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J. Jung
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P2.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 210)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.02-040 - Clinical Outcome of Fiducial-Less CyberKnife Stereotactic Ablative Body Radiotherapy for Stage I Non-Small Cell Lung Cancer (ID 1221)
09:30 - 09:30 | Author(s): J. Jung
- Abstract
Background:
CyberKnife[TM] is a dedicated system for radiosurgery, with a capability of real-time tumor tracking; Synchrony[®] Respiratory tracking system. Xsight[®] lung tracking system with Synchrony[®] Respiratory tracking system make possible direct lung tumor tracking without fiducial markers. However, there was no establised indication of fiducial-less Cyberknife Radiosurgery (CKRS). So, to ascertain whether indication of fiducial-less CKRS can be extended or not , we had evaluated treatment outcome of fiducial-less CKRS using Xsight[®] lung tracking system at AMC and tested accuracy of CyberKnife Xsight[®] lung tracking system without fiducial marker by phantom experiment. Here are the results of fiducial-less CKRS using Xsight[®] lung tracking system for stage I NSCLC.
Methods:
From June 2011 to November 2013, 58 patients received Cyberknife Radiosurgery to lung at Asan medical center. We retrospectively reviewed records of 44 patients of stage I lung cancer exclude 14 patients (6 with Advanced NSCLC, 6 with Rec. lung cancer within 5 years, 2 with lung metastasis from other primary cancer). All analyses were performed using SPSS, version 21.
Results:
Median age at diagnosis was 75 years. Man was 37 (84.1%). Most of patients were inoperable primary lung cancer with poor PFT (mean FEV1: 63.0 % (range 24-138%), mean DLCo : 50.8 % (range 43- 96 %)) or comorbidity or old age. Clinical stage was IA in 30 (68.2 %), IB in 14 (31.8 %) patients. Mean tumor size was 2.6 cm. (1.2 cm-4.8cm, smaller than 2 cm was 12 (27.3%)) Radiation dose were 48 – 60 Gy per 3 - 4 fx. With median follow-up of 23.1 months, there were LR in 3 patients ( 1Y LRFSR : 94.9%, 2Y LRFSR : 90.4% ) and DM in 13 patients (DM only, n= 7). All patients tolerated the radiosurgery well, only 2 patients had grade 3 dyspnea (1 of 2 suffered from ILD aggravation). Most common complication was RT-induced fibrosis & pneumonitis. Eight patients have died due to cancer progression.(1Y OSR : 86%, 2Y OSR : 80.3%)
Conclusion:
Fiducial-less cyberknife radiosurgery showed good local tumor control and survival in medically inoperable stage I NSCLC, which was comparable with that of linac-based stereotactic body radiosurgery or CKRS with fiducial marker. Even though there were some limitations to apply Xsight [®] lung tracking system without fiducial marker, but it could be used safely in relatively small tumor located in not recommended site.
