#gil lederman

Purpose/Objective(s): Hypofractionated Stereotactic Body Radiosurgery (HFSR) is a non-invasive focused beam technique that delivers high dose radiation to extracranial cancers. The use of HFSR was evaluated for the treatment of adrenal metastases.

Materials/Methods: 45 patients with 49 adrenal metastases underwent HFSR during a 74 month period. 61% of the metastases were from a lung cancer origin. All the patients were evaluated prospectively before and after treatment. Age ranged from 42 to 78 years (mean 60.6) with 19 females and 26 males. 75% of patients had prior chemotherapy. Tumor volumes ranged from 2.3 to 892 cc (mean 116.35 cc). Patients were treated with 500-900 cGy (median 800) in 5-8 fractions (median 5) for a total dose of 2500-4500 cGy (median 4000). Cancers were radiographically evaluated with contrast CT and/or MRI studies and reviewed independently by radiologists. Control of the treated cancer is defined as cessation of growth, shrinkage or disappearance of the cancer after treatment.

Results: Follow up ranged from 1 to 54 months (mean 10.4). The overall control rate was 88%. For tumors <116.35cc there was an 87% control rate, and a 91% control rate for tumors ≥116.35cc. For tumors receiving <4000 cGy there was an 80% control rate compared to 93% for adrenal metastases that received ≥4000 cGy. Of the tumors treated with ≥4000 cGy, the control rate for those <116.35cc was 91%, and 100% for metastases ≥116.35. Adrenal metastases from lung cancer had an 83% control rate, while those from non-lung primaries had a 95% control rate.

Conclusions: HFSR for adrenal metastases offers a generally well-tolerated, non-invasive method with a high rate of tumor control. A larger patient group may show a dose-response analysis, as is suggested in this study. Patients will continue to be evaluated for longer follow up, possible benefits of local control and potential survival advantage. HFSR for adrenal metastases remains an option for those whom standard approaches have not produced desired results or in patients seeking an alternative to surgical or chemotherapeutic treatment.

The stereotactic radiosurgery program has brought together the essential ingredients of state of the art cancer care in a central Manhattan location. Radiosurgery offers treatment which is innovative yet with a highly desirable track record for newly diagnosed and recurrent cancers located throughout the body including head and neck, chest and abdomen. Our doctors have probably the largest experience worldwide with fractionated stereotactic radiosurgery.   Stereotactic radiosurgery uses highly focused radiation often in higher than usual doses. Stereotactic radiosurgery is precise by its nature and delivery. Because of larger than usual doses, the results are in general more effective and can often be used even when prior chemotherapy, radiation, or surgery has been unsuccessful. The difference is based on biologic principles.

Stereotactic radiosurgery is not for every patient. We decline to treat one-half of the potential patients who apply. We believe, however, that for selected patients, there is great appeal. We have the ability to offer, when appropriate, more intense treatment locally, smaller fields of radiation (so healthy tissues receive lesser amounts of radiation), higher doses per fraction (means, in general, less treatments) with higher control rates.

Greater precision is accomplished by use of our Stereotactic frame and sophisticated treatment planning. Our experience is critical.   Stereotactic Radiosurgery allows us more confidence in delivery of treatment and greater likelihood of decreasing the radiation field, thus reducing radiation exposure to healthy tissue. Further, Hypo-Fractionation means fewer doses of such radiation is given but each one has greater intensity - which should mean greater effectiveness based upon known radio-biologic principles. Thus, select patients have the potential advantage of Stereotactic Radiosurgery combined with the treatment benefits of Hypo-fractionated therapy.

Gil lederman and his team and RSNY has experience in treating all major cancer and tumors of body.

What We Treat-

Cancers of the Body

head and neck

Esophagus

Chest

Stomach

Abdomen

adreanl gland

digestive tract

Digestive tract

Pelvis

Lung

Mediastinum

Melanomas

Sarcomas

Lymph Nodes

Liver

Pancreas

Kidney

Gynecologic

Urologic

Prostate Cancer

EXTREMITIES

All Tumors of the Brain, Regardless of Cell Type

head and neck

Esophagus

Chest

Stomach

Abdomen

adreanl gland

digestive tract

Digestive tract

Pelvis

Lung

Mediastinum

Melanomas

Sarcomas

Welcome to Radiosurgery New York, one of the leading centers for radiation and radiosurgery worldwide - having led by Dr. Gil Lederman, an experienced Oncologist. Radiosurgery New York is dedicated to sophisticated radiation treatments. Our physicians have had extensive   experience using non-invasive fractionated stereotactic radiosurgery - both in the brain and body, as well as prostate.

Gil Lederman were the first, as physician, to bring fractionated body radiosurgery to the Western Hemisphere and believe we have the most experience with this technique. Patients find satisfaction and comfort knowing that our level of experience can help guide them when making treatment decisions. Obviously, each treatment decision will be made ultimately by the patient with support of his or her family. Stereotactic Radiosurgery is different from standard radiation therapy, chemotherapy or surgery. Stereotactic Radiosurgery can be used to treat kidney cancer, pancreas cancer, prostate cancer, lung cancer, and recurrent cancers located throughout the body - including the head and neck, chest and abdomen, and also sarcoma.

Brief Description of “Standard” Surgery. Surgery is the mechanism that gives a surgeon access to a lesion within the body. Conventional surgery cuts the body open to remove diseased tissue. That lesion management approach has been refined in recent years to allow access to the diseased tissue through smaller and smaller incisions. With the advent of microsurgery aided by specialized endoscopy instrumentation, a surgeon now can work through the smallest of incisions.

Yoga is traditionally a mind-body exercise. The movements are executed in conjunction with controlled breathing, which has a quieting effect on the mind. Some postures, also known as asanas, are easily achieved. Some are extremely challenging. The good news is that anyone can do yoga. If you can move one inch into the posture, and do so consistently, you will increase your range of movement, thereby increasing your flexibility and strength. Guaranteed.

Soft drink marketing has always flirted with edgy and cool. Looking to snag as much of the insatiable teen market as possible, soft drink companies want their PR to be eye-catching and, when possible, conversation generating. Not too long ago, Snapple became all the rage thanks to the trivia “Snapple Facts” found under the cap on their juices and teas. Now, another company is trying this tactic … but taking it a step further and … perhaps … a step too far.