International Stereotactic Radiosurgery Society

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The ISRS began a serie of Webinars, starting October 11th, 2016.

These Webinars are organized through a specific online service. If you wish to attend these sessions, you will be asked to register first, but you also need to have a device (computer, smartphone, tablet) that meets specific requirements. Click here to check your system

After the webinar, a video replay is made available to ISRS members.

Next Webinars

August 03, 2017

Dose differences according to different planning philosophies by Ian PADDICK

Common parameters quoted with clinical treatment often give an incomplete picture of the actual doses delivered to the radiosurgical target. Doses adopted from one centre to another can in reality be significantly different due to subtle variations in parameters such as target definition, normalisation, coverage, gradient and margins applied. In this webinar, the effect of planning parameters on the delivered treatment are examined and the case for a standardisation of dosimetric parameters made.

August 24, 2017

Multi-session stereotactic radiosurgery for large cavernous sinus hemangiomas: Medium- and long-term outcomes by Enmin WANG

1:00 pm (Dublin, Edinburgh, Lisbon, London) - 2:00 pm CET (Amsterdam, Berlin, Bern, Paris, Rome, Stockholm, Vienna) - 8:00 am (Eastern time - New York, Canada) - 9:00 am (Brasilia) - 9:00 pm (Tokyo) - 5:00 am (Pacific time - Los Angeles) - 10:00pm (Brisbane)

Cavernous sinus hemangiomas (CHSs) are rare extra-axial highly vascular, benign tumors that account for 2-3% of all lesions within the cavernous sinus. Before the era of magnetic resonance imaging (MRI), the preoperative radiological diagnosis of CSHs was difficult. Stereotactic radiosurgery (SRS) has emerged as a principal alternative to microsurgical resection for small and medium-sized CSHs. However, large CSH management remains a challenge for the neurosurgeon. Although preliminary studies have demonstrated that multi-fraction radiosurgery for large CSHs is both safe and effective, the number of patients in the clinical series and the length of follow-up were limited.In this webinar, we will cover the role, rationale, planning technique, outcomes and complicatons of stereotactic radiosurgery in the treatment of large CSHs.

August 28, 2017

Gamma Knife Radiosurgery of Craniopharyngiomas by Abid SALEEM

1:00 pm (Dublin, Edinburgh, Lisbon, London) - 2:00 pm CET (Amsterdam, Berlin, Bern, Paris, Rome, Stockholm, Vienna) - 8:00 am (Eastern time - New York, Canada) - 9:00 am (Brasilia) - 9:00 pm (Tokyo) - 5:00 am (Pacific time - Los Angeles) - 10:00pm (Brisbane)

Craniopharyngiomas are benign tumors with malignant clinical course. The microsurgical removal is desirable but perilous due to its adherence with adjacent neurovascular structures.  In this webinar an   account of our own experience with adult and pediatric cases will be provided and the literature reviewed to define the role of gamma knife radiosurgery in the management of craniopharyngiomas.

September 13, 2017

Gamma Knife Radiosurgery of Arterio-Venous Fistulas (AVF) by Wade HUAI-CHE YANG

1:00 pm (Dublin, Edinburgh, Lisbon, London) - 2:00 pm CET (Amsterdam, Berlin, Bern, Paris, Rome, Stockholm, Vienna) - 8:00 am (Eastern time - New York, Canada) - 9:00 am (Brasilia) - 9:00 pm (Tokyo) - 5:00 am (Pacific time - Los Angeles) - 10:00pm (Brisbane)

Intracranial arteriovenous fistulas (DAVFs) are abnormal arteriovenous communications within the dura, in which meningeal arteries shunt blood directly into the dural sinus or leptomeningeal veins. Stereotactic radiosurgery has long been used for treatment of cerebral AVMs, and treatment of DAVFs would be a natural extension. In this webinar, we will cover the role, rationale, planning technique, outcomes and limitations of stereotactic radiosurgery in the treatment of DAVFs.

October 11, 2017

SRS and AVMs after the ARUBA Trial by Antonio DE SALLES

1:00 pm (Dublin, Edinburgh, Lisbon, London) - 2:00 pm CET (Amsterdam, Berlin, Bern, Paris, Rome, Stockholm, Vienna) - 8:00 am (Eastern time - New York, Canada) - 9:00 am (Brasilia) - 9:00 pm (Tokyo) - 5:00 am (Pacific time - Los Angeles) - 10:00pm (Brisbane)

The ARUBA Trial came to "organize and challenge" the treatment of AVMs. Extreme aggressive treatment to these challenging lesions brought harm to patients to a level that alarmed the Neurologists. They made the diagnosis of AVMs in healthy asymptomatic patients, just to have the difficult experience of seeing their patients returning to them with neurological disasters. They especially questioned the then proposed treatments for these lesions. The multi-disciplinary approach so much preached by all teams working in teaching centers was frequently not practiced in the private offices of the doctors proposing treatments. Now, in the aftermath of the hard truth of the data generated by the ARUBA trial, Radiosurgery takes a new role approaching the patients with AVMs. This webinar seeks to summarize the discussion of the ARUBA data; the new data generated since the disclosure of ARUBA results and propose an algorithm for approaching patients with AVMs that hopefully will generate trust among the Neurologists referring the patients for treatment.

November 09, 2017

Differentiation of Radiation-induced Changes and Tumor Progression after Intracranial Radiosurgery by Mikhail CHERNOV

1:00 pm (Dublin, Edinburgh, Lisbon, London) - 2:00 pm CET (Amsterdam, Berlin, Bern, Paris, Rome, Stockholm, Vienna) - 8:00 am (Eastern time - New York, Canada) - 9:00 am (Brasilia) - 9:00 pm (Tokyo) - 5:00 am (Pacific time - Los Angeles) - 10:00pm (Brisbane)

A number of intracranial tumors demonstrate some degree of enlargement after stereotactic radiosurgery. It necessitates differentiation of their regrowth and various treatment-related effects. The diagnosis is frequently complicated by histopathological heterogeneity of the lesion with coexistent viable neoplasm and radiation-induced tissue changes. Several neuroimaging modalities, namely structural MRI, DWI, DTI, perfusion CT and MRI, single-voxel and multi-voxel proton MRS, as well as SPECT and PET with various radioisotope tracers, may provide valuable diagnostic information. Each of these methods has advantages and limitations that may influence their usefulness and diagnostic accuracy.

November 24, 2017

SBRT for Borderline Resectable/Locally Advanced Pancreatic Cancer by Marta SCORSETTI

1:00 pm (Dublin, Edinburgh, Lisbon, London) - 2:00 pm CET (Amsterdam, Berlin, Bern, Paris, Rome, Stockholm, Vienna) - 8:00 am (Eastern time - New York, Canada) - 9:00 am (Brasilia) - 9:00 pm (Tokyo) - 5:00 am (Pacific time - Los Angeles) - 10:00pm (Brisbane)

Pancreatic ductal adenocarcinoma is characterized by a poor prognosis, with a 5-year overall survival rate of about 6%. Surgery is the gold standard of care with 5-year OS rates of 20% to 25%. More than 50% of patients, however, are borderline resectable or unresectable at the time of diagnosis, mainly due to locally advanced disease or distant metastases. In patients with locally advanced pancreatic cancer, the integration of chemotherapy and chemo-radiation treatment is the current therapeutic option. In the recent years, the role of SBRT in the treatment of borderline resectable and unresectable pancreatic cancer was investigated to confirm the hypothetical advantages of this therapy over conventional chemo-radiation.  In this webinar clinical data of SBRT efficacy and toxicity will be discussed.

Previous Webinars

#16 - July 18, 2017

Stereotactic Radiosurgery in the Treatment of Recurrent Glioblastoma: The Recent Evidence by Bodo LIPPITZ

Despite recent improvements, even after resection and fractionated radiother­apy, glioblastoma tends to recur locally. In recurrent glioblastoma only few treatment options remain and survival both after re-operation or chemotherapy is generally limited.

Stereotactic radiosurgery using Gamma Knife, stereotac­tic Linear Accelera­tor (LINAC) or CyberKnife is a potential treatment alternative. While it was shown that radiosur­gery had no addi­tive effect when given as upfront treatment in addition to surgical resection and fraction­ated radiotherapy, stereotactic radiosurgery can be applied as minimal invasive treatment in the almost inevitable situation of a glioblastoma recurrence even after previous fractionated radiotherapy. Due to the risk of adverse radiation effects however, larger recurrences should not be treated using single session radiosurgery. The median survival after glioblastoma recurrence was ≥ 10 months in 9 out of 13 studies represent­ing 80% of published radiosurgically treated patients, which compares favourably to the out­come after reoperation, treatment with temozolomide or bevacizumab. The retrospective evidence indicates that stereotactic radiosurgery offers a safe and effective treatment option for glioblastoma recurrences in a situation when only very few alternatives exist.  

The webinar will review and discuss the current evidence. 

#15 - May 23, 2017

Radiosurgery for brain metastasis by Clark CHEN

Approximately 25-35% of all cancer patients suffer from brain metastasis (BM). Stereotactic radiosurgery (SRS) is an attractive therapeutic option for patients afflicted with BM.  However, the decision between SRS and whole brain radiation therapy (WBRT) remain a matter of clinical judgment. A key factor in this decision involve survival expectation. The objective of the webinar will be to 1) review the rationale for SRS versus WBRT in the treatment of BM 2) review the available prognostic scales available for SRS-treated BM (RPA, mRPA, BSBM, SIR, GPA, ds-GPA) and 3) review cumulative intracranial tumor volume as a prognostic variable.

#14 - May 10, 2017

Radiosurgery for Trigeminal Neuralgia by Alessandra GORGULHO

Radiosurgery for Trigeminal Neuralgia (TN) was the birth of radiosurgery. The popularization of this technique was only possible upon improvement of imaging techniques, which allowed proper targeting of the trigeminal pathway. Radiosurgery is a very attractive surgical modality, especially to the elderly. Radiosurgery centers offering Functional Radiosurgery need to be aware of extra scrutiny during protocol implementation and treatment execution. This webinar will place radiosurgery in the context of other surgical modalities options for TN, discuss indications, results, complications and nuances of different radiosurgery protocols, including frameless.

#13 - April 25, 2017

New Frontiers: SBRT for primary kidney cancers by Shankar SIVA

Primary kidney cancer has historically been considered a resistant tumour to radiotherapy. However, with the incidence of primary kidney cancers increasing in the developed world at the same time as an increase in life expectancy and prevalence of obesity, there are a growing number of patients who may present with inoperable primary kidney cancer.  Advances in technologies have facilitated the application of ablative radiation as a viable alternative in this scenario. In this webinar, we cover the biological and technical considerations for kidney SBRT, as well as update the current evidence base.

#12 - April 13, 2017

MR-guided Adaptive Stereotactic Radiotherapy by Miguel PALACIOS

Magnetic resonance imaging (MRI) offers the best anatomical information and it can be used for adaptive radiation therapy.  In this webinar an overview of the key components to implement stereotactic magnetic resonance adaptive radiotherapy (SMART) will be discussed. Examples will be highlighted with the MRIdian system (ViewRayTM), which enables to perform continuous MRI during RT delivery and rapid adaptive planning and beam-delivery control based on visualization of soft tissues.

#11 - March 28, 2017

Post-operative SBRT by Arjun SAHGAL

The objective of this presentation is to understand the current evidence as it pertains to the rationale for post-operative SBRT, the clinical data to support it, the technique and current consensus guidelines with respect to contouring, and the issues with respect to the presence of hardware and response determination.

#10 - March 14, 2017

SRS for Spine Tumors by Samuel RYU

In this webinar session, I will cover the topic of Stereotactic Radiosurgery (SRS) for spine tumors. In this context, I will review the safety and efficacy of SRS for spine metastasis, and discuss the ongoing RTOG (NRG) 0631 trial. There will be an emphasis on the spinal cord partial volume tolerance and radiosurgical decompression of malignant spinal cord compression.

#9 - February 28, 2017

Radiosurgery for Uveal Melanoma by Pavel IVANOV

Over the years SRS has been established as a reliable eye-sparing option in the management of uveal melanoma against enucleation. However it cannot be called a routine procedure in daily radiosurgical activity due to the necessity of close cooperation with ophthalmologists. A detailed review of all stages of the treatment procedure emphasizing the most crucial points such as the reliability of eye fixation, imaging requirements, treatment planning and post-treatment care, will be given in this Webinar.

#8 - February 13, 2017

Exploring, Understanding and Exploiting the Radiobiology of Radiosurgery by John KIRKPATRICK

Stereotactic radiosurgery (SRS) provides a unique ability to ablate tumors while minimizing damage to surrounding normal tissues.  While the efficacy and safety of SRS have been established based on several decades of treatment of intracranial and, more recently, extracranial disease, the underlying radiobiology is controversial.  In this presentation, we will present and discuss the evidence and opinions on the fundamental and clinical aspects of radiobiology at high dose/fraction, focusing on the reduction of what is known to guide clinical practice, today, and what needs to be understood to optimize SRS, in the future.

#7 - January 31, 2017

SRS for Pituitary by Jason P. SHEEHAN

In this webinar, I will cover the topic of Stereotactic Radiosurgery (SRS) for pituitary adenomas. In this context, I will review the safety and efficacy of SRS for nonfunctioning and functioning adenomas. In addition, I will discuss the results of multicenter trials on this topic.

#6 - January 17, 2017

SBRT as an alternative for surgery in early stage NSCLC by Ben SLOTMAN

SBRT is now the standard treatment for patients with medically inoperable NSCLC. SABR is safe, effective and is associated with limited toxicity. These excellent results have led to the question whether SABR can also be used in medically operable NSCLC patients. In this webinar, after a short overview of the accomplishments of SABR in medically inoperable patients, available evidence from non-randomized and randomized studies in operable patients will be discussed.

#5 - December 12, 2016

SRS for Meningiomas by Laura FARISELLI & Marcello MARCHETTI

Meningiomas are rare benign tumors. The surgical excision still remains the first treatment option but, when a complete removal is not achievable, an alternative treatment modality has to be considered. In this sense, the radiosurgery represents the rising treatment paradigm.
The present report, focus on the main problems related to the radiosurgery of the anterior skull base meningiomas. Particularly the radiobiology, the rationale and the limits of the single and multisession radiosurgery as well as the risk of toxicity will be debated.

#4 - November 22, 2016

SBRT for Liver by Brian CZITO & Fang-Fang YIN

This talk was focused on 1) The rational of for liver SBRT; 2) The clinical indications for liver SBRT; 3) The management strategies (fractionation and post treatment assessment) for SBRT; 4) SBRT workflow; 5) Delivery techniques and 6) The motion management techniques.

#3 - November 07, 2016

Radiobiology of Radiosurgery (a neurosurgeon’s perspective) by Antonio DE SALLES

Radiosurgery has revolutionized Neurosurgery, Radiation Oncology and Medical Physics. The matched surgical results and even superior in many instances with radiation delivery precision asks for novel Radiobiology understanding... read more

#2 - October 11, 2016

SRS for Brain Metastases by Bodo LIPPITZ

There has a been a recent paradigm change in the treatment of brain metastases. On one hand, there has been significant progress in developments of chemotherapy, on the other hand, recent data have raised significant doubts concerning effectiveness and safety of Whole Brain Radiotherapy. With increasing survival of cancer patients with brain metastases, the requirements in terms of efficacy and quality of life are being re-evaluated. The high efficacy and low complication rates of stereotactic radiosurgery, even in radio-resistant or multiple metastases, solve a number of the mentioned shortcomings of fractionated WBRT. Technicalities of radiosurgical treatment will be discussed.

#1 - October 11, 2016

SRS physics - Imaging and QA by Ian PADDICK

This 60 minute presentation covers Quality Assurance tests for radiosurgery, including the QA of image distortion, which potentially can represent the largest factor in treatment uncertainty.