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 language | English |
|---|---|
| Pages (from-to) | 87-94 |
| Number of pages | 8 |
| Journal | Cancer Journal |
| Volume | 13 |
| Issue number | 2 |
| DOIs | |
| State | Published - Mar 1 2007 |
| Externally published | Yes |
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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 journal › Article
}
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
C2 - 17476136
AN - SCOPUS:34347222574
VL - 13
SP - 87
EP - 94
JO - Cancer journal (Sudbury, Mass.)
JF - Cancer journal (Sudbury, Mass.)
SN - 1528-9117
IS - 2
ER -