Hypo-Fractionated SRS Management of Arteriovenous Malformations
Reinhard Wurm, MD, from the Klinikum Frankfurt (Oder) discusses hypo-fractionated stereotactic radiotherapy management of large arteriovenous malformations (AVMs). Specifically, he speaks about a hypothesis-based prospective observational study that his team began more than twelve years previous after they made the switch to Brainlab frameless radiosurgery. He outlines the goals of treating AVMs with radiosurgery, including eliminating risk of intracranial bleeding and minimal morbidity. He then gives specific case examples of AVMs he treated with this method as well as other studies that examine the treatment of AVMs with fractionation.
About the speaker
Reinhard Wurm, MD, PhD
Klinikum Frankfurt (Oder), Germany
Head of Department of Radiation Oncology
Dr. Wurm has 26 years of experience with stereotactic radiosurgery (SRS) and radiotherapy (SRT) using various types of equipment since his training at the Royal Marsden Hospital and Institute of Cancer Research in London, United Kingdom. Dr. Wurm was one of the earliest adopters of Brainlab stereotactic radiosurgery and radiotherapy technology. His team at the Department of Radiation Oncology, Charité-University Medicine Berlin was the first in the world to use the m3 micromultileaf collimator. They were also an early adopter of hypofractionation and extracranial stereotactic radiosurgery and radiotherapy. In 2001, he began treating with the Novalis classic and for the last seven years with Novalis TX. Today, the major focus of his work in radiation oncology is image guided high-precision intra- (image guided SRS and SRT) and extracranial radiation therapy (image guided SBRT and SABR). In these areas, he has established a reputation for clinical excellence, both regionally and internationally.
Dr. Wurm has been and continues to be instrumental in the development of stereotactic radiosurgery and radiotherapy for the non-invasive image-guided treatment of tumors, vascular malformations and functional disorders of the brain. He was one of the first to use image-guided radiotherapy for real-time monitoring and breath control, including 4D CT and PET/CT scans for biologically-based radiation treatment planning to manage tumor and organ motion, as well as deliver high precision external beam radiation therapy using intensity-modulated radiation therapy (IMRT). In addition, he is interested in developing novel ways of utilizing image-guided radiation therapy (SRS and SBRT) in terms of single and hypofractionation to improve radiation curative and palliative treatment outcomes. A particular advantage of these types of treatments is that the radiation can be concentrated on moving tumors of the lung and liver with submillimetric precision, while normal tissue can be spared as much as possible.
Dr. Wurm is an expert in the implementation of standard operating procedures for treatment and equipment commissioning and acceptance in Germany.
The clinical focus of Dr. Wurm and his team is image guided SRS and SRT for a variety of brain tumors, vascular malformations and functional conditions, including acoustic neuroma, meningioma, arteriovenous malformation, trigeminal neuralgia, pituitary adenoma, craniopharyngioma, glioma, cavernous hemangioma, pineal tumor, astrocytoma, and brain metastases. SBRT is currently used and/or being investigated in treating malignant or benign small-to-medium tumors in the body at common disease sites, including the lung, liver, abdomen, spine, head and neck and prostate, including oligometastases.
Dr. Wurm’s research is primarily focused on translational research and clinical trials. Translational research interests include image fusion, computer-guided medical image segmentation, real-time image processing and registration, and machine vision applied to radiotherapy for fast, automatic, image-guided procedures for the planning and delivery of SRS and SBRT treatments. He specifically aims for multi-modality treatments by combining targeted therapy and radiation therapy, as well as anti-angiogenic drugs and immunotherapy.
On a personal note, his primary goal as a physician is to provide the highest quality of care, as well as advancing current treatment paradigms in cancer therapy, regardless of patient’s income or circumstances.
Reinhard E. Wurm, MD, was educated in West Germany, receiving his medical degree from the University of Essen Medical School. Dr. Wurm served his residency in neurology and radiation oncology at the University of Essen and Düsseldorf and later became fellow in clinical research and oncology at the Royal Marsden Hospital and Institute of Cancer Research in London. Dr. Wurm arrived at the Department of Radiation Oncology, Charité-University Medicine Berlin in 1996 and for eleven years served as senior physician and head of the stereotactic radiosurgery and radiotherapy unit before his appointment as head of the Department of Radiation Oncology in 2008.
Klinikum Frankfurt (Oder) GmbH
Müllroser Chaussee 7
15236 Frankfurt (Oder), Germany
Specialty: Radiation Oncology
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