To discern the effectiveness of CyberKnifeR stereotactic radiosurgery with SynchronyTM motion tracking on both central and peripheral thoracic tumors measured by both CT and PET imaging at three-month and six-month intervals.
All patients who underwent CyberKnife with Synchrony for treatment of thoracic malignancies were enrolled. Patients were divided into two groups according to the location of their tumors within the thorax. Peripheral nodules received a total of 45–60 Gy applied in 3 fractions over a 7-10 day period while those with central tumors received doses of 18-30 Gy over 3-5 treatments. CT of the chest and PET scans were obtained at three-month and six-month intervals post treatment.
A total of 24 patients were enrolled since July 2004. Etiology of the ten peripheral malignancies consisted of primary NSCLC (7) and metastatic diseases including esophageal (1), muscle (1), and skin (1). Etiology of the 14 central lesions consisted of primary NSCLC (11), and metastatic diseases including colon (1), breast (1) and kidney (1). Tumor size ranged from 7mm to 8cm. The major side effect consisted of fatigue. At three months, partial response was noted in first 7 patients treated for peripheral nodules. A complete response was noted at 6 months in the first patient with a peripheral nodule. Two patients with central tumors showed stable disease at three months. One central tumor patient showed initial improvement, followed by progression of disease at three months.
All patients tolerated the treatment well. Patients with peripheral lung nodules who received Cyberknife with Synchrony had a significant response to treatment.
Cyberknife stereotactic radiosurgery with Synchrony motion tracking is a safe and effective modality for treating tumors in the thorax. This treatment may be suitable for non-surgical candidates and patients who refuse surgery. Cyberknife may also be an option in patients who have received prior irradiation.
Amit Patel, None.