Treatment of early non-small cell lung cancer, stage IA, by image-guided robotic stereotactic Radioablationg-CyberKnife

William T. Brown, Xiaodong Wu, Beatriz Amendola, Mark Perman, Hoke Han, Fahed Fayad, Silvio Garcia, Alan Lewin, Andre Abitbol, Alberto De La Zerda, James G. Schwade

Research output: Contribution to journalArticle

47 Scopus citations

Abstract

Objective:: To evaluate the efficacy of using image-guided robotic stereotactic radioablation as an alternative treatment modality for patients with surgically resectable, but medically inoperable, T1 N0 M0, stage IA non-small cell lung cancer. Methods:: Between January 2004 and May 2006, 19 patients, 11 women and 8 men ranging in age from 52 to 88 years, with stage IA non-small cell lung cancer were treated. Tumor volume ranged from 1.7 to 13 mL. Total doses ranged from 24 to 60 Gy delivered in 3 fractions. Eleven patients received 60 Gy. Real-time target localization was accomplished by radiographic detection of fiducial marker(s) implanted within the tumor combined with respiratory motion tracking. Results:: All patients tolerated radioablation well with fatigue as the main side effect. Fourteen patients are alive from 1 to 25 months posttreatment. Four patients died: 2 of comorbid disease and 2 of cancer progression (status post 60 and 55.5 Gy). Three patients developed grade I radiation pneumonitis. Two patients have stable disease. In 3 patients, cancer recurred in the planning treatment volume: in 2 patients after treatment with 60 Gy and in 1 patient after treatment with 55.5 Gy. One patient had local control in the target volume but developed metastasis to the ipsilateral hilum. Nine patients had a complete response and show no evidence of disease. Conclusions:: In our early experience, stereotactic radioablation using the CyberKnife system appears to be a safe, minimally invasive, and effective modality for treating early stage lung cancer in patients with medically inoperable disease. Dose escalation and/or increasing the treatment volumes, with the aid of the high conformality of this technique, may help to achieve further improvements in these promising results.

Original languageEnglish (US)
Pages (from-to)87-94
Number of pages8
JournalCancer Journal
Volume13
Issue number2
DOIs
StatePublished - Mar 1 2007

Keywords

  • Extracranial stereotactic radiotherapy
  • Imageguided radiotherapy
  • Robotic radiotherapy; CyberKnife; non-small cell lung cancer stage IA

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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    Brown, W. T., Wu, X., Amendola, B., Perman, M., Han, H., Fayad, F., Garcia, S., Lewin, A., Abitbol, A., De La Zerda, A., & Schwade, J. G. (2007). Treatment of early non-small cell lung cancer, stage IA, by image-guided robotic stereotactic Radioablationg-CyberKnife. Cancer Journal, 13(2), 87-94. https://doi.org/10.1097/PPO.0b013e31803c5415