All of the experiments adhered to the guidelines of the IASP Committee for Rese

Stereotactic body radiation therapy, defined as hypofractionation of 500 cGy per fraction util izing image guidance for delivery, was used for 9 tumors, Three patients were treated with a partial course of 300 cGy×10 but did not complete their course due to clinical deterioration while on treatment. Conventional opposed photon fields were used in the treatment of 13 tumors ARN-509 956104-40-8 and IMRT was used for nine tumors in the abdomen, pelvis, and paraspinal region. Systemic therapy Prior to radiation therapy, 14 of the 15 patients received systemic therapy in the form of tyrosine kinase inhibitors, chemotherapy, or both, TKIs that were used prior to radiation therapy included ima tinib for all 11 patients, sunitinib in 7 patients, sorafenib in 5 patients, nilotinib in 1 patient and pazopanib in 1 pa tient.

Other systemic agents used before radiation therapy included mesna, doxorubicin, ifosfamide and dacarbazine and postoperative mitoxantrone, doxo rubicin and dacarbazine, doxorubicin, paclitaxel and flavopiridol, and doxorubicin and vinorelbine, Notably, all patients AUY922 747412-49-3 treated with these systemic agents developed progressive disease. TKIs were used concurrently with radiation therapy for the treatment of 9 of the 22 tu mors, 6 of which were treated with SBRT, No tumors were treated with concurrent chemotherapy. Follow up Patients were assessed weekly while on treatment. There after, patients were seen at variable intervals by a multidis ciplinary disease management team that generally included surgeons, medical oncologists, and radiation oncologists.

The median interval between follow up visits was 5 weeks, At each on treatment visit and follow up visit, toxicity was assessed per Common Terminology Criteria for Adverse Events v4. 0. Effectiveness of palliation was assessed during on treatment visits Alisertib 臨床試験 and at the time of follow up. A patient was considered to have partial palliation if there was any appreciable improve ment of symptoms after beginning radiation therapy. Complete palliation was defined as the complete reso lution of the presenting symptoms after the beginning of radiation therapy. Follow up imaging was available for assessment in 17 of the 22 tumors. Initial radiographic response was assessed according to Response Evaluation Criteria in Solid Tu mors, The median time to the first radiographic assessment after radiation therapy was 2. 2 months.

Local progression was defined as any clinical or radio graphic evidence of tumor growth. Overall survival was defined from the date of the first radiation treatment to the date of death from any cause. Local progression free survival and overall survival were estimated using the Kaplan Meier method. Results The median follow up of the entire cohort was 5. 1 months, At the time of analysis, 12 of the 15 patients had died. Among the 18 tumors that were symptomatic at presentation and treated with palliative in tent, at least partial palliation was achieved in 17 tumors, Symptoms were completely palliated in eight tumors, Partial radiographic response was seen in 35. 3% of tumors. Stable disease was seen in 52. 9% of tumors and progressive disease in 11. 8%, Among tumors treated with SBRT with radiographic follow up, partial response was seen in 62.