Endobronchial coil spring fiducial markers for CyberKnife® stereotactic body radiation therapy.
airway markers
bronchoscopy and interventional techniques
lung cancer
metallic fiducial marker
stereotactic body radiation therapy
Journal
Respirology (Carlton, Vic.)
ISSN: 1440-1843
Titre abrégé: Respirology
Pays: Australia
ID NLM: 9616368
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
revised:
15
11
2020
received:
18
08
2020
accepted:
08
12
2020
pubmed:
7
1
2021
medline:
6
10
2021
entrez:
6
1
2021
Statut:
ppublish
Résumé
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. 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. 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). 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.
Sections du résumé
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.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
469-476Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 Asian Pacific Society of Respirology.
Références
Kilby W, Dooley JR, Kuduvalli G, Sayeh S, Maurer CR Jr. The CyberKnife robotic radiosurgery system in 2010. Technol. Cancer Res. Treat. 2010; 9: 433-52.
El Shafie RA, Tonndorf-Martini E, Schmitt D, Celik A, Weber D, Lang K, König L, Höne S, Forster T, von Nettelbladt B et al. Single-isocenter volumetric modulated arc therapy vs CyberKnife M6 for stereotactic radiosurgery of multiple brain metastases. Front. Oncol. 2020; 10: 568.
Prunaretty J, Boisselier P, Aillères N, Riou O, Simeon S, Bedos L, Azria D, Fenoglietto P. Tracking, gating, free-breathing, which technique to use for lung stereotactic treatments? A dosimetric comparison. Rep. Pract. Oncol. Radiother. 2019; 24: 97-104.
Ding C, Chang CH, Haslam J, Timmerman R, Solberg T. A dosimetric comparison of stereotactic body radiation therapy techniques for lung cancer: robotic versus conventional linac-based systems. J. Appl. Clin. Med. Phys. 2010; 11: 3223: 212-24.
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: 252-6.
Kothary N, Heit JJ, Louie JD, Kuo WT, Loo BW Jr, Koong A, Chang DT, Hovsepian D, Sze DY, Hofmann LV. Safety and efficacy of percutaneous fiducial marker implantation for image-guided radiation therapy. J. Vasc. Interv. Radiol. 2009; 20: 235-9.
Bhagat N, Fidelman N, Durack JC, Collins J, Gordon RL, LaBerge JM, Kerlan RK Jr. Complications associated with the percutaneous insertion of fiducial markers in the thorax. Cardiovasc. Intervent. Radiol. 2010; 33: 1186-91.
Mongeon M, Thibault F, Chartrand-Lefebvre C, Gorgos AB, Soulez G, Filion E, Therasse E. Safety and efficacy of endovascular fiducial marker insertion for CyberKnife stereotactic radiation therapy planning in early-stage lung cancer. J. Vasc. Interv. Radiol. 2017; 28: 1090-7.
Prévost JBG, Nuyttens JJ, Hoogeman MS, Pöll JJ, van Dijk LC, Pattynama PMT. Endovascular coils as lung tumor markers in real-time tumor tracking stereotactic radiotherapy: preliminary results. Eur. Radiol. 2008; 18: 1569-76.
Schroeder C, Hejal R, Linden PA. Coil spring fiducial markers placed safely using navigation bronchoscopy in inoperable patients allows accurate delivery of CyberKnife stereotactic radiosurgery. J. Thorac. Cardiovasc. Surg. 2010; 140: 1137-42.
Zhang W, Chen S, Dong X, Lei P. Meta-analysis of the diagnostic yield and safety of electromagnetic navigation bronchoscopy for lung nodules. J. Thorac. Dis. 2015; 7: 799-809.
Belanger AR, Burks AC, Chambers DM, Ghosh S, MacRosty CR, Conterato AJ, Rivera MP, Akulian JA. Peripheral lung nodule diagnosis and fiducial marker placement using a novel tip-tracked electromagnetic navigation bronchoscopy system. J. Bronchology Interv. Pulmonol. 2019; 26: 41-8.
Lachkar S, Guisier F, Roger M, Obstoy B, Bota S, Lerouge D, Piton N, Thiberville L, Salaün M. Assessment of per-endoscopic placement of fiducial gold markers for small peripheral lung nodules < 20 mm before stereotactic radiation therapy. Chest 2018; 153: 387-94.
Harley DP, Krimsky WS, Sarkar S, Highfield D, Aygun C, Gurses B. Fiducial marker placement using endobronchial ultrasound and navigational bronchoscopy for stereotactic radiosurgery: an alternative strategy. Ann. Thorac. Surg. 2010; 89: 368-73.
Minnich DJ, Bryant AS, Wei B, Hinton BK, Popple RA, Cerfolio RJ, Dobelbower MC. Retention rate of electromagnetic navigation bronchoscopic placed fiducial markers for lung radiosurgery. Ann. Thorac. Surg. 2015; 100: 1163-5.
Jackson P, Steinfort DP, Kron T, Siva S. Practical assessment of bronchoscopically inserted fiducial markers for image guidance in stereotactic lung radiotherapy. J. Thorac. Oncol. 2016; 11: 1363-8.
Steinfort DP, Siva S, Kron T, Chee RR, Ruben JD, Ball DL, Irving LB. Multimodality guidance for accurate bronchoscopic insertion of fiducial markers. J. Thorac. Oncol. 2015; 10: 324-30.
Du Rand IA, Blaikley J, Booton R, Chaudhuri N, Gupta V, Khalid S, Mandal S, Martin J, Mills J, Navani N et al.; British Thoracic Society Bronchoscopy Guideline Group. British thoracic society guideline for diagnostic flexible bronchoscopy in adults. Thorax 2013; 68: i1-i44.
Steinfort DP, Khor YH, Manser RL, Irving LB. Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis. Eur. Respir. J. 2011; 37: 902-10.