{"id":34776,"date":"2024-10-22T15:58:13","date_gmt":"2024-10-22T20:58:13","guid":{"rendered":"https:\/\/www.accuray.com\/?post_type=studies&p=34776"},"modified":"2024-10-30T17:16:45","modified_gmt":"2024-10-30T22:16:45","slug":"the-cyberknife-system-provides-an-alternative-for-lung-cancer-patients","status":"publish","type":"studies","link":"https:\/\/www.accuray.com\/ja\/case-studies\/the-cyberknife-system-provides-an-alternative-for-lung-cancer-patients\/","title":{"rendered":"The CyberKnife\u00ae System Provides an Alternative for Lung Cancer Patients"},"content":{"rendered":"\t\t
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\n\t\t\t\t\t\t\t\t\t< View All Case Studies<\/a>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Case Study | ERLANGER HEALTH SYSTEM<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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The CyberKnife\u00ae System Provides an Alternative for Lung Cancer Patients<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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ERLANGER HEALTH SYSTEM USES THE CYBERKNIFE SYSTEM TO PROVIDE FIDUCIAL-FREE TREATMENT FOR EARLY-STAGE LUNG CANCER PATIENTS<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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\n\t\t\t\t\t\t\t\t\tErlanger Health System in Chattanooga, Tennessee, purchased a CyberKnife\nRobotic Radiosurgery System in December 2010 to develop a stereotactic body\nradiation therapy (SBRT) program in its Radiation Oncology Department. The\nCyberKnife System included the Lung Optimized Treatment (LOT) function, which\nprovides fiducial-free SBRT of early-stage lung cancer patients by enabling a\nhybrid method of spine tracking and tumor density tracking. Once the CyberKnife\nSystem was in use, the clinical team at Erlanger collaborated with referring\nphysicians to explain to thoracic surgeons and pulmonologists \u2014 at Erlanger\nand other hospitals in the community \u2014 how the system could be utilized as a\ntreatment option for their patients.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Lung Optimized Treatments: 2-View<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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The CyberKnife LOT function offers several solutions for patients with lung tumors, including the 2-View tracking solution, which uses both of the system\u2019s ceiling-mounted X-ray cameras, along with Synchrony Respiratory Tracking to automatically track and adjust the beam to tumor motion. This function was used to treat a 70-year-old woman whose\u00a0cancer had returned after previous therapy. She received treatment three-and-a-half years prior with conventional radiation therapy to 6480cGy over the course of 36 fractions. In addition, four cycles of Taxotere and Carboplatin had been administered neoadjuvantly. However, PET\/CT showed a 1.8cm\nhypermetabolic nodule in the right medial lung base.<\/p>\n

The Surgical solutions and conventional radiation\ntherapy were not options for this recurrence, so\nphysicians agreed that SBRT was an excellent\nopportunity to eradicate or provide long-term\nsuppression to the area of recurrence. Based on the\n2-View LOT protocol, a prescription dose of 6000cGy was\nprescribed to the 82 percent isodose line and delivered\nover three fractions utilizing 111 non-coplanar beams.<\/p>\n

Eight months after treatment, a CT scan showed no\nresidual tumor in the medial right lobe.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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2-View: A 3-D, axial, sagittal and coronal view of the treated area highlighted in pink, as well as radiation dose shown in multicolored isodose lines.<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t

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WHO\/WHERE<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\tErlanger Health System is a non-profit academic\nteaching system affiliated with the University of\nTennessee. Located in Chattanooga, Tennessee,\nErlanger is one of three major hospital systems in the\narea that caters to a regional population of more\nthan 1.5 million, including patients from Georgia,\nAlabama and North Carolina.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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CHALLENGE<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\tDevelop a stereotactic body radiation\ntherapy (SBRT) program to provide a painless,\nnoninvasive treatment option for early-stage\nlung cancer patients.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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SOLUTION<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\tThe CyberKnife System with the Lung Optimized\nTreatment (LOT) function provides quick, painless,\nnoninvasive, fiducial-free SBRT for patients with\nearly-stage lung cancer using three different\ntreatment protocols: 2-view, 1-view and 0-view.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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1-View: Orthogonal planar images showing the position of the tumor during initial simulation to determine the method in which the tumor is tracked during treatment. Notice that the tumor is only clearly visible in Image A.<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Lung Optimized Treatments: 2-View<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Another treatment protocol available with Erlanger\u2019s CyberKnife\u00ae System is the 1-View LOT function. The 1-View LOT protocol uses one of the CyberKnife\u2019s two orthogonally mounted X-ray cameras to enable fiducial-free, real-time adjustment of the beam to the respiratory motion of the tumor. A margin is then added to the tumor volume to account for the motion that would have been seen only in the \u201cblind\u201c X-ray camera view.\nThis protocol was utilized for a 70-year-old woman with medically inoperable, stage I, poorly differentiated large\ncell carcinoma of the right\/mid upper lobe at the hilum. She was not a surgical candidate due to poor pulmonary function, and physicians did not believe that she would\ntolerate conventional radiation therapy. However, foregoing therapy had an associated risk of progression and lymphatic spread, which could occur within a matter of months.<\/p>\n

Physicians chose to treat the patient with non-invasive SBRT. While side effects, including coughing and chest\nwall or rib tenderness are possible, the probability for this patient was low due to the location of the tumor.<\/p>\n

Based on the 1-View LOT function, the treatment plan was developed using the MultiPlan\u00ae Treatment Planning System, and a dose of 5400cGy was prescribed to the 82 percent isodose line and delivered over four fractions, utilizing 98 non-coplanar beams. Each\nfraction lasted approximately 36 minutes.<\/p>\n

\nAside from reports of fatigue one week after completion of treatments, the patient had no complaints. Seven\nmonths post-treatment, the patient reported doing\nwell. She was not on oxygen and indicated she had no shortness of breath. The treated lesion was no longer visible in CT scans taken at three- and six-month follow-ups.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Lung Optimized Treatments: 0-View<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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The third LOT function that Erlanger uses with its CyberKnife System is the 0-View option. The 0-View LOT protocol is used when a tumor cannot be clearly identified by either of the CyberKnife\u2019s two X-ray cameras. The planning margin is expanded to include the entire inhale-to-exhale tumor motion. Erlanger used this feature with a 72-year-old man with a stage I lung cancer in the left upper and mediastinal nodal sampling, as well as wedge resection. But the patient was considered a marginal operative risk and he wanted to explore less invasive interventions.<\/p>\n

Physicians suggested SBRT as a non-invasive alternative to surgery. SBRT using the CyberKnife\u00ae System is equivalent to surgical wedge resection with respect to local control. Additionally, the LOT treatment would not require placement of any fiducials and was unlikely to cause adverse side effects given the location of his lesion.<\/p>\n

Based on the 0-View LOT protocol, the clinical team utilized both inhale and exhale CT data sets to design a treatment plan on the MultiPlan\u00ae Treatment Planning system. The tumor excursion was measured and PTV margins drawn to account for the extent of tumor motion.<\/p>\n

The patient was treated using the CyberKnife System\u2019s automated Iris\u2122 Variable Aperture Collimator. A prescription dose of 6000cGy was prescribed to the 81 percent isodose line and delivered over three fractions, lasting approximately 24 minutes each, utilizing 77 non-coplanar beams. Aside from reports of fatigue about a week after his final treatment, the patient had no complaints. One year after treatment, at his follow up visit, the patient was still doing well with no distress.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Benefits of CyberKnife for Early Stage Lung Cancer<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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The CyberKnife System provides early-stage lung\ncancer patients at Erlanger with an alternative treatment option to surgery. \u201cOften we get patients who wonder if there is a treatment for them,\u201d said David Taliaferro, CyberKnife coordinator at Erlanger\u2019s\nCyberKnife Center. \u201cWe find it very gratifying that now we can tell our patients that we indeed have a treatment option for them. Not only that, but it is quick, painless, and non-invasive.\u201d<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Important Safety Information
Most side effects of radiotherapy, including radiotherapy delivered with Accuray systems, are mild and temporary, often involving fatigue, nausea, and skin irritation. Side effects can be severe, however, leading to pain, alterations in normal body functions (for example, urinary or salivary function), deterioration of quality of life, permanent injury, and even death. Side effects can occur during or shortly after radiation treatment or in the months and years following radiation. The nature and severity of side effects depend on many factors, including the size and location of the treated tumor, the treatment technique (for example, the radiation dose), and the patient\u2019s general medical condition, to name a few. For more details about the side effects of your radiation therapy, and to see if treatment with an Accuray product is right for you, ask your doctor. Accuray Incorporated as a medical device manufacturer cannot and does not recommend specific treatment approaches. Individual results may vary.<\/p>\n

\u00a9 2022 Accuray Incorporated. All Rights Reserved. Accuray, the Accuray logo, and other trademarks are trademarks or registered trademarks of Accuray Incorporated and may not be used without permission. For more information on Accuray and its trademarks, please visit www.accuray.com\/trademarks. MKT000059(2)<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

Erlanger Health System in Chattanooga, Tennessee, purchased a CyberKnife Robotic Radiosurgery System in December 2010 to develop a stereotactic body radiation therapy (SBRT) program in its Radiation Oncology Department. The CyberKnife System included the Lung Optimized Treatment (LOT) function, which provides fiducial-free SBRT of early-stage lung cancer patients by enabling a hybrid method of spine tracking and tumor density tracking. Once the CyberKnife System was in use, the clinical team at Erlanger collaborated with referring physicians to explain to thoracic surgeons and pulmonologists \u2014 at Erlanger and other hospitals in the community \u2014 how the system could be utilized as a treatment option for their patients.<\/p>\n","protected":false},"featured_media":34786,"menu_order":0,"template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"_links_to":"","_links_to_target":""},"categories":[1266],"studies_products":[],"case_studies_products":[1269],"class_list":["post-34776","studies","type-studies","status-publish","has-post-thumbnail","hentry","category-cyberknife","case_studies_products-cyberknife"],"acf":[],"yoast_head":"\nThe CyberKnife\u00ae System Provides an Alternative for Lung Cancer Patients - Accuray<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.accuray.com\/case-studies\/the-cyberknife-system-provides-an-alternative-for-lung-cancer-patients\/\" \/>\n<meta property=\"og:locale\" content=\"ja_JP\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The CyberKnife\u00ae System Provides an Alternative for Lung Cancer Patients\" \/>\n<meta property=\"og:description\" content=\"Erlanger Health System in Chattanooga, Tennessee, purchased a CyberKnife Robotic Radiosurgery System in December 2010 to develop a stereotactic body radiation therapy (SBRT) program in its Radiation Oncology Department. The CyberKnife System included the Lung Optimized Treatment (LOT) function, which provides fiducial-free SBRT of early-stage lung cancer patients by enabling a hybrid method of spine tracking and tumor density tracking. 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