gy/1 fraction (fx), 24 Gy/2 fx, 24-27 Gy/3 fx, and 30-35 Gy/5 fx. In studies that reported crude results regarding in-field local tumor control, 346 (85%) of 407 lesions remained controlled. For studies that reported actuarial values, the weighted average revealed a 90% 1-year local control rate. Only 3 studies reported data on complete pain response, and the weighted average of these results yielded a complete pain response rate of 54%. The most common toxicity was new or progressing vertebral compression fracture, which was observed in 9.4% of cases; 2 cases (0.2%) of neurologic injury were reported. CONCLUSION There is a paucity of prospective data specific to SBRT in patients with spinal metastases not otherwise irradiated. This systematic review found that SBRT is associated with favorable rates of local control (approximately 90% at 1 year) and complete pain response (approximately 50%), and low rates of serious adverse events were found. Practice guidelines are summarized based on these data and International Stereotactic Radiosurgery Society consensus.

3 Review An integrated multidisciplinary algorithm for the management of spinal metastases: an International Spine Oncology Consortium report. 2017

Spratt, Daniel E / Beeler, Whitney H / de Moraes, Fabio Y / Rhines, Laurence D / Gemmete, Joseph J / Chaudhary, Neeraj / Shultz, David B / Smith, Sean R / Berlin, Alejandro / Dahele, Max / Slotman, Ben J / Younge, Kelly C / Bilsky, Mark / Park, Paul / Szerlip, Nicholas J. ·Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA. Electronic address: sprattda@med.umich.edu. · Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA. · Department of Radiation Oncology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada; Department of Radiation Oncology, Hospital Sirio-Libanes, São Paulo, Brazil. · Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. · Department of Radiology, University of Michigan, Ann Arbor, MI, USA. · Department of Radiation Oncology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada. · Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA. · Department of Radiation Oncology, VU University Medical Center, Amsterdam, Netherlands. · Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. · Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA. ·Lancet Oncol · Pubmed #29208438.

ABSTRACT: Spinal metastases are becoming increasingly common because patients with metastatic disease are living longer. The close proximity of the spinal cord to the vertebral column limits many conventional therapeutic options that can otherwise be used to treat cancer. In response to this problem, an innovative multidisciplinary approach has been developed for the management of spinal metastases, leveraging the capabilities of image-guided stereotactic radiosurgery, separation surgery, vertebroplasty, and minimally invasive local ablative approaches. In this Review, we discuss the variables that should be considered during the management of these patients and review the role of each discipline and their respective management options to provide optimal care. This work is synthesised into a practical algorithm to aid clinicians in the management of patients with spinal metastasis.

4 Review Imaging for stereotactic spine radiotherapy: clinical considerations. 2011

Dahele, Max / Zindler, Jaap D / Sanchez, Esther / Verbakel, Wilko F / Kuijer, Joost P A / Slotman, Ben J / Senan, Suresh. ·Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands. m.dahele@vumc.nl ·Int J Radiat Oncol Biol Phys · Pubmed #21664062.

ABSTRACT: There is growing interest in the use of stereotactic body radiation therapy (SBRT) for spinal metastases. With the need for accurate target definition and conformal avoidance of critical normal structures, high-quality multimodal imaging has emerged as a key component at each stage of the treatment process. Multidisciplinary collaboration is necessary to optimize imaging protocols and implement imaging advances into routine patient care.

5 Clinical Trial Stereotactic body radiotherapy for spine and bony pelvis using flattening filter free volumetric modulated arc therapy, 6D cone-beam CT and simple positioning techniques: Treatment time and patient stability. 2016

Dahele, Max / Slotman, Ben / Verbakel, Wilko. ·a Department of Radiation Oncology , VU University Medical Center , Amsterdam , The Netherlands. ·Acta Oncol · Pubmed #27029341.

ABSTRACT: -- No abstract --

6 Article Subsecond and Submillimeter Resolution Positional Verification for Stereotactic Irradiation of Spinal Lesions. 2016

Hazelaar, Colien / Dahele, Max / Mostafavi, Hassan / van der Weide, Lineke / Slotman, Ben J / Verbakel, Wilko F A R. ·Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: c.hazelaar@vumc.nl. · Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands. · Ginzton Technology Center, Varian Medical Systems, Palo Alto, California. ·Int J Radiat Oncol Biol Phys · Pubmed #27026317.

ABSTRACT: PURPOSE: Spine stereotactic body radiation therapy (SBRT) requires highly accurate positioning. We report our experience with markerless template matching and triangulation of kilovoltage images routinely acquired during spine SBRT, to determine spine position. METHODS AND MATERIALS: Kilovoltage images, continuously acquired at 7, 11 or 15 frames/s during volumetric modulated spine SBRT of 18 patients, consisting of 93 fluoroscopy datasets (1 dataset/arc), were analyzed off-line. Four patients were immobilized in a head/neck mask, 14 had no immobilization. Two-dimensional (2D) templates were created for each gantry angle from planning computed tomography data and registered to prefiltered kilovoltage images to determine 2D shifts between actual and planned spine position. Registrations were considered valid if the normalized cross correlation score was ≥0.15. Multiple registrations were triangulated to determine 3D position. For each spine position dataset, average positional offset and standard deviation were calculated. To verify the accuracy and precision of the technique, mean positional offset and standard deviation for twenty stationary phantom datasets with different baseline shifts were measured. RESULTS: For the phantom, average standard deviations were 0.18 mm for left-right (LR), 0.17 mm for superior-inferior (SI), and 0.23 mm for the anterior-posterior (AP) direction. Maximum difference in average detected and applied shift was 0.09 mm. For the 93 clinical datasets, the percentage of valid matched frames was, on average, 90.7% (range: 49.9-96.1%) per dataset. Average standard deviations for all datasets were 0.28, 0.19, and 0.28 mm for LR, SI, and AP, respectively. Spine position offsets were, on average, -0.05 (range: -1.58 to 2.18), -0.04 (range: -3.56 to 0.82), and -0.03 mm (range: -1.16 to 1.51), respectively. Average positional deviation was <1 mm in all directions in 92% of the arcs. CONCLUSIONS: Template matching and triangulation using kilovoltage images acquired during irradiation allows spine position detection with submillimeter accuracy at subsecond intervals. Although the majority of patients were not immobilized, most vertebrae were stable at the sub-mm level during spine SBRT delivery.

7 Article Best of International Stereotactic Radiosurgery Society Congress 2013: stereotactic body radiation therapy. Part I: spinal tumors. 2013

Lo, Simon S / Chang, Eric L / Ryu, Samuel / Chung, Hans / Slotman, Ben J / Teh, Bin S / Sahgal, Arjun. ·Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Cleveland, OH, USA. simon.lo@UHhospitals.org ·Future Oncol · Pubmed #23980676.

ABSTRACT: The 11th biennial International Stereotactic Radiosurgery Society Congress represented another historical gathering of professionals in the field of stereotactic radiosurgery. This congress was held on 16-20 June 2013 in Toronto (ON, Canada), and the chairman was Arjun Sahgal, the co-chair was Michael Schwartz and president of the society was Jean Regis. The congress attracted 550 attendants from all over the world and over 300 abstracts were presented. Among the abstracts presented, 62 (36 oral) were pertaining to stereotactic body radiation therapy (SBRT). Exciting new findings were presented by colleagues from North America, Europe and Asia. This short conference scene (part I) provides a summary of the best abstracts on SBRT for spinal tumors presented in the congress. A separate conference scene on SBRT for nonspinal tumors (part II) also appears in this issue of Future Oncology.

8 Article Dosimetric impact of intrafraction motion during RapidArc stereotactic vertebral radiation therapy using flattened and flattening filter-free beams. 2013

Ong, Chin Loon / Dahele, Max / Cuijpers, Johan P / Senan, Suresh / Slotman, Ben J / Verbakel, Wilko F A R. ·Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands. c.ong@vumc.nl ·Int J Radiat Oncol Biol Phys · Pubmed #23523183.

ABSTRACT: PURPOSE: To study the dosimetric impact of relatively short-duration intrafraction shifts during a single fraction of RapidArc delivery for vertebral stereotactic body radiation therapy (SBRT) using flattened (FF) and flattening filter-free (FFF) beams. METHODS AND MATERIALS: The RapidArc plans, each with 2 to 3 arcs, were generated for 9 patients using 6-MV FF and 10-MV FFF beams with maximum dose rates of 1000 and 2400 MU/min, respectively. A total of 1272 plans were created to estimate the dosimetric consequences in target and spinal cord volumes caused by intrafraction shifts during one of the arcs. Shifts of 1, 2, and 3 mm for periods of 5, 10, and 30 seconds, and 5 mm for 5 and 10 seconds, were modelled during a part of the arc associated with high doses and steep dose gradients. RESULTS: For FFF plans, shifts of 2 mm over 10 seconds and 30 seconds could increase spinal cord Dmax by up to 6.5% and 13%, respectively. Dosimetric deviations in FFF plans were approximately 2-fold greater than in FF plans. Reduction in target coverage was <1% for 83% and 96% of the FFF and FF plans, respectively. CONCLUSION: Even short-duration intrafraction shifts can cause significant dosimetric deviations during vertebral SBRT delivery, especially when using very high dose rate FFF beams and when the shift occurs in that part of the arc delivering high doses and steep gradients. The impact is greatest on the spinal cord and its planning-at-risk volume. Accurate and stable patient positioning is therefore required for vertebral SBRT.

9 Article Fast arc delivery for stereotactic body radiotherapy of vertebral and lung tumors. 2012

Ong, Chin Loon / Verbakel, Wilko F A R / Dahele, Max / Cuijpers, Johan P / Slotman, Ben J / Senan, Suresh. ·Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands. c.ong@vumc.nl ·Int J Radiat Oncol Biol Phys · Pubmed #22365628.

ABSTRACT: PURPOSE: Flattening filter-free (FFF) beams with higher dose rates and faster delivery are now clinically available. The purpose of this planning study was to compare optimized non-FFF and FFF RapidArc plans for stereotactic body radiotherapy (SBRT) and to validate the accuracy of fast arc delivery. METHODS AND MATERIAL: Ten patients with peripheral lung tumors and 10 with vertebral metastases were planned using RapidArc with a flattened 6-MV photon beam and a 10-MV FFF beam for fraction doses of 7.5-18 Gy. Dosimetry of the target and organs at risk (OAR), number of monitor units (MU), and beam delivery times were assessed. GafChromic EBT2 film measurements of FFF plans were performed to compare calculated and delivered dose distributions. RESULTS: No major dosimetric differences were seen between the two delivery techniques. For lung SBRT plans, conformity indices and OAR doses were similar, although the average MU required were higher with FFF plans. For vertebral SBRT, FFF plans provided comparable PTV coverage, with no significant differences in OAR doses. Average beam delivery times were reduced by a factor of up to 2.5, with all FFF fractions deliverable within 4 min. Measured FFF plans showed high agreement with calculated plans, with more than 99% of the area within the region of interest fulfilling the acceptance criterion. CONCLUSION: The higher dose rate of FFF RapidArc reduces delivery times significantly, without compromising plan quality or accuracy of dose delivery.