Background: Surgery and stereotactic body radiotherapy (SBRT) are two of the options available as local treatments for pulmonary oligometastases from colorectal cancer (CRC). We hypothesized that SBRT would have, at least, a similar local control rate to surgery. Methods: We identified an initial cohort of 100 patients with CRC who received SBRT or surgery for lung metastases. This was then narrowed down to 75 patients: those who underwent surgery (n = 50) or SBRT (n = 25) as their first local thoracic treatment between 1 January 2004 and 29 December 2017. The Kaplan–Meier method was used to calculate lung-progression-free survival (L-PFS) and overall survival (OS). Results: The 1 and 2-year L-PFS was 85% and 70% in the surgical group and 87% and 71% in the SBRT group, respectively (p = 0.809). No significant differences were found between the two groups in terms of OS. The biologically effective dose (BED), age and initial CRC stage did not have a significant effect on local control or survival. No grade 3 or above acute- or late-toxicity events were reported. Conclusions: These results add retrospective evidence that SBRT and surgery have similar results in terms of OS and local control in patients with lung oligometastases from CRC.

Trigeminal neuralgia (TN) resistant to pharmacologic treatment can be treated with microvascular decompression, percutaneous procedures, or radiosurgery. Regarding radiosurgery, there is variability in target definition, dose selection, radiation delivery and positioning, and immobilization. This observational prospective study included patients with TN treated with 90 Gy prescribed to an anterior cisternal isocenter, delivered with a TrueBeam LINAC, under mask immobilization, Novalis couch positioning, and ExacTrac X-ray and infrared positioning and motion monitoring. Treatment response, intensity and frequency of pain, presence of recurrence, and adverse effects were analyzed. A total of 91% of patients responded to treatment, with a median latency of 15 days (interquartile range [IQR], 41). Nine patients (22%) experienced minor recurrence at a median time of 7 months (IQR, 3), and 14 patients (34%) experienced a major recurrence at a median time of 12 months (IQR, 19). After recurrence, both frequency and intensity of episodes remained significantly lower than pretreatment. At last follow-up, response was maintained in 25 patients (60%). No radiosurgery-related severe morbidity or mortality was found. Mask-based immobilization combined with image-guided radiation delivered by rotating gantry-based LINAC system provides a safe and effective radiosurgical treatment for TN, which is indicated for drug-resistant idiopathic or secondary TN patients and for drug-resistant classical TN patients who are not candidates for microvascular decompression.