title: Stereotactic body radiotherapy with CyberKnife for cardiac malignancies.
abstract: OBJECTIVE
  Radiobiological and technical considerations have traditionally limited the role of radiation therapy in the context of primary and secondary cardiac malignancies. Stereotactic body radiotherapy (SBRT) is a promising modality for the delivery of focused high-dose radiation with ablative potential to complex targets such as small, deep-seated, moving lesions, allowing also for re-irradiation.
  
  
  METHODS
  Between January 2013 and October 2013, 3 patients underwent SBRT for cardiac lesions: 2 patients had recurrent, previously irradiated cardiac angiosarcomas (PCA) and 1 patient had a cardiac metastasis from melanoma. They were treated with fiducial-guided robotic radiotherapy with CyberKnife. As for dose prescription, 24 Gy in 3 fractions (80% isodose) and 30 Gy in 5 fractions (80% isodose) were administered to the recurrent PCAs and cardiac metastasis, respectively.
  
  
  RESULTS
  At 2 months after SBRT, cardiac MRI showed a partial response in the patients treated for recurrent PCA while the cardiac metastasis remained stable. In all cases, absence of local progression was subsequently confirmed by contrast-enhanced cardiac MRI after 6 months, without any evidence of treatment-related side effects.
  
  
  CONCLUSIONS
  Fiducial-guided SBRT proved to be feasible and effective in preventing local disease progression in selected patients with cardiac malignancies.
authors.affiliation: 1 Radiation Oncology, Azienda Ospedaliero Universitaria Careggi, University of Florence, Florence - Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Bonomo
authors.forename: Samantha
authors.initials: S
authors.lastname: Cipressi
authors.forename: Isacco
authors.initials: I
authors.lastname: Desideri
authors.forename: Laura
authors.initials: L
authors.lastname: Masi
authors.forename: Raffaela
authors.initials: R
authors.lastname: Doro
authors.forename: Carmine
authors.initials: C
authors.lastname: Iermano
authors.forename: Daniela
authors.initials: D
authors.lastname: Greto
authors.forename: Gabriele
authors.initials: G
authors.lastname: Simontacchi
authors.forename: Monica
authors.initials: M
authors.lastname: Mangoni
authors.forename: Fabiola
authors.initials: F
authors.lastname: Paiar
authors.forename: Icro
authors.initials: I
authors.lastname: Meattini
authors.forename: Silvia
authors.initials: S
authors.lastname: Scoccianti
authors.forename: Gennaro
authors.initials: G
authors.lastname: Santoro
authors.forename: Serafina
authors.initials: S
authors.lastname: Valente
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gensini
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Livi
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D019788:Fluorodeoxyglucose F18; D006338:Heart Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D006394:Hemangiosarcoma / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy / Q000601:surgery*; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D016634:Radiosurgery; D011880:Radiotherapy Planning, Computer-Assisted; D012086:Reoperation; D019233:Retreatment; D012371:Robotics; D016896:Treatment Outcome
chemical_list: D018943:Anthracyclines; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18