Longkanker In Duitse kliniek worden longtumoren met LITT met gebruikmaking van uiterst fijne apparatuur en tumor voor tumor aangepakt. Dus niet alles tegelijk. Ook cyberknife wordt succesvol bij inoperabele longtumoren ingezet.

15 juni 2011: ik heb onderaan enkele andere studies toegevoegd die aantonen dat een laserbehandeling van longtumoren wel degelijk succesvol kan zijn, zoals in onderstaande studie is aangetoond en mensen met longtumoren kan helpen.

1 augustus 2006: Bron: 1: Eur Radiol. 2006 Aug;16(8):1769-78. Epub 2006 May 3.

Duitse kliniek meldt succesvolle aanpak van longtumoren met LITT = Laser-induced Interstitial Thermotherapy. Een man met longkanker wees ons op deze Duitse kliniek waar hij onder behandeling is en waar hij zeer tevreden over is. Hij wordt behandeld met LITT en aanvullend complementaire natuurlijke ondersteuning. Bovendien worden de tumoren een voor een behandeld en niet allemaal tegelijk. De behandeling is heel voorzichtig en nauwkeurig met gebruikmaking van zeer fijne apparatuur. Aanvullend vonden we een heel recent gepubliceerde studie uit deze kliniek, (zie hieronder abstract van de studie) die bevestigt dat een behandeling met LITT van longtumoren succesvol kan zijn.

Adres van deze kliniek is:

Ernst-Moritz-Arndt-Universität Greifswald

Domstraße 11
17487 Greifswald
Tel.: +49 (0)3834 86-0
Fax: +49 (0)3834 86-1248
pressestelle@uni-greifswald.de

Laser ablation of lung metastases: results according to diameter and location.Weigel C, Rosenberg C, Langner S, Frohlich CP, Hosten N. Department of Diagnostic Radiology and Neuroradiology, Ernst-Moritz-Arndt-Universitat Greifswald, Greifswald, Germany.

Lung tumour ablation with a thin-calibre laser applicator system was evaluated. We quantified feasibility, technical success and complication rates in relation to lesion diameter and location. Forty-two patients with 64 lung tumours were treated (39 patients with metastases and three with primary tumours). Mean follow-up was 7.6 months (range 6 weeks to 39 months). Eighty-six percent of treatments were technically successful in the first session. Pneumothorax was the main complication and occurred in 50% of the first 20 patients and in 35% of the rest. Two patients required a chest tube. Fourteen lesions were central and 50 were peripheral. It took several weeks for the effect of the therapy to become apparent on follow-up CT. Thirty-nine percent of all lesions increased in size immediately after treatment. Gross reduction in size with scar formation was seen in 50% of the lesions and cavitation in 13%. Local tumour control was achieved in 51 lesions. Progression after therapy was seen in 9% of lesions <1.5 cm but in more than 11% of larger lesions. Progression was also more frequent in lesions located in the basal parts of the lung (47%). Sixteen patients died due to systemic progression. Our results suggest that successful laser ablation of lung lesions is possible with a miniaturized applicator.

PMID: 16670870 [PubMed - in process]

Laser ablation of lung metastases: results according to diameter and location

Bron: Springerlink

Lung tumour ablation with a thin-calibre laser applicator system was evaluated. We quantified feasibility, technical success and complication rates in relation to lesion diameter and location. Forty-two patients with 64 lung tumours were treated (39 patients with metastases and three with primary tumours). Mean follow-up was 7.6 months (range 6 weeks to 39 months). Eighty-six percent of treatments were technically successful in the first session. Pneumothorax was the main complication and occurred in 50% of the first 20 patients and in 35% of the rest. Two patients required a chest tube. Fourteen lesions were central and 50 were peripheral. It took several weeks for the effect of the therapy to become apparent on follow-up CT. Thirty-nine percent of all lesions increased in size immediately after treatment. Gross reduction in size with scar formation was seen in 50% of the lesions and cavitation in 13%. Local tumour control was achieved in 51 lesions. Progression after therapy was seen in 9% of lesions <1.5 cm but in more than 11% of larger lesions. Progression was also more frequent in lesions located in the basal parts of the lung (47%). Sixteen patients died due to systemic progression. Our results suggest that successful laser ablation of lung lesions is possible with a miniaturized applicator.

Radical cyberknife radiosurgery with tumor tracking: an effective treatment for inoperable small peripheral stage I non-small cell lung cancer.

Bron: Journal of hematology and oncology

Hier een studie die aantoont dat met de cyberknife toch succesvol longtumoren kunnen worden verwijderd. Het gaat in deze studie om beginnende niet operabele longkanker.

Abstract

Objective

Curative surgery is not an option for many patients with clinical stage I non-small-cell lung carcinoma (NSCLC), but radical radiosurgery may be effective.

Methods

Inoperable patients with small peripheral clinical stage I NSCLC were enrolled in this study. Three-to-five fiducial markers were implanted in or near tumors under CT guidance. Gross tumor volumes (GTVs) were contoured using lung windows. The GTV margin was expanded by 5 mm to establish the planning treatment volume (PTV). A dose of 42–60 Gy was delivered to the PTV in 3 equal fractions in less than 2 weeks using the CyberKnife radiosurgery system. The 30-Gy isodose contour extended at least 1 cm from the GTV. Physical examination, CT imaging and pulmonary function testing were completed at 6 months intervals for three years following treatment.

Results

Twenty patients with an average maximum tumor diameter of 2.2 cm (range, 1.1 – 3.5 cm) and a mean FEV1 of 1.08 liters (range, 0.53 – 1.71 L) were treated. Pneumothorax requiring tube thoracostomy occurred following CT-guided fiducial placement in 25% of the patients. All patients completed treatment with few acute side effects and no procedure-related mortality. Transient chest wall discomfort developed in 8 of the 12 patients with lesions within 5 mm of the pleura. The mean percentage of the total lung volume receiving a minimum of 15 Gy was 7.3% (range, 2.4% to 11.3%). One patient who received concurrent gefitinib developed short-lived, grade III radiation pneumonitis. The mean percent predicted DLCO decreased by 9% and 11% at 6 and 12 months, respectively. There were no local failures, regional lymph node recurrences or distant metastases. With a median follow-up of 25 months for the surviving patients, Kaplan-Meier overall survival estimate at 2 years was 87%, with deaths due to COPD progression.

Conclusion

Radical CyberKnife radiosurgery is a well-tolerated treatment option for inoperable patients with small, peripheral stage I NSCLC. Effective doses and adequate margins are likely to have contributed to the optimal early local control seen in this study.

>>>>>Read here the complete study report

References

Ginsberg RJ, Rubinstein LV: Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group.

Ann Thorac Surg 1995, 60:615-622.

discussion 622–613
PubMed Abstract | Publisher Full Text

Return to text
Swanson SJ, Herndon JE 2nd, D'Amico TA, Demmy TL, McKenna RJ Jr, Green MR, Sugarbaker DJ: Video-assisted thoracic surgery lobectomy: report of CALGB 39802 – a prospective, multi-institution feasibility study.

J Clin Oncol 2007, 25:4993-4997. PubMed Abstract | Publisher Full Text

Return to text
Allen MS, Darling GE, Pechet TT, Mitchell JD, Herndon JE 2nd, Landreneau RJ, Inculet RI, Jones DR, Meyers BF, Harpole DH, Putnam JB Jr, Rusch VW: Morbidity and mortality of major pulmonary resections in patients with early-stage lung cancer: initial results of the randomized, prospective ACOSOG Z0030 trial.

Ann Thorac Surg 2006, 81:1013-1019.

discussion 1019–1020
PubMed Abstract | Publisher Full Text

Return to text
Handy JR Jr, Asaph JW, Skokan L, Reed CE, Koh S, Brooks G, Douville EC, Tsen AC, Ott GY, Silvestri GA: What happens to patients undergoing lung cancer surgery? Outcomes and quality of life before and after surgery.

Chest 2002, 122:21-30. PubMed Abstract | Publisher Full Text

Return to text
El-Sherif A, Gooding WE, Santos R, Pettiford B, Ferson PF, Fernando HC, Urda SJ, Luketich JD, Landreneau RJ: Outcomes of sublobar resection versus lobectomy for stage I non-small cell lung cancer: a 13-year analysis.

Ann Thorac Surg 2006, 82:408-415.

discussion 415–406
PubMed Abstract | Publisher Full Text

Return to text
Qiao X, Tullgren O, Lax I, Sirzen F, Lewensohn R: The role of radiotherapy in treatment of stage I non-small cell lung cancer.

Lung Cancer 2003, 41:1-11. PubMed Abstract | Publisher Full Text

Return to text
Saunders M, Dische S, Barrett A, Harvey A, Griffiths G, Palmar M: Continuous, hyperfractionated, accelerated radiotherapy (CHART) versus conventional radiotherapy in non-small cell lung cancer: mature data from the randomised multicentre trial. CHART Steering committee.

Radiother Oncol 1999, 52:137-148. PubMed Abstract | Publisher Full Text

Return to text
Withers HR, Taylor JM, Maciejewski B: The hazard of accelerated tumor clonogen repopulation during radiotherapy.

Acta Oncol 1988, 27:131-146. PubMed Abstract | Publisher Full Text

Return to text
Lax I, Panettieri V, Wennberg B, Amor Duch M, Naslund I, Baumann P, Gagliardi G: Dose distributions in SBRT of lung tumors: Comparison between two different treatment planning algorithms and Monte-Carlo simulation including breathing motions.

Acta Oncol 2006, 45:978-988. PubMed Abstract | Publisher Full Text

Return to text
McGarry RC, Papiez L, Williams M, Whitford T, Timmerman RD: Stereotactic body radiation therapy of early-stage non-small-cell lung carcinoma: phase I study.

Int J Radiat Oncol Biol Phys 2005, 63:1010-1015. PubMed Abstract | Publisher Full Text

Return to text
Timmerman R, McGarry R, Yiannoutsos C, Papiez L, Tudor K, DeLuca J, Ewing M, Abdulrahman R, DesRosiers C, Williams M, Fletcher J: Excessive toxicity when treating central tumors in a phase II study of stereotactic body radiation therapy for medically inoperable early-stage lung cancer.

J Clin Oncol 2006, 24:4833-4839. PubMed Abstract | Publisher Full Text

Return to text
Timmerman R, Papiez L, McGarry R, Likes L, DesRosiers C, Frost S, Williams M: Extracranial stereotactic radioablation: results of a phase I study in medically inoperable stage I non-small cell lung cancer.

Chest 2003, 124:1946-1955. PubMed Abstract | Publisher Full Text

Return to text
Timmerman RD, Park C, Kavanagh BD: The North American experience with stereotactic body radiation therapy in non-small cell lung cancer.

J Thorac Oncol 2007, 2:S101-112. PubMed Abstract | Publisher Full Text

Return to text
Collins BT, Erickson K, Reichner CA, Collins SP, Gagnon GJ, Dieterich S, McRae DA, Zhang Y, Yousefi S, Levy E, Chang T, Jamis-Dow C, Banovac F, Anderson ED: Radical stereotactic radiosurgery with real-time tumor motion tracking in the treatment of small peripheral lung tumors.

Radiat Oncol 2007, 2:39. PubMed Abstract | BioMed Central Full Text | PubMed Central Full Text

Return to text
Wong KH, Dieterich S, Tang J, Cleary K: Quantitative measurement of CyberKnife robotic arm steering.

Technol Cancer Res Treat 2007, 6:589-594. PubMed Abstract | Publisher Full Text

Return to text
Giraud P, Antoine M, Larrouy A, Milleron B, Callard P, De Rycke Y, Carette MF, Rosenwald JC, Cosset JM, Housset M, Touboul E: Evaluation of microscopic tumor extension in non-small-cell lung cancer for three-dimensional conformal radiotherapy planning.

Int J Radiat Oncol Biol Phys 2000, 48:1015-1024. PubMed Abstract | Publisher Full Text

Return to text
Goldstein NS, Ferkowicz M, Kestin L, Chmielewski GW, Welsh RJ: Wedge resection margin distances and residual adenocarcinoma in lobectomy specimens.

Am J Clin Pathol 2003, 120:720-724. PubMed Abstract | Publisher Full Text

Return to text
Colice GL, Shafazand S, Griffin JP, Keenan R, Bolliger CT: Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: ACCP evidenced-based clinical practice guidelines.

Chest 2nd edition. 2007, 132:161S-177S. PubMed Abstract | Publisher Full Text

Return to text
Banovac F, McRae D, Dieterich S, Wong K, Dias L, Chang T: Percutaneous Placement of Fiducial Markers for Thoracic Malignancies. In Robotic Radiosurgery: Treating Tumors that Move with Respiration. Edited by Urschel HC, Kresel JJ, Luketich JD, et al. Berlin: Springer-Verlag; 2007:15-29.

Return to text
Yousefi S, Collins BT, Reichner CA, Anderson ED, Jamis-Dow C, Gagnon G, Malik S, Marshall B, Chang T, Banovac F: Complications of thoracic computed tomography-guided fiducial placement for the purpose of stereotactic body radiation therapy.

Clin Lung Cancer 2007, 8:252-256. PubMed Abstract | Publisher Full Text

Return to text
Program, CTE: Common Terminology Criteria for Adverse Events, Version 3.0. DCTD N, NIH, DHHS; 2006.

Return to text
Wisnivesky JP, Yankelevitz D, Henschke CI: The effect of tumor size on curability of stage I non-small cell lung cancers.

Chest 2004, 126:761-765. PubMed Abstract | Publisher Full Text

Return to text
Ketchedjian A, Daly BD, Fernando HC, Florin L, Hunter CJ, Morelli DM, Shemin RJ: Location as an important predictor of lymph node involvement for pulmonary adenocarcinoma.

J Thorac Cardiovasc Surg 2006, 132:544-548. PubMed Abstract | Publisher Full Text

Return to text
Onishi H, Araki T, Shirato H, Nagata Y, Hiraoka M, Gomi K, Yamashita T, Niibe Y, Karasawa K, Hayakawa K, Takai Y, Kimura T, Hirokawa Y, Takeda A, Ouchi A, Hareyama M, Kokubo M, Hara R, Itami J, Yamada K: Stereotactic hypofractionated high-dose irradiation for stage I nonsmall cell lung carcinoma: clinical outcomes in 245 subjects in a Japanese multiinstitutional study.

Cancer 2004, 101:1623-1631. PubMed Abstract | Publisher Full Text

Return to text
Barton M: Tables of equivalent dose in 2 Gy fractions: a simple application of the linear quadratic formula.

Int J Radiat Oncol Biol Phys 1995, 31:371-378. PubMed Abstract | Publisher Full Text

Return to text
Group LCS: Effects of postoperative mediastinal radiation on completely resected stage II and stage III epidermoid cancer of the lung.

N Engl J Med 1986, 315:1377-1381. PubMed Abstract

Return to text
Keller SM, Adak S, Wagner H, Herskovic A, Komaki R, Brooks BJ, Perry MC, Livingston RB, Johnson DH: A randomized trial of postoperative adjuvant therapy in patients with completely resected stage II or IIIA non-small-cell lung cancer. Eastern Cooperative Oncology Group.

N Engl J Med 2000, 343:1217-1222. PubMed Abstract | Publisher Full Text

Return to text
Papiez L, Timmerman R, DesRosiers C, Randall M: Extracranial stereotactic radioablation: physical principles.

Acta Oncol 2003, 42:882-894. PubMed Abstract | Publisher Full Text

Return to text
Aoki T, Nagata Y, Negoro Y, Takayama K, Mizowaki T, Kokubo M, Oya N, Mitsumori M, Hiraoka M: Evaluation of lung injury after three-dimensional conformal stereotactic radiation therapy for solitary lung tumors: CT appearance.

Radiology 2004, 230:101-108. PubMed Abstract | Publisher Full Text

Return to text
Kimura T, Matsuura K, Murakami Y, Hashimoto Y, Kenjo M, Kaneyasu Y, Wadasaki K, Hirokawa Y, Ito K, Okawa M: CT appearance of radiation injury of the lung and clinical symptoms after stereotactic body radiation therapy (SBRT) for lung cancers: are patients with pulmonary emphysema also candidates for SBRT for lung cancers?

Int J Radiat Oncol Biol Phys 2006, 66:483-491. PubMed Abstract | Publisher Full Text

Return to text
Takeda A, Kunieda E, Takeda T, Tanaka M, Sanuki N, Fujii H, Shigematsu N, Kubo A: Possible Misinterpretation of Demarcated Solid Patterns of Radiation Fibrosis on CT Scans as Tumor Recurrence in Patients Receiving Hypofractionated Stereotactic Radiotherapy for Lung Cancer.

Int J Radiat Oncol Biol Phys 2008, 70:1057-1065. PubMed Abstract | Publisher Full Text

Return to text
Takeda T, Takeda A, Kunieda E, Ishizaka A, Takemasa K, Shimada K, Yamamoto S, Shigematsu N, Kawaguchi O, Fukada J, Ohashi T, Kuribayashi S, Kubo A: Radiation injury after hypofractionated stereotactic radiotherapy for peripheral small lung tumors: serial changes on CT.

AJR Am J Roentgenol 2004, 182:1123-1128. PubMed Abstract | Publisher Full Text

Return to text
Hoopes DJ, Tann M, Fletcher JW, Forquer JA, Lin PF, Lo SS, Timmerman RD, McGarry RC: FDG-PET and stereotactic body radiotherapy (SBRT) for stage I non-small-cell lung cancer.

Lung Cancer 2007, 56:229-234. PubMed Abstract | Publisher Full Text

Return to text
Ballonoff A, Kavanagh B, Schefter T: The effect of novel molecularly targetted agents on normal lung after SBRT to pulmonary maignancies.

8th International Stereotactic Radiosurgery Society Congress. San Francisco, CA 2007.

Return to text
Wang JS, Abboud RT, Wang LM: Effect of lung resection on exercise capacity and on carbon monoxide diffusing capacity during exercise.

Chest 2006, 129:863-872. PubMed Abstract | Publisher Full Text

Return to text
Le QT, Loo BW, Ho A, Cotrutz C, Koong AC, Wakelee H, Kee ST, Constantinescu D, Whyte RI, Donington J: Results of a phase I dose-escalation study using single-fraction stereotactic radiotherapy for lung tumors.

Journal of Thoracic Oncology 2006, 1:802-809. PubMed Abstract | Publisher Full Text

Return to text
Pennathur A, Luketich JD, Burton S, Abbas G, Heron DE, Fernando HC, Gooding WE, Ozhasoglu C, Ireland J, Landreneau RJ, Christie NA: Stereotactic radiosurgery for the treatment of lung neoplasm: initial experience.

Ann Thorac Surg 2007, 83:1820-1824.

discussion 1824–1825
PubMed Abstract | Publisher Full Text

Return to text
Brown WT, Wu X, Amendola B, Perman M, Han H, Fayad F, Garcia S, Lewin A, Abitbol A, de la Zerda A, Schwade JG: Treatment of early non-small cell lung cancer, stage IA, by image-guided robotic stereotactic radioablation – CyberKnife.

Cancer J 2007, 13:87-94. PubMed Abstract | Publisher Full Text

Return to text
Nyman J, Johansson KA, Hulten U: Stereotactic hypofractionated radiotherapy for stage I non-small cell lung cancer – mature results for medically inoperable patients.

Lung Cancer 2006, 51:97-103. PubMed Abstract | Publisher Full Text

Return to text
Anantham D, Feller-Kopman D, Shanmugham LN, Berman SM, DeCamp MM, Gangadharan SP, Eberhardt R, Herth F, Ernst A: Electromagnetic navigation bronchoscopy-guided fiducial placement for robotic stereotactic radiosurgery of lung tumors: a feasibility study.

Chest 2007, 132:930-935. PubMed Abstract | Publisher Full Text

Return to text
Fu D, Kahn R, Wang B, Wang H, Mu Z, Park J, Kuduvalli G, Maurer CR: Xsight Lung Tracking System: A Fiducial-less Method for Respiratory Motion Tracking. In Robotic Radiosurgery: Treating Tumors that Move with Respiration. Edited by Urschel HC, Kresl JJ, Luketich JD, et al. Berlin: Springer-Verlag; 2007:15-29.

Return to text
Reichner CA, Collins BT, Gagnon GJ, Malik S, Jamis-Dow C, Anderson ED: The placement of gold fiducials for CyberKnife stereotactic radiosurgery using a modified transbronchial needle aspiration technique.

Journal of Bronchology 2005, 12:193-195. Publisher Full Text

Return to text