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

46 Citations (Scopus)

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

Fingerprint

Robotics
Non-Small Cell Lung Carcinoma
Therapeutics
Fiducial Markers
Radiation Pneumonitis
Neoplasms
Tumor Burden
Fatigue
Lung Neoplasms

Keywords

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

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Treatment of early non-small cell lung cancer, stage IA, by image-guided robotic stereotactic Radioablationg-CyberKnife. / Brown, William T.; Wu, Xiaodong; Amendola, Beatriz; Perman, Mark; Han, Hoke; Fayad, Fahed; Garcia, Silvio; Lewin, Alan; Abitbol, Andre; De La Zerda, Alberto; Schwade, James G.

In: Cancer Journal, Vol. 13, No. 2, 01.03.2007, p. 87-94.

Research output: Contribution to journalArticle

Brown, WT, Wu, X, Amendola, B, Perman, M, Han, H, Fayad, F, Garcia, S, Lewin, A, Abitbol, A, De La Zerda, A & Schwade, JG 2007, 'Treatment of early non-small cell lung cancer, stage IA, by image-guided robotic stereotactic Radioablationg-CyberKnife', Cancer Journal, vol. 13, no. 2, pp. 87-94. https://doi.org/10.1097/PPO.0b013e31803c5415
Brown, William T. ; Wu, Xiaodong ; Amendola, Beatriz ; Perman, Mark ; Han, Hoke ; Fayad, Fahed ; Garcia, Silvio ; Lewin, Alan ; Abitbol, Andre ; De La Zerda, Alberto ; Schwade, James G. / Treatment of early non-small cell lung cancer, stage IA, by image-guided robotic stereotactic Radioablationg-CyberKnife. In: Cancer Journal. 2007 ; Vol. 13, No. 2. pp. 87-94.
@article{bc0095120fd346f59be4c17fbf9f6d42,
title = "Treatment of early non-small cell lung cancer, stage IA, by image-guided robotic stereotactic Radioablationg-CyberKnife",
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.",
keywords = "Extracranial stereotactic radiotherapy, Imageguided radiotherapy, Robotic radiotherapy; CyberKnife; non-small cell lung cancer stage IA",
author = "Brown, {William T.} and Xiaodong Wu and Beatriz Amendola and Mark Perman and Hoke Han and Fahed Fayad and Silvio Garcia and Alan Lewin and Andre Abitbol and {De La Zerda}, Alberto and Schwade, {James G.}",
year = "2007",
month = "3",
day = "1",
doi = "10.1097/PPO.0b013e31803c5415",
language = "English",
volume = "13",
pages = "87--94",
journal = "Cancer journal (Sudbury, Mass.)",
issn = "1528-9117",
publisher = "Association Pour le Developpement de la Communication Cancerologique",
number = "2",

}

TY - JOUR

T1 - Treatment of early non-small cell lung cancer, stage IA, by image-guided robotic stereotactic Radioablationg-CyberKnife

AU - Brown, William T.

AU - Wu, Xiaodong

AU - Amendola, Beatriz

AU - Perman, Mark

AU - Han, Hoke

AU - Fayad, Fahed

AU - Garcia, Silvio

AU - Lewin, Alan

AU - Abitbol, Andre

AU - De La Zerda, Alberto

AU - Schwade, James G.

PY - 2007/3/1

Y1 - 2007/3/1

N2 - 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.

AB - 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.

KW - Extracranial stereotactic radiotherapy

KW - Imageguided radiotherapy

KW - Robotic radiotherapy; CyberKnife; non-small cell lung cancer stage IA

UR - http://www.scopus.com/inward/record.url?scp=34347222574&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34347222574&partnerID=8YFLogxK

U2 - 10.1097/PPO.0b013e31803c5415

DO - 10.1097/PPO.0b013e31803c5415

M3 - Article

VL - 13

SP - 87

EP - 94

JO - Cancer journal (Sudbury, Mass.)

JF - Cancer journal (Sudbury, Mass.)

SN - 1528-9117

IS - 2

ER -