Endobronchial coil spring fiducial markers for CyberKnife® stereotactic body radiation therapy.

Autor: Casutt A; Department of Pulmonology, University Hospital of Lausanne, CHUV, Lausanne, Switzerland., Noirez L; Department of Pulmonology, University Hospital of Lausanne, CHUV, Lausanne, Switzerland., Bernasconi M; Department of Pulmonology, Ospedale San Giovanni, Bellinzona, Switzerland., Koutsokera A; Department of Pulmonology, University Hospital of Lausanne, CHUV, Lausanne, Switzerland., Beigelman-Aubry C; Department of Radiodiagnostic and Interventional Radiology, University Hospital of Lausanne, CHUV, Lausanne, Switzerland., Kinj R; Department of Radiation Oncology, University Hospital of Lausanne, CHUV, Lausanne, Switzerland., Ozsahin EM; Department of Radiation Oncology, University Hospital of Lausanne, CHUV, Lausanne, Switzerland., Durham AD; Department of Radiation Oncology, University Hospital of Lausanne, CHUV, Lausanne, Switzerland., von Garnier C; Department of Pulmonology, University Hospital of Lausanne, CHUV, Lausanne, Switzerland., Lovis A; Department of Pulmonology, University Hospital of Lausanne, CHUV, Lausanne, Switzerland.
Jazyk: angličtina
Zdroj: Respirology (Carlton, Vic.) [Respirology] 2021 May; Vol. 26 (5), pp. 469-476. Date of Electronic Publication: 2021 Jan 05.
DOI: 10.1111/resp.14006
Abstrakt: Background and Objective: SBRT is an alternative treatment for early-stage inoperable lung cancer. Metallic FM allow to increase tumour tracking precision by CyberKnife®. Currently used techniques for FM placement have many limitations; transthoracic insertion has a high risk for pneumothorax, endovascular insertion requires expertise and dedicated angiography infrastructure and endobronchial linear-gold FM dislocate frequently. This is the first study to assess the safety and efficacy of cs-FM endobronchial insertion under fluoroscopy with or without R-EBUS assessment.
Methods: We retrospectively evaluated all consecutive patients undergoing endobronchial cs-FM placement for at least one PPL <25 mm between 10.2015 and 12.2019. TBB of the PPL were performed in case of a typical R-EBUS signal. PPL tracking accuracy by CyberKnife, complications, cs-FM migration rate and procedure duration were analysed.
Results: A total of 52 patients were treated during 55 procedures and 207 cs-FM were placed in 70 PPL. Tracking was successful for 65 of 70 (93%) PPL. R-EBUS was performed for 33 (47%) PPL and TBB for 9 (13%) PPL. Bronchospasm occurred once and any other complications were observed. Migration of cs-FM occurred in 16 of 207 (8%) cs-FM. Migration was more frequent when the target was in a previously irradiated area (P = 0.022). The median bronchoscopy duration was 31.5 min (n = 48 procedures).
Conclusion: Bronchoscopic cs-FM placement is a rapid and safe procedure. It is associated with a low migration rate and allows precise SBRT delivery. Previous irradiation of the PPL was associated with a higher migration rate.
(© 2021 Asian Pacific Society of Respirology.)
Databáze: MEDLINE
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