Clinical outcome of fiducial-less CyberKnife radiosurgery for stage I non-small cell lung cancer.
- Author:
In Hye JUNG
1
;
Si Yeol SONG
;
Jinhong JUNG
;
Byungchul CHO
;
Jungwon KWAK
;
Hyoung Uk JE
;
Wonsik CHOI
;
Nuri Hyun JUNG
;
Su Ssan KIM
;
Eun Kyung CHOI
Author Information
- Publication Type:Original Article
- Keywords: Lung; NSCLC; Radiosurgery; Cyberknife; Fiducialless; Marker
- MeSH: Carcinoma, Non-Small-Cell Lung*; Chungcheongnam-do; Comorbidity; Diagnosis; Dyspnea; Fibrosis; Fiducial Markers; Follow-Up Studies; Humans; Lung; Lung Neoplasms; Neoplasm Metastasis; Pneumonia; Radiosurgery*; Recurrence; Respiratory Function Tests; Retrospective Studies; Survival Rate
- From:Radiation Oncology Journal 2015;33(2):89-97
- CountryRepublic of Korea
- Language:English
- 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.
