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CyberKnife® frameless image-guided stereotactic radiosurgery with the Synchrony™ Motion Tracking Module in the treatment of small lung tumors

Collins BT, Anderson ED, Margolis M, Jamis-Dow C, Dieterich S, Espinoza DS, Malik S (Georgetown University Hospital, Washington, DC)
        Hypothesis: Early stage non-small cell lung cancer (NSCLC) is a major public health problem. The tumors are aggressive and the patients are typically frail secondary to smoking-related health issues and advanced age. Radical surgery is an effective standard therapy. However, a significant number of patients are not surgical candidates and the postoperative morbidity is significant. Traditional irradiation has been utilized with limited success due to poor local tumor control and significant pulmonary toxicity. Radioablation has been evaluated recently, with promising results. However, broader acceptance has been slowed by its variable, tedious application. The CyberKnife system has been successfully utilized to treat stationary tumors anywhere in the body. With the Synchrony™ Motion Tracking Module, lung tumors that are influenced by the motion of respiration may be treated accurately and effectively with minimal patient discomfort. The system accomplishes this by utilizing a continually updated model predicting target location. This model is generated by the use of continuously sampled surface visible red light emitting tracking markers, as sampled by a camera array and episodically sampled target fiducials as measured by the CyberKnife X-ray targeting system.
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