Clinical outcome of stereotactic ablative radiotherapy with CyberKnife® for lung tumors: A single center experience

Yıl 2018, Cilt: 2 Sayı: 3, 324 - 329, 01.09.2018

Ebru Atasever Akkaş Ebru Karakaya Gonca Altınışık İnan Yasemin Güzle Adaş Ömer Yazıcı Esra Kekilli Ferhat Kıran Ferihan Ertan Bülent Küçükpilakçı Yıldız Güney

https://doi.org/10.28982/josam.432680

Öz

Aim: To evaluate retrospectively clinical outcomes of treated with stereotactic ablative radiotherapy (SABR) using the CyberKnife® (Accuray, Sunnyvale, CA, USA), for early primary and oligometastatic lung tumors.

Methods: This descriptive study included thirty tumors from 29 patients with primary lung cancer (n=21) or oligometastatic lung tumors (n=9), who underwent SABR with robotic linear accelerator between March 2011 and July2015. Out of the 30 tumors, 21 were NSCLC, 9 were metastatic lung disease. Treatment was given using different tracking methods including fiducial tracking with Synchrony (21 patients) , Xsight lung with Synchrony (4 patients) and Xsight spine (5 patients). Treatment was delivered two to three fractions per week and with different fractionations depending on location and other tumor related factors. Factors, potentially effective on local control and overall survival were investigated.

Results: Median follow-up time for local control was 11 months (2.4-39 months). Of 25 patients with known follow-up data, local control (LC) rates for 1, 2 and 3 years were 82.8%, 82.8% and 55.2 %, respectively. Overall survival (OS) rates for primary lung tumor patients 1, 2 and 3 years were 72.2%, 64.2%, 51.4% and metastatic lung tumor patients for 1 year was 71%, respectively. Except for gender, none of the factors were statistically significantly associated with local control in univariate analysis; female gender was associated with worse local control (p=0.001). Also in univariate analysis of overall survival, there was a trend for worse survival in females, too (p=0.07). 

Conclusion: This small study may give some idea about utilizing different tracking ways for CyberKnife® with less toxicity. 

Anahtar Kelimeler

Lung tumor, CyberKnife®, Stereotactic ablative radiotherapy

Akciğer tümörlerinde CyberKnife® ile stereotaktik ablatif radyoterapi sonuçlarımız: Tek merkez deneyimi

Öz

Amaç: Primer ve oligometastatik akciğer karsinomu tanısıyla CyberKnife® (Accuray, Sunnyvale, CA, USA) kullanarak stereotaktik ablatif radyoterapi (SABR) ile tedavi edilen olgularımızın tedavi sonuçlarımızı değerlendirmek.

Yöntemler: Bu tanımlayıcı çalışmaya Mart 2011- Temmuz 2015 tarihleri arasında robotik lineer akselatör ile SABR tedavisi alan primer akciğer kanserli (n=21) ve oligometastatik akciğer tümörlü (n=9) 30 hastanın 29’u dahil edilmiştir. 30 tümörden 21'i KHDAK, 9'u metastatik akciğer hastalığı idi. Tüm tedavi adımları aynı doktor tarafından kontrol edildi. Tedavi, Synchrony (21 hasta), Synchrony ile Xsight akciğer (4 hasta) ve Xsight vertebra (5 hasta) ile fidusiyal izleme dahil olmak üzere farklı izleme yöntemleri kullanılarak verildi. Tedavi, lokal ve diğer tümörle ilişkili faktörlere bağlı olarak, haftada iki veya üç farklı fraksiyonlarda verildi. Lokal kontrol ve genel sağkalım üzerinde potansiyel olarak etkili faktörler araştırıldı.

Bulgular: Lokal kontrol için medyan takip süresi 11 ay (2,4-39 ay) idi. Bilinen takip verileri bulunan 25 hastanın 1, 2 ve 3 yıllık lokal kontrol (LC) oranları sırasıyla% 82,8, % 82,8 ve % 55,2 idi. Tüm sağkalım oranları primer akciğer tümörlü hastalar için 1,2 ve 3 yıllık sırasıyla %72,2, %64,2 ve %51,4 ve metastatik akciğer tümörleri için 1 yıllık %71 idi. Cinsiyet haricinde, tek değişkenli analizde faktörlerin hiçbiri lokal kontrol ile istatistiksel olarak anlamlı bir şekilde ilişkili değildi; kadın cinsiyeti daha kötü lokal kontrol ile ilişkiliydi (p=0.001). Ayrıca genel sağkalımın tek değişkenli analizinde, kadınlarda da daha kötü bir sağkalım eğilimi vardı (p=0.07).

Sonuç: Bu küçük çalışma, CyberKnife® için daha az toksisite ile farklı tedavi takip yöntemlerinin kullanımı hakkında biraz fikir verebilir.

Anahtar Kelimeler

CyberKnife®, Akciğer tümörü, Stereotaktik ablatif radyoterapi

Kaynakça

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