Stereotactic radiosurgery for lung tumors: Preliminary report of a phase I trial

Richard I. Whyte, Richard Crownover, Martin J. Murphy, David P. Martin, Thomas W. Rice, Malcolm M. DeCamp, Raymond Rodebaugh, Martin S. Weinhous, Quynh Thu Le

Research output: Contribution to journalArticle

252 Scopus citations

Abstract

Background. Stereotactic radiosurgery is well established for the treatment of intracranial neoplasms but its use for lung tumors is novel. Methods. Twenty-three patients with biopsy-proven lung tumors were recruited into a two-institution, dose-escalation, phase I clinical trial using a frameless stereotactic radiosurgery system (CyberKnife). Fifteen patients had primary lung tumors and 8 had metastatic tumors. The age range was 23 to 87 years (mean, 63 years). After undergoing computed tomography-guided percutaneous placement of two to four small metal fiducials directly into the tumor, patients received 1,500 cGY of radiation in a single fraction using a linear accelerator mounted on a computer-controlled robotic arm. Safety, feasibility, and efficacy were studied. Results. Nine patients were treated with a breath-holding technique, and 14 with a respiratory-gating, automated, robotic technique. Tumor size ranged from 1 to 5 cm in maximal diameter. There were four complications related to fiducial placement: three pneumothoraces requiring chest tube insertion and one emphysema exacerbation. There were no grade 3 to 5 radiation-related complications. Follow-up ranged from 1 to 26 months (mean, 7.0 months). Radiographic response was scored as complete in 2 patients, partial in 15, stable in 4, and progressive in 2. Four patients died of non-treatment-related causes at 1, 5, 9, and 11 months after radiation. Conclusions. Single-fraction stereotactic radiosurgery is safe and feasible for the treatment of selected lung tumors. Additional studies are planned to investigate the optimal radiation dose, best motion-suppression technique, and overall treatment efficacy.

Original languageEnglish (US)
Pages (from-to)1097-1101
Number of pages5
JournalAnnals of Thoracic Surgery
Volume75
Issue number4
DOIs
StatePublished - Apr 1 2003
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    Whyte, R. I., Crownover, R., Murphy, M. J., Martin, D. P., Rice, T. W., DeCamp, M. M., Rodebaugh, R., Weinhous, M. S., & Le, Q. T. (2003). Stereotactic radiosurgery for lung tumors: Preliminary report of a phase I trial. Annals of Thoracic Surgery, 75(4), 1097-1101. https://doi.org/10.1016/S0003-4975(02)04681-7