Early results of CyberKnife image-guided robotic stereotactic radiosurgery for treatment of lung tumors

Abstract

The delivery of precisely targeted high radiation doses with surgical precision to lung tumors in a hypo-fractionated fashion is feasible and safe. Image-guided robotic stereotactic radiosurgery (IGR-SRS) of lung tumors with the CyberKnife achieves excellent rates of local disease control with limited toxicity to surrounding tissues, and in many cases may be curative for patients for whom surgery is not an option.

Individualized higher dose of 70–75 Gy using five-fraction robotic stereotactic radiotherapy for non-small-cell lung cancer: A feasibility study

“…Squamous cell carcinomas were treated with margins of 4 mm and 2 mm to cover microscopic extension and uncertainty, respectively. The CyberKnife radiosurgical technique for lung tumors has been described in several previous reports from our group [19][20][21][22][23]. The total system accuracy of the device and the respiratory motion tracking in a phantom has been reported as 1 mm in two recent articles [27,28].…”

Treatment of stage I non-small cell lung cancer with CyberKnife, image-guided robotic stereotactic radiosurgery

“…The accuracy of the tracking system is within 1.5 mm of the planning treatment volume (PTV) margins and allows the tumor to be destroyed precisely (8,9). Although this system is increasingly being used, there have been a few reports from a very limited number of centers about the results of CyberKnife treatment for early lung cancer (8)(9)(10). We evaluated the clinical characteristics and outcomes of patients with stage I NSCLC who underwent radiosurgery using the CyberKnife at a cancer center in Korea.…”

“…The accuracy of target localization and dose delivery can be achieved through combining real-time, periodic X-ray imaging of implanted metallic markers (called fiducials) within the tumor. The accuracy of the tracking system is within 1.5 mm of the planning treatment volume (PTV) margins and allows the tumor to be destroyed precisely (8,9). Although this system is increasingly being used, there have been a few reports from a very limited number of centers about the results of CyberKnife treatment for early lung cancer (8)(9)(10).…”

Robotic Applications in Neurosurgery

“…For intracranial conditions, the CyberKnife system has been used to radiosurgically treat a variety of tumours such as residual small skull base menigiomas, small acoustic schwanomas (Sakamoto et al, 2005), small pituitary adenomas, and small metastases as well as other abnormalities such as small arteriovenous malformations (AVMs) and intractable pain such as in Trigeminal Neuralgia (Massaudi et al, 2005). With the Synchrony™ motion tracking system, tumours in organs moving with respiration such as the lung (Brown et al, 2005), the pancreas (Goodman & Koong, 2005), the liver and the kidney can be successfully targeted. Other tumours based in more rigid body anatomy, where minimal motion is expected, may be tracked via rigidly implanted markers including those in the spine and the prostate .…”

“…To date, more than 10,000 patients have benefited from the revolutionary concept of marrying robotics to image-guided radiosurgery. Scientific presentations and publications on the clinical applications of the CyberKnife are numerous -including intracranial , spine , paediatric (Giller et al, 2005), prostate , pancreas (Goodman & Koong, 2005), kidney and lung (Brown et al, 2005).…”