TY - JOUR
T1 - Lung metastases treated by CyberKnife® image-guided robotic stereotactic radiosurgery at 41 months
AU - Brown, William T.
AU - Wu, Xiaodong
AU - Fowler, John F.
AU - García, Silvio
AU - Fayad, Fahed
AU - Amendola, Beatriz E.
AU - De La Zerda, Alberto
AU - Schwade, James G.
PY - 2008/4/1
Y1 - 2008/4/1
N2 - OBJECTIVES: Based on the reported success of stereotactic body radiotherapy in treating extracranial tumors, we used CyberKnife® (Accuray Incorporated, Sunnyvale, CA) to treat patients with metastatic lung cancer. METHODS: This is a retrospective report of treatment details and outcomes of 35 patients, ranging in age from 33 to 91 years, with 69 histologically proven pulmonary metastases, treated by image-guided robotic stereotactic radiosurgery at the CyberKnife® Center of Miami, between March 2004 and August 2007. Tumor volumes ranged from 0.7 mL to 152 mL. Total doses ranged from 5 to 60 Gy delivered in one to four fractions with an equivalent dose range from 6 to 110 Gy NTD delivered in 2-Gy fractions assuming an α/β of 20 Gy. RESULTS: All patients tolerated radiosurgery well with fatigue as the main side effect. Grade 3 and grade 4 pulmonary toxic reactions were observed in one patient who had undergone a repeat treatment. Of the 35 treated patients, 27 (77%) were still alive at a median 18-month (range 2-41 mo) follow-up. Local control was 71% with 25 tumors showing a complete response, 16 a partial response, and 7 stable with disease. Eight had progressive disease. CONCLUSIONS: The delivery of precisely targeted radiation doses to lung tumors in a hypofractionated fashion is feasible and safe. image-guided robotic stereotactic radiosurgery of pulmonary metastases with the CyberKnife® achieves good rates of local disease control with limited toxicity to surrounding tissues and in many cases may be beneficial for patients for whom surgery is not an option.
AB - OBJECTIVES: Based on the reported success of stereotactic body radiotherapy in treating extracranial tumors, we used CyberKnife® (Accuray Incorporated, Sunnyvale, CA) to treat patients with metastatic lung cancer. METHODS: This is a retrospective report of treatment details and outcomes of 35 patients, ranging in age from 33 to 91 years, with 69 histologically proven pulmonary metastases, treated by image-guided robotic stereotactic radiosurgery at the CyberKnife® Center of Miami, between March 2004 and August 2007. Tumor volumes ranged from 0.7 mL to 152 mL. Total doses ranged from 5 to 60 Gy delivered in one to four fractions with an equivalent dose range from 6 to 110 Gy NTD delivered in 2-Gy fractions assuming an α/β of 20 Gy. RESULTS: All patients tolerated radiosurgery well with fatigue as the main side effect. Grade 3 and grade 4 pulmonary toxic reactions were observed in one patient who had undergone a repeat treatment. Of the 35 treated patients, 27 (77%) were still alive at a median 18-month (range 2-41 mo) follow-up. Local control was 71% with 25 tumors showing a complete response, 16 a partial response, and 7 stable with disease. Eight had progressive disease. CONCLUSIONS: The delivery of precisely targeted radiation doses to lung tumors in a hypofractionated fashion is feasible and safe. image-guided robotic stereotactic radiosurgery of pulmonary metastases with the CyberKnife® achieves good rates of local disease control with limited toxicity to surrounding tissues and in many cases may be beneficial for patients for whom surgery is not an option.
KW - Body radiation therapy (SBRT)
KW - CyberKnife®
KW - Hypofractionation
KW - Image-guided robotic stereotactic radiosurgery (IGRSRS)
KW - Pulmonary metastasis stereotactic
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U2 - 10.1097/SMJ.0b013e318167ad8d
DO - 10.1097/SMJ.0b013e318167ad8d
M3 - Article
C2 - 18360342
AN - SCOPUS:41949113415
VL - 101
SP - 376
EP - 382
JO - Southern Medical Journal
JF - Southern Medical Journal
SN - 0038-4348
IS - 4
ER -