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Clinical outcome of fiducial-less CyberKnife radiosurgery for stage I non-small cell lung cancer.

Jung IH, Song SY, Jung J, Cho B, Kwak J, Je HU, Choi W, Jung NH, Kim SS, Choi EK - Radiat Oncol J (2015)

Bottom Line: Eight patients died due to cancer progression.The results showed that fiducial-less CKRS shows comparable local tumor control and survival rates to those of LINAC-based SABR or CKRS with a fiducial marker.Thus, fiducial-less CKRS using Xsight lung tracking system can be effectively and safely performed for patients with medically inoperable stage I non-small cell lung cancer without any risk of procedure-related complication.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To evaluate the treatment results in early stage non-small cell lung cancer patients who have undergone fiducial-less CyberKnife radiosurgery (CKRS).

Materials and methods: From June 2011 to November 2013, 58 patients underwent CKRS at Asan Medical Center for stage I lung cancer. After excluding 14 patients, we retrospectively reviewed the records of the remaining 44 patients. All analyses were performed using SPSS ver. 21.

Results: The median age at diagnosis was 75 years. Most patients had inoperable primary lung cancer with a poor pulmonary function test with comorbidity or old age. The clinical stage was IA in 30 patients (68.2%), IB in 14 (31.8%). The mean tumor size was 2.6 cm (range, 1.2 to 4.8 cm), and the tumor was smaller than 2 cm in 12 patients (27.3%). The radiation dose given was 48-60 Gy in 3-4 fractions. In a median follow-up of 23.1 months, local recurrence occurred in three patients (2-year local recurrence-free survival rate, 90.4%) and distant metastasis occurred in 13 patients. All patients tolerated the radiosurgery well, only two patients developing grade 3 dyspnea. The most common complications were radiation-induced fibrosis and pneumonitis. Eight patients died due to cancer progression.

Conclusion: The results showed that fiducial-less CKRS shows comparable local tumor control and survival rates to those of LINAC-based SABR or CKRS with a fiducial marker. Thus, fiducial-less CKRS using Xsight lung tracking system can be effectively and safely performed for patients with medically inoperable stage I non-small cell lung cancer without any risk of procedure-related complication.

No MeSH data available.


Related in: MedlinePlus

Schema of central and peripheral locations. This diagram showed definition of central, peripheral and apical location of lung tumor. Tumors located at proximal bronchial tree (according to the Radiation Therapy Oncology Group) defined as centrally located tumor, tumor located above aortic arch defined as apically located tumor, and tumor located closer than 1 cm to chest wall defined as chest wall abutted. Except of these locations, others defined as peripherally located tumor.
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Figure 2: Schema of central and peripheral locations. This diagram showed definition of central, peripheral and apical location of lung tumor. Tumors located at proximal bronchial tree (according to the Radiation Therapy Oncology Group) defined as centrally located tumor, tumor located above aortic arch defined as apically located tumor, and tumor located closer than 1 cm to chest wall defined as chest wall abutted. Except of these locations, others defined as peripherally located tumor.

Mentions: Tumor locations were classified as central, peripheral (Fig. 2), apical (superior to aortic arch) or chest wall abutted (closer than 1 cm to chest wall) according to the classification by Timmerman et al [14].


Clinical outcome of fiducial-less CyberKnife radiosurgery for stage I non-small cell lung cancer.

Jung IH, Song SY, Jung J, Cho B, Kwak J, Je HU, Choi W, Jung NH, Kim SS, Choi EK - Radiat Oncol J (2015)

Schema of central and peripheral locations. This diagram showed definition of central, peripheral and apical location of lung tumor. Tumors located at proximal bronchial tree (according to the Radiation Therapy Oncology Group) defined as centrally located tumor, tumor located above aortic arch defined as apically located tumor, and tumor located closer than 1 cm to chest wall defined as chest wall abutted. Except of these locations, others defined as peripherally located tumor.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493433&req=5

Figure 2: Schema of central and peripheral locations. This diagram showed definition of central, peripheral and apical location of lung tumor. Tumors located at proximal bronchial tree (according to the Radiation Therapy Oncology Group) defined as centrally located tumor, tumor located above aortic arch defined as apically located tumor, and tumor located closer than 1 cm to chest wall defined as chest wall abutted. Except of these locations, others defined as peripherally located tumor.
Mentions: Tumor locations were classified as central, peripheral (Fig. 2), apical (superior to aortic arch) or chest wall abutted (closer than 1 cm to chest wall) according to the classification by Timmerman et al [14].

Bottom Line: Eight patients died due to cancer progression.The results showed that fiducial-less CKRS shows comparable local tumor control and survival rates to those of LINAC-based SABR or CKRS with a fiducial marker.Thus, fiducial-less CKRS using Xsight lung tracking system can be effectively and safely performed for patients with medically inoperable stage I non-small cell lung cancer without any risk of procedure-related complication.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To evaluate the treatment results in early stage non-small cell lung cancer patients who have undergone fiducial-less CyberKnife radiosurgery (CKRS).

Materials and methods: From June 2011 to November 2013, 58 patients underwent CKRS at Asan Medical Center for stage I lung cancer. After excluding 14 patients, we retrospectively reviewed the records of the remaining 44 patients. All analyses were performed using SPSS ver. 21.

Results: The median age at diagnosis was 75 years. Most patients had inoperable primary lung cancer with a poor pulmonary function test with comorbidity or old age. The clinical stage was IA in 30 patients (68.2%), IB in 14 (31.8%). The mean tumor size was 2.6 cm (range, 1.2 to 4.8 cm), and the tumor was smaller than 2 cm in 12 patients (27.3%). The radiation dose given was 48-60 Gy in 3-4 fractions. In a median follow-up of 23.1 months, local recurrence occurred in three patients (2-year local recurrence-free survival rate, 90.4%) and distant metastasis occurred in 13 patients. All patients tolerated the radiosurgery well, only two patients developing grade 3 dyspnea. The most common complications were radiation-induced fibrosis and pneumonitis. Eight patients died due to cancer progression.

Conclusion: The results showed that fiducial-less CKRS shows comparable local tumor control and survival rates to those of LINAC-based SABR or CKRS with a fiducial marker. Thus, fiducial-less CKRS using Xsight lung tracking system can be effectively and safely performed for patients with medically inoperable stage I non-small cell lung cancer without any risk of procedure-related complication.

No MeSH data available.


Related in: MedlinePlus