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Radical stereotactic radiosurgery with real-time tumor motion tracking in the treatment of small peripheral lung tumors

BACKGROUND: Recent developments in radiotherapeutic technology have resulted in a new approach to treating patients with localized lung cancer. We report preliminary clinical outcomes using stereotactic radiosurgery with real-time tumor motion tracking to treat small peripheral lung tumors. METHODS:...

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Autores principales: Collins, Brian T, Erickson, Kelly, Reichner, Cristina A, Collins, Sean P, Gagnon, Gregory J, Dieterich, Sonja, McRae, Don A, Zhang, Ying, Yousefi, Shadi, Levy, Elliot, Chang, Thomas, Jamis-Dow, Carlos, Banovac, Filip, Anderson, Eric D
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2174503/
https://www.ncbi.nlm.nih.gov/pubmed/17953752
http://dx.doi.org/10.1186/1748-717X-2-39
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author Collins, Brian T
Erickson, Kelly
Reichner, Cristina A
Collins, Sean P
Gagnon, Gregory J
Dieterich, Sonja
McRae, Don A
Zhang, Ying
Yousefi, Shadi
Levy, Elliot
Chang, Thomas
Jamis-Dow, Carlos
Banovac, Filip
Anderson, Eric D
author_facet Collins, Brian T
Erickson, Kelly
Reichner, Cristina A
Collins, Sean P
Gagnon, Gregory J
Dieterich, Sonja
McRae, Don A
Zhang, Ying
Yousefi, Shadi
Levy, Elliot
Chang, Thomas
Jamis-Dow, Carlos
Banovac, Filip
Anderson, Eric D
author_sort Collins, Brian T
collection PubMed
description BACKGROUND: Recent developments in radiotherapeutic technology have resulted in a new approach to treating patients with localized lung cancer. We report preliminary clinical outcomes using stereotactic radiosurgery with real-time tumor motion tracking to treat small peripheral lung tumors. METHODS: Eligible patients were treated over a 24-month period and followed for a minimum of 6 months. Fiducials (3–5) were placed in or near tumors under CT-guidance. Non-isocentric treatment plans with 5-mm margins were generated. Patients received 45–60 Gy in 3 equal fractions delivered in less than 2 weeks. CT imaging and routine pulmonary function tests were completed at 3, 6, 12, 18, 24 and 30 months. RESULTS: Twenty-four consecutive patients were treated, 15 with stage I lung cancer and 9 with single lung metastases. Pneumothorax was a complication of fiducial placement in 7 patients, requiring tube thoracostomy in 4. All patients completed radiation treatment with minimal discomfort, few acute side effects and no procedure-related mortalities. Following treatment transient chest wall discomfort, typically lasting several weeks, developed in 7 of 11 patients with lesions within 5 mm of the pleura. Grade III pneumonitis was seen in 2 patients, one with prior conventional thoracic irradiation and the other treated with concurrent Gefitinib. A small statistically significant decline in the mean % predicted DLCO was observed at 6 and 12 months. All tumors responded to treatment at 3 months and local failure was seen in only 2 single metastases. There have been no regional lymph node recurrences. At a median follow-up of 12 months, the crude survival rate is 83%, with 3 deaths due to co-morbidities and 1 secondary to metastatic disease. CONCLUSION: Radical stereotactic radiosurgery with real-time tumor motion tracking is a promising well-tolerated treatment option for small peripheral lung tumors.
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spelling pubmed-21745032008-01-04 Radical stereotactic radiosurgery with real-time tumor motion tracking in the treatment of small peripheral lung tumors Collins, Brian T Erickson, Kelly Reichner, Cristina A Collins, Sean P Gagnon, Gregory J Dieterich, Sonja McRae, Don A Zhang, Ying Yousefi, Shadi Levy, Elliot Chang, Thomas Jamis-Dow, Carlos Banovac, Filip Anderson, Eric D Radiat Oncol Research BACKGROUND: Recent developments in radiotherapeutic technology have resulted in a new approach to treating patients with localized lung cancer. We report preliminary clinical outcomes using stereotactic radiosurgery with real-time tumor motion tracking to treat small peripheral lung tumors. METHODS: Eligible patients were treated over a 24-month period and followed for a minimum of 6 months. Fiducials (3–5) were placed in or near tumors under CT-guidance. Non-isocentric treatment plans with 5-mm margins were generated. Patients received 45–60 Gy in 3 equal fractions delivered in less than 2 weeks. CT imaging and routine pulmonary function tests were completed at 3, 6, 12, 18, 24 and 30 months. RESULTS: Twenty-four consecutive patients were treated, 15 with stage I lung cancer and 9 with single lung metastases. Pneumothorax was a complication of fiducial placement in 7 patients, requiring tube thoracostomy in 4. All patients completed radiation treatment with minimal discomfort, few acute side effects and no procedure-related mortalities. Following treatment transient chest wall discomfort, typically lasting several weeks, developed in 7 of 11 patients with lesions within 5 mm of the pleura. Grade III pneumonitis was seen in 2 patients, one with prior conventional thoracic irradiation and the other treated with concurrent Gefitinib. A small statistically significant decline in the mean % predicted DLCO was observed at 6 and 12 months. All tumors responded to treatment at 3 months and local failure was seen in only 2 single metastases. There have been no regional lymph node recurrences. At a median follow-up of 12 months, the crude survival rate is 83%, with 3 deaths due to co-morbidities and 1 secondary to metastatic disease. CONCLUSION: Radical stereotactic radiosurgery with real-time tumor motion tracking is a promising well-tolerated treatment option for small peripheral lung tumors. BioMed Central 2007-10-22 /pmc/articles/PMC2174503/ /pubmed/17953752 http://dx.doi.org/10.1186/1748-717X-2-39 Text en Copyright © 2007 Collins et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Collins, Brian T
Erickson, Kelly
Reichner, Cristina A
Collins, Sean P
Gagnon, Gregory J
Dieterich, Sonja
McRae, Don A
Zhang, Ying
Yousefi, Shadi
Levy, Elliot
Chang, Thomas
Jamis-Dow, Carlos
Banovac, Filip
Anderson, Eric D
Radical stereotactic radiosurgery with real-time tumor motion tracking in the treatment of small peripheral lung tumors
title Radical stereotactic radiosurgery with real-time tumor motion tracking in the treatment of small peripheral lung tumors
title_full Radical stereotactic radiosurgery with real-time tumor motion tracking in the treatment of small peripheral lung tumors
title_fullStr Radical stereotactic radiosurgery with real-time tumor motion tracking in the treatment of small peripheral lung tumors
title_full_unstemmed Radical stereotactic radiosurgery with real-time tumor motion tracking in the treatment of small peripheral lung tumors
title_short Radical stereotactic radiosurgery with real-time tumor motion tracking in the treatment of small peripheral lung tumors
title_sort radical stereotactic radiosurgery with real-time tumor motion tracking in the treatment of small peripheral lung tumors
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2174503/
https://www.ncbi.nlm.nih.gov/pubmed/17953752
http://dx.doi.org/10.1186/1748-717X-2-39
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