Who does a lot of frameless SRS without Cyberknife?

[RadOncLova]

I'm curious to know which institutions are doing a lot of frameless SRS without Cyberknife? What platform are they using?

Do they do only brain mets or will they do things requiring higher doses like Trigeminal Neuralgia?

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[Neuronix]

We do a ton of frameless with Novalis for brain mets. Because we're a cancer center only we don't treat benign conditions like TN or AVM.

 

[OTN]

I'm curious to know which institutions are doing a lot of frameless SRS without Cyberknife? What platform are they using?

Do they do only brain mets or will they do things requiring higher doses like Trigeminal Neuralgia?

I do. We have a Novalis platform as well, which works just fine. Also do TN.

 

[medgator]

We do a ton of frameless with Novalis for brain mets. Because we're a cancer center only we don't treat benign conditions like TN or AVM.

I don't get why that would exclude you from treating those indications

 

[Irradi8or]

We do a ton of frameless with Novalis for brain mets. Because we're a cancer center only we don't treat benign conditions like TN or AVM.

Same at my cancer center - we don't have a vascular neurosurgeon and don't get the referrals

 

[Palex80]

We treat both brain mets and AVM framelessly on a normal Linac.
We have a stereotactic invasive ring, but we've never actually used it. We would probably use it, if we got referrals for trigeminus neuralgia, but we don't.
Precision on modern Linacs is very high, if you spend enough time to check and correct all possible influence factors, our physicists have perfected this on the Linacs we use for stereotactic treatments with countless tests.

During the first 20 patients or so we performed mid-treatment CBCTs to check for intrafractactional movement. We found none (<1mm), which is more or less the standard error of the CBCT itself.

 

[seper]

for intrafraction error of < 1mm, are there any data to support that? My experience (limited) does not match it.

 

[Palex80]

Here is an article:
http://www.redjournal.org/article/S0360-3016(04)01932-7/abstract

They did it with fiducials, which IMHO is less precise than CBCT-bone-matching.
<1mm

 

[seper]

yep, thanks