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Image-Guided Robotic Stereotactic Ablative Radiotherapy for Lung Tumors: The CyberKnife

  • Billy W. LooJr.
  • Iris C. Gibbs
Chapter
Part of the Medical Radiology book series (MEDRAD)

Abstract

Stereotactic ablative radiotherapy (SABR) is a new paradigm in radiation therapy, achieving high rates of local tumor control with low toxicity through very high dose intensity and conformity, and requiring highly precise and accurate delivery. The CyberKnife robotic radiosurgery system, originally designed for frameless intracranial radiosurgery using automated image-guidance, has unique characteristics suitable for lung tumor SABR, including dynamic tumor tracking capabilities. We review here the technical characteristics and clinical outcomes of lung tumor SABR using the CyberKnife system.

Keywords

Stereotactic Body Radiation Therapy Treatment Planning System Robotic Manipulator Fiducial Marker Biologically Effective Dose 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Ahn SH, Han MS, Yoon JH et al (2009) Treatment of stage I non-small cell lung cancer with CyberKnife, image-guided robotic stereotactic radiosurgery. Oncol Rep 21:693–696PubMedGoogle Scholar
  2. Anantham D, Feller-Kopman D, Shanmugham LN et al (2007) Electromagnetic navigation bronchoscopy-guided fiducial placement for robotic stereotactic radiosurgery of lung tumors: a feasibility study. Chest 132:930–935PubMedCrossRefGoogle Scholar
  3. Baumann P, Nyman J, Hoyer M et al (2009) Outcome in a prospective Phase II trial of medically inoperable Stage I non-small cell lung cancer patients treated with stereotactic body radiotherapy. J Clin Oncol 27:3290–3296PubMedCrossRefGoogle Scholar
  4. Brown JM, Diehn M, Loo BW (2010) Stereotactic ablative radiotherapy should be combined with a hypoxic cell radiosensitizer. Int J Radiat Oncol Biol Phys 78:323–327PubMedCrossRefGoogle Scholar
  5. Brown WT, Wu X, Amendola B et al (2007a) Treatment of early non-small cell lung cancer, stage IA, by image-guided robotic stereotactic radioablation–CyberKnife. Cancer J 13:87–94PubMedCrossRefGoogle Scholar
  6. Brown WT, Wu X, Fayad F et al (2007b) CyberKnife radiosurgery for stage I lung cancer: results at 36 months. Clin Lung Cancer 8:488–492PubMedCrossRefGoogle Scholar
  7. Brown WT, Wu X, Wen BC et al (2007c) Early results of CyberKnife image-guided robotic stereotactic radiosurgery for treatment of lung tumors. Comput Aided Surg 12:253–261PubMedGoogle Scholar
  8. Brown WT, Wu X, Fayad F et al (2009) Application of robotic stereotactic radiotherapy to peripheral stage I non-small cell lung cancer with curative intent. Clin Oncol (R Coll Radiol) 21:623–631CrossRefGoogle Scholar
  9. Brown WT, Wu X, Fowler JF et al (2008) Lung metastases treated by CyberKnife image-guided robotic stereotactic radiosurgery at 41 months. South Med J 101:376–382PubMedCrossRefGoogle Scholar
  10. Chang CN, Zhou LY, MacFarlane G et al (2009) Excellent early local control with tumor volume adapted dosing of stereotactic body radiation therapy for pulmonary tumors. J Thorac Oncol 4:S938–S939Google Scholar
  11. ClinicalTrials.gov (2008) CyberKnife radiosurgical treatment of inoperable early stage non-small cell cancer. http://www.clinicaltrials.gov/show/NCT00643318. Accessed 1 Mar 2011
  12. ClinicalTrials.gov (2009) International randomized study to compare CyberKnife stereotactic radiotherapy with surgical resection in stage I non-small cell lung cancer (STARS). http://www.clinicaltrials.gov/show/NCT00840749. Accessed 1 Mar 2011
  13. Collins BT, Erickson K, Reichner CA et al (2007) Radical stereotactic radiosurgery with real-time tumor motion tracking in the treatment of small peripheral lung tumors. Radiat Oncol 2:39PubMedCrossRefGoogle Scholar
  14. Collins BT, Vahdat S, Erickson K et al (2009) Radical cyberknife radiosurgery with tumor tracking: an effective treatment for inoperable small peripheral stage I non-small cell lung cancer. J Hematol Oncol 2:1PubMedCrossRefGoogle Scholar
  15. Coon D, Gokhale AS, Burton SA, Heron DE, Ozhasoglu C, Christie N (2008) Fractionated stereotactic body radiation therapy in the treatment of primary, recurrent, and metastatic lung tumors: the role of positron emission tomography/computed tomography-based treatment planning. Clin Lung Cancer 9:217–221PubMedCrossRefGoogle Scholar
  16. CyberKnife radiosurgical treatment of inoperable early stage non-small cell cancer. Accessed March 1, 2011. http://www.clinicaltrials.gov/show/NCT00643318
  17. Ding C, Chang C-H, Haslam J, Timmerman R, Solberg T (2010) A dosimetric comparison of stereotactic body radiation therapy techniques for lung cancer: robotic versus conventional linac-based systems. J Appl Clin Med Phys/Am Coll Med Phys 11:3223Google Scholar
  18. Harley DP, Krimsky WS, Sarkar S, Highfield D, Aygun C, Gurses B (2010) Fiducial marker placement using endobronchial ultrasound and navigational bronchoscopy for stereotactic radiosurgery: an alternative strategy. Ann Thorac Surg 89:368–373 Discussion 73-4PubMedCrossRefGoogle Scholar
  19. Hong JC, Yu Y, Rao AK et al (2010) High retention and safety of percutaneously implanted endovascular embolization coils as fiducial markers for image-guided stereotactic ablative radiotherapy of pulmonary tumors. Int J Radiat Oncol Biol Phys, in press, published online ahead of print August 2010Google Scholar
  20. Hoogeman M, Prévost J-B, Nuyttens J, Pöll J, Levendag P, Heijmen B (2009) Clinical accuracy of the respiratory tumor tracking system of the cyberknife: assessment by analysis of log files. Int J Radiat Oncol Biol Phys 74:297–303PubMedCrossRefGoogle Scholar
  21. International randomized study to compare CyberKnife stereotactic radiotherapy with surgical resection in Stage I non-small cell lung cancer (STARS). (Accessed March 1, 2011, at http://www.clinicaltrials.gov/show/NCT00840749.)
  22. Kothary N, Heit JJ, Louie JD et al (2009) Safety and efficacy of percutaneous fiducial marker implantation for image-guided radiation therapy. J Vasc Interv Radiol: JVIR 20:235–239PubMedCrossRefGoogle Scholar
  23. Le Q-T, Loo BW, Ho A et al (2006) Results of a phase I dose-escalation study using single-fraction stereotactic radiotherapy for lung tumors. J Thorac Oncol 1:802–809PubMedCrossRefGoogle Scholar
  24. Muacevic A, Drexler C, Wowra B et al (2007) Technical description, phantom accuracy, and clinical feasibility for single-session lung radiosurgery using robotic image-guided real-time respiratory tumor tracking. Technol Cancer Res Treat 6:321–328PubMedGoogle Scholar
  25. Nuyttens JJ, Prévost J-B, Praag J et al (2006) Lung tumor tracking during stereotactic radiotherapy treatment with the CyberKnife: Marker placement and early results. Acta Oncol 45:961–965PubMedCrossRefGoogle Scholar
  26. Pennathur A, Luketich JD, Burton S et al (2007) Stereotactic radiosurgery for the treatment of lung neoplasm: initial experience. Ann Thorac Surg 83:1820–1824 discussion 4-5PubMedCrossRefGoogle Scholar
  27. Pennathur A, Luketich JD, Heron DE et al (2009a) Stereotactic radiosurgery for the treatment of lung neoplasm: experience in 100 consecutive patients. Ann Thorac Surg 88:1594–1600 discussion 600PubMedCrossRefGoogle Scholar
  28. Pennathur A, Luketich JD, Heron DE et al (2009b) Stereotactic radiosurgery for the treatment of stage I non-small cell lung cancer in high-risk patients. J Thorac Cardiovasc Surg 137:597–604PubMedCrossRefGoogle Scholar
  29. Prévost J-BG, Nuyttens JJ, Hoogeman MS, Pöll JJ, van Dijk LC, Pattynama PMT (2008) Endovascular coils as lung tumour markers in real-time tumour tracking stereotactic radiotherapy: preliminary results. Eur Radiol 18:1569–1576PubMedCrossRefGoogle Scholar
  30. Schroeder C, Hejal R, Linden PA (2010) Coil spring fiducial markers placed safely using navigation bronchoscopy in inoperable patients allows accurate delivery of CyberKnife stereotactic radiosurgery. J Thorac Cardiovasc Surg 140:1137–1142PubMedCrossRefGoogle Scholar
  31. Schweikard A, Glosser G, Bodduluri M, Murphy MJ, Adler JR (2000) Robotic motion compensation for respiratory movement during radiosurgery. Comput Aided Surg 5:263–277PubMedCrossRefGoogle Scholar
  32. Schweikard A, Shiomi H, Adler J (2004) Respiration tracking in radiosurgery. Med Phys 31:2738–2741PubMedCrossRefGoogle Scholar
  33. Sharma SC, Ott JT, Williams JB, Dickow D (2010) Clinical implications of adopting Monte Carlo treatment planning for CyberKnife. J Appl Clin Med Phys/Amer Coll Med Phys 11:3142Google Scholar
  34. Timmerman R, Paulus R, Galvin J et al (2010) Stereotactic body radiation therapy for inoperable early stage lung cancer. JAMA 303:1070–1076PubMedCrossRefGoogle Scholar
  35. Trakul N, Harris J, Dieterich S et al (2010) Volume adapted dosing in stereotactic ablative radiotherapy of lung tumors. Int J Radiat Oncol Biol Phys 78(3 suppl 1):S179CrossRefGoogle Scholar
  36. Unger K, Ju A, Oermann E, et al. (2010) CyberKnife for hilar lung tumors: report of clinical response and toxicity. J Hematol Oncol 3:39–45PubMedCrossRefGoogle Scholar
  37. Vahdat S, Oermann EK, Collins SP et al (2010) CyberKnife radiosurgery for inoperable stage IA non-small cell lung cancer: 18F-fluorodeoxyglucose positron emission tomography/computed tomography serial tumor response assessment. J Hematol Oncol 3:6PubMedCrossRefGoogle Scholar
  38. van der Voort van Zyp NC, Prévost J-B, Hoogeman MS et al (2009) Stereotactic radiotherapy with real-time tumor tracking for non-small cell lung cancer: clinical outcome. Radiother and Oncol J Eur Soc Ther Radiol and Oncol 91:296–300CrossRefGoogle Scholar
  39. van der Voort van Zyp NC, Hoogeman MS, van de Water S et al (2010a) Clinical introduction of Monte Carlo treatment planning: a different prescription dose for non-small cell lung cancer according to tumor location and size. Radiother and Oncol J Eur Soc Ther Radiol Oncol 96:55–60CrossRefGoogle Scholar
  40. van der Voort van Zyp NC, Prévost J-B, van der Holt B et al (2010b) Quality of life after stereotactic radiotherapy for stage I non-small cell lung cancer. Int J Radiat Oncol Biol Phys 77:31–37CrossRefGoogle Scholar
  41. van der Voort van Zyp NC, van der Holt B, van Klaveren RJ, Pattynama P, Maat A, Nuyttens JJ (2010c) Stereotactic body radiotherapy using real-time tumor tracking in octogenarians with non-small cell lung cancer. Lung Cancer 69:296–301CrossRefGoogle Scholar
  42. Whyte RI, Crownover R, Murphy MJ et al (2003) Stereotactic radiosurgery for lung tumors: preliminary report of a phase I trial. Ann Thorac Surg 75:1097–1101PubMedCrossRefGoogle Scholar
  43. Wilcox EE, Daskalov GM, Lincoln H, Shumway RC, Kaplan BM, Colasanto JM (2010) Comparison of planned dose distributions calculated by Monte Carlo and Ray-Trace algorithms for the treatment of lung tumors with cyberknife: a preliminary study in 33 patients. Int J Radiat Oncol Biol Phys 77:277–284PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  1. 1.Department of Radiation OncologyStanford University and Cancer InstituteStanfordUSA

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