{"id":4010,"date":"2022-12-05T16:31:48","date_gmt":"2022-12-05T15:31:48","guid":{"rendered":"https:\/\/www.icotec-medical.com\/case\/erweiterte-therapieoptionen"},"modified":"2023-11-14T09:57:31","modified_gmt":"2023-11-14T08:57:31","slug":"expanded-therapy-options","status":"publish","type":"case","link":"https:\/\/www.icotec-medical.com\/en\/cases\/expanded-therapy-options\/","title":{"rendered":"Expanded Therapy Options"},"content":{"rendered":"\n

Case 2<\/h4>\n\n\n\n

BlackArmor\u00ae<\/sup> Carbon\/PEEK Implants Enable the Use of High-Precision Proton Therapy<\/strong><\/h1>\n\n\n\n

60-year-old female patient with suspected spinal metastasis at Th11. The patient\u2019s MRI showed a spinal cord compression caused by a lesion.<\/p>\n\n\n\n

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Therapy<\/h2>\n\n\n\n
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Step 1<\/strong>
Therapeutic Decision for Surgical Treatment with Adjuvant Photon Irradiation<\/span><\/i><\/span><\/i><\/span><\/a><\/h3><\/div>
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Surgical treatment through laminectomy, debulking, biopsy, and dorsal stabilization with titanium implants.

Histological finding: Chordoma. The resulting decision for adjuvant proton therapy called for the revision of contraindicated titanium implants and the use of BlackArmor\u00ae<\/sup> Carbon\/PEEK<\/a> implants.<\/p>\n<\/div><\/div>\n\n\n\n

Step 2<\/strong>
Implant Revision<\/span><\/i><\/span><\/i><\/span><\/a><\/h3><\/div>
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Replacement of titanium implants with BlackArmor\u00ae<\/sup> Carbon\/PEEK implants, dorsal percutaneous stabilization with the VADER\u00ae<\/sup> Pedicle System<\/a> and anterior stabilization with the KONG\u00ae<\/sup>-TL VBR System<\/a><\/p>\n\n\n\n

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\"CT,
CT, sagittal<\/figcaption><\/figure>\n\n\n\n
\"CT,
CT, axial<\/figcaption><\/figure>\n<\/figure>\n<\/div><\/div>\n\n\n\n

Step 3<\/strong>
Adjuvant Proton Therapy<\/span><\/i><\/span><\/i><\/span><\/a><\/h3><\/div>
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Precise planning and safe performance of the indicated proton therapy could be carried out.<\/p>\n\n\n\n

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\"Planung
Planning of proton therapy in axial CT<\/figcaption><\/figure>\n<\/figure>\n<\/div><\/div>\n\n\n\n

Therapeutic Success<\/span><\/i><\/span><\/i><\/span><\/a><\/h3><\/div>
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17 months postoperatively no radiological evidence of a tumor<\/p>\n<\/div><\/div>\n\n\n\n

Conclusion<\/span><\/i><\/span><\/i><\/span><\/a><\/h3><\/div>
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BlackArmor\u00ae<\/sup> Carbon\/PEEK expands radiation therapy options.1<\/a><\/sup>Shi C. et al. (2022): Comprehensive Evaluation of Carbon-Fiber-Reinforced Polyetheretherketone (CFR-PEEK) Spinal Hardware for Proton and Photon Planning. Technology in Cancer Research & Treatment. (PubMed, PMID: 35410544<\/a>)<\/span><\/span>2<\/a><\/sup>Schmidhalter D. et al. (2020): Dosimetric Analysis of Spine SBRT in Case of CFR-PEEK Implants. Annual SASRO Meeting.<\/span><\/span>3<\/a><\/sup>Poel R. et al. (2020): Assessing the Advantages of CFR-PEEK over Titanium Spinal Stabilization Implants in Proton Therapy \u2013 A Phantom Study. Physics in Medicine and Biology. (PubMed, PMID: 32315991<\/a>)<\/span><\/span>4<\/a><\/sup>Henzen D. et al. (2022): Feasibility of Postoperative Spine Stereotactic Body Radiation Therapy in Proximity of Carbon and Titanium Hybrid Implants Using a Robotic Radiotherapy Device. Radiation Oncology. (PubMed, PMID: 35549961<\/a>)<\/span><\/span>Since the tumor entity is not always determined preoperatively, the primary choice of implants is essential. Cutting-edge technologies such as stereotactic body radiotherapy (SBRT) and proton therapy are highly effective and often indicated if conventional radiation therapy reaches its limits. Artifact-free imaging is of even greater importance because the adjacent organs at risk must be very precisely delineated during planning. BlackArmor\u00ae<\/sup> Carbon\/PEEK can optimize the critical planning and validation processes as well as the delivery of the prescribed dose.5<\/a><\/sup>Shi C. et al. (2022): Comprehensive Evaluation of Carbon-Fiber-Reinforced Polyetheretherketone (CFR-PEEK) Spinal Hardware for Proton and Photon Planning. Technology in Cancer Research & Treatment. (PubMed, PMID: 35410544<\/a>)<\/span><\/span>6<\/a><\/sup>Kr\u00e4tzig T. et al. (2021): Carbon-Fiber-Reinforced PEEK versus Titanium Implants: An In Vitro Comparison of Susceptibility Artifacts in CT and MR Imaging. Neurosurgical Review. (PubMed, PMID: 32930911<\/a>)<\/span><\/span>7<\/a><\/sup>M\u00fcller BS. et al. (2020): The Dosimetric Impact of Stabilizing Spinal Implants in Radiotherapy Treatment Planning with Protons and Photons: Standard Titanium Alloy vs. Radiolucent Carbon-Riber-Reinforced PEEK Systems. Journal of Applied Clinical Medical Physics. <\/a>(PubMed, PMID: 32476247<\/a>)<\/span><\/span>8<\/a><\/sup>Klippel N. (2018): Dosimetric Impact of Titanium and Carbon Implants in Photon Therapy. Annual SSRMP Meeting.<\/span><\/span>9<\/a><\/sup>Schmidhalter D. et al. (2020): Dosimetric Analysis of Spine SBRT in Case of CFR-PEEK Implants. Annual SASRO Meeting.<\/span><\/span>10<\/a><\/sup>Ringel F. et al. (2017): Radiolucent Carbon Fiber-Reinforced Pedicle Screws for Treatment of Spinal Tumors: Advantages for Radiation Planning and Follow-Up Imaging. World Neurosurgery. (PubMed, PMID: 28478252<\/a>)<\/span><\/span>11<\/a><\/sup>Poel R. et al. (2020): Assessing the Advantages of CFR-PEEK over Titanium Spinal Stabilization Implants in Proton Therapy \u2013 A Phantom Study. Physics in Medicine and Biology. (PubMed, PMID: 32315991<\/a>)<\/span><\/span><\/p>\n<\/div><\/div>\n<\/div>\n\n\n

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Inserted BlackArmor\u00ae<\/sup> Carbon\/PEEK Implants<\/h3>\n Show all implants<\/a>\n <\/div>\n \n
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VADER\u00ae<\/sup> Pedicle System<\/h3>\n
\n Thoracolumbar Pedicle System <\/div>\n \n
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KONG\u00ae<\/sup>-TL VBR System<\/h3>\n
\n Thoracolumbar VBR <\/div>\n \n
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