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Lung Tumor Treatment Options

Discover your lung cancer radiation options

Cyberknife is the first and only Robotic Radiotherapy system for detecting and treating tumors in real time, maintaining sub-millimeter accuracy. This is particularly important for the treatment of lung tumors. Treatments are completed in 5 days or less. Most patients experience minimal to no side effects with a quick recovery time.

*Cyberknife and TrueBeam Lung tumor treatments are covered by Medicare and most all insurances.

What Sets CyberKnife Apart?

CyberKnife Stereotactic
Radiosurgery For Lung Cancer

Learning you have lung cancer is a life changing event. At Spokane CyberKnife Center we understand this and are proud to offer patients new hope with the most advanced non-invasive treatment for removing lung tumor without surgery, and without the complications of regular conventional radiation therapy.

The CyberKnife® Robotic Stereotactic Body Radiotherapy (SBRT) System was cleared by the U.S. Food and Drug Administration in 2001 to treat tumors anywhere in the body, including the lung. Despite its name, the CyberKnife System is not a surgical procedure. In fact, there is no cutting, anesthesia or needles involved. Instead, the CyberKnife System delivers high doses of pin-point radiation directly to lung tumors.

The CyberKnife advanced robotic design, sophisticated tumor tracking and real-time imaging makes Cyberknife the only technology available to treat tumors while in motion and maintain sub-millimeter accuracy. Treatments are completed in just 5 days or less, vs. ordinary conventional radiation therapy treatments that are delivered over 25 to 47 days. The CyberKnife System offers patients who cannot undergo lung cancer surgery due to their poor medical condition, or who refuse surgery, a non-invasive alternative treatment for lung cancer.

*CyberKnife is also used as a conjunctive therapy pre or post surgery and chemotherapy, and is also an excellent treatment option for those patients that can no longer have radiation, due to previous treatments.


Lung Cancer Treatment At Spokane CyberKnife

1. How Does The CyberKnife System Treat Lung Cancer open

The challenge that doctors face with tumors in the lung is that those tumors move as the patient breathes. The CyberKnife® Robotic Stereotactic Body Radiotherapy (SBRT) System, offer patients the most advanced radiosurgery option for the treatment of lung cancer. Unlike regular conventional radiation therapy, the CyberKnife Robotic Radiosurgery System precisely identifies the tumor location as the patient breathes normally, following the patients breathing pattern and treating the tumor maintaining sub-millimeter accuracy.

CyberKnife lung cancer treatments involve a team approach, in which several specialists participate. The team may include:

Once the team is in place, preparations begin for the CyberKnife treatment. Generally there are three steps involved:

As part of the diagnosis, our board certified Radiation Oncologists will identify the location and size of the lung tumor. The CyberKnife System will use only the identifying characteristics of the tumor itself to clearly visualize the tumor within the chest and track the tumor as the patient breathes normally.

Some tumors may require the placement of fiducials within the lung to help the CyberKnife System pinpoint the tumor’s exact location. In that case, the patient will be scheduled for a short outpatient procedure beforehand in which three to five tiny gold seeds — called fiducial markers — are inserted into the tumor or surrounding lung tissue. These markers may be placed by putting a small needle through the chest, guided by CT scan or an ultrasound. Alternatively, a camera might be passed through the patient’s mouth and into the airways or into the esophagus to allow access to the tumor. If fiducials are required, the patient must wait approximately one week before CyberKnife treatment planning can begin to ensure that fiducial movement has stabilized.

*If a patient cannot tolerate the fiducials due to poor health or other conditions Spokane Cyberknife offers the most advanced second option with the gantry designed Truebeam radiation therapy system.

Before CyberKnife lung treatments can begin, patients will be fitted for a special body cradle. The cradle is made of a soft material that molds to the patient’s body and is designed to make treatment more comfortable and to ensure body position is the same for each treatment session. The patient also will be fitted with a special vest, which is worn during CyberKnife treatment and enables the robot to correlate chest motion and breathing patterns with the tumor position. The data generated with the vest allows the CyberKnife robot to precisely follow the tumor’s motion as it delivers each beam of radiation, ensuring safe and accurate radiation delivery.

While lying in the cradle, a CT scan will be performed to locate the patient’s tumor. This CT data will be used by the CyberKnife team to determine the exact size, shape and location of the tumor. An MRI or PET scan also may be necessary to fully visualize the tumor and nearby anatomy. Once the imaging is done, the patient will remove his or her vest and it will be stored with the custom-fit body cradle for use in CyberKnife treatment.

A treatment plan will be specifically designed by a medical physicist in conjunction with our board certified Radiation Oncology physicians. Patients will not need to be present at this time. During treatment planning, the CT, MRI and/or PET scan data will be downloaded into the CyberKnife System’s treatment planning software. The medical team will determine the size of the area to be targeted by radiation and the radiation dose, as well as identifying critical structures – such as the spinal cord or vital organs – where radiation should be minimized.

At this time, the CyberKnife System will be able to calculate the optimal radiation delivery plan to treat the lung tumor(s). Each patient’s unique treatment plan will take full advantage of the CyberKnife System’s extreme maneuverability, allowing for a safe and accurate lung cancer treatment. After the treatment plan is developed, the patient will return to the CyberKnife Center for treatment. The treatment is delivered in one to five sessions.

For most patients, the CyberKnife treatment is a completely pain-free experience. You may dress comfortably in street clothes our center allows our patients to bring music to listen to during the treatment. You also may want to bring something to read or listen to during any waiting time, and be accompanied by a friend or family member to provide support before and after treatment.

When it is time for treatment, the patient will be asked to put on their vest and lie on their custom body cradle. The radiation therapist will ensure the vest is properly adjusted and that the patient is positioned correctly on the treatment couch.

As treatment begins, the location of the lung tumor will be tracked and detected continually as the patient breathes normally. Our cancer experts will be watching every step of the way as the CyberKnife tracks the patient’s lung tumor as it moves, and safely and precisely delivers radiation to it.

The CyberKnife System’s computer-controlled robot will move around the patient’s body to various locations from which it will deliver radiation. At each position, the robot will stop. Then, special software will determine precisely where the radiation should be delivered by correlating breathing motion with the tumor. Nothing will be required of the patient during treatment, except to relax and lie still.

Once treatment is complete, most patients quickly return to their daily routines with little interruption to their normal activities. If treatment is being delivered in stages, the patient will need to return for additional treatments over the next several days as determined by their doctors. After CyberKnife treatments, most patients experience minimal side effects, which typically go away within the first week or two after treatment. Doctors will discuss all possible side effects prior to treatment. In addition, doctors may prescribe medication to control any side effects, should they occur.

After completing CyberKnife radiosurgery treatment, it is important for patients to schedule and attend any follow-up appointments. The patient should be aware that his or her tumor will not suddenly disappear. Response to lung cancer treatment varies from patient to patient. Clinical experience thus far has shown most patients respond very well to CyberKnife treatments. Your physician at Spokane Cyberknife will monitor the outcome in the months and years following your treatment, often using CT scans or PET-CT scans.


2. How Does TrueBeam Treat Lung Cancer? open

RapidArc Lung Cancer Treatment
on Truebeam only at Spokane Cyberknife

Spokane Cyberknife is pleased to announce the arrival of the new TrueBeam™ system to Spokane. TrueBeam™ is an advanced radiotherapy technology for treating cancers throughout the body, including spinal tumors. Spokane Cyberknife is the only center in the United States with not one, but the two most advanced Radiation Treatment Technologies in one center – Cyberknife M6 and Truebeam. Your Cancer Experts at Spokane Cyberknife work with your unique condition to personalize the most effective treatment plan, that at times involves multiple technologies and methodologies, and only Spokane Cyberknife can offer this with the Cyberknife M6 and Truebeam from one center.

TrueBeam can be used for many forms of advanced radiation treatment techniques including:

Because of this, patients can receive the treatment that is best suited for their specific clinical circumstances. Opening up treatment options for patients with cancers of the lung, it targets tumors with accuracy measured in millimeters. With its power and flexibility, our cancer experts can develop treatments that are best suited for patients’ individual circumstances. 

Advanced Features of the leading edge Radiation Therapy Truebeam system:


3. What is Radiosurgery? open
What is Radiosurgery?

Radiosurgery = Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiotherapy (SBRT)

Many cancers cannot be completely eradicated with traditional radiation therapy (RT) techniques. The goal of radiation treatment has always been to maximize the delivery of radiation to tumors while minimizing the amount of radiation to normal tissue. The higher the radiation dose delivered to a tumor, the greater the chance of tumor destruction. Likewise, the lower the radiation dose delivered to surrounding normal tissue, the less destruction. Historically, the available technology, found at other centers, was unable to accurately deliver high dose radiation to a tumor without also affecting the surrounding tissue. To minimize collateral damage to the surrounding tissues, radiation oncologists traditionally deliver radiation over many sessions, giving low doses each day over usually several weeks, (25 to 45 days). Following each fraction of radiation the normal tissue cells can recover better than many cancerous cells. Over many sessions, the hope is that more tumor cells die than normal tissue cells. Unfortunately, this strategy is often unsuccessful.

With the development of SRS & SBRT, physicians are now able to deliver lethal (surgical) doses of radiation to a tumor with sub-millimeter (surgical) accuracy, in 1 to 5 treatments. This methodology maximizes the amount of radiation going directly to the target tissue (and thus maximizing tumor response rate) while minimizing the radiation exposure to surrounding tissue. This is evidenced in the studies that compare the clinical treatment volume (CTV) to the planning treatment volume (PTV). With SRS & SBRT, unlike RT, the CTV and PTV are more closely aligned, which means that SRS & SBRT is able to precisely deliver lethal doses of radiation to the target tissue. By minimizing the impact on healthy tissue, SRS & SBRT shortens patient recovery time and decreases complication rates.

As technology has continued to evolve advancements have enabled physicians to apply SRS & SBRT to lesions in the body, as well as to lesions in the cranium, head, and neck. Procedures were originally performed on cranial tumors because the technology at the time required a frame, which can easily be screwed into the skull, as with the Gamma Knife. Attempts to develop body frames were cumbersome and unsuccessful. As a result, initially, no technological solution was available to accurately deliver lethal doses of radiation to tumors below the head without also destroying normal tissue.

Then came CyberKnife, the first and only dedicated robotic, SRS & SBRT treatment technology. And for the first time we now have a technology that allows for real time tracking of a tumor regardless of where it is in the body. Physicians are now able to achieve sub-millimeter (.3MM) accuracy in the head, without the frame, by using the anatomical markings of the skull and taking advantage of the stable relationship between the skull and an intracranial tumor. In the same manner, we are now able to use the anatomical markings of the spine to treat spinal lesions. For other tumors in soft tissue throughout the body, we are able to track, in real time, small gold fiducials placed in the tumor to accurately deliver radiosurgical doses.

Over the last 17 years, SRS & SBRT has case study data proving the clinical effectiveness in treating intra-cranial, extra-cranial neck, and body tumors. In many cases SRS & SBRT provides a clinically superior alternative to either surgery or traditional RT for head and body lesions. In some cases, SRS & SBRT is the only effective option. The SRS & SBRT approach allows for dose escalation, hypo-fractionation, and

heterogeneity of dosage within the tumor volume, and improved conformality and accuracy. As a result, SRS & SBRT delivers unique benefits to the patient, including improved tumor response, higher cure rates, improved pain control, success against tumors that had been radio-resistant or had exceeded tolerance levels, reduction in organ damage, and improved tolerance. These unique benefits apply to tumors regardless of their location in the head/neck or body.

Lung Cancer and Tumor Information

Cyberknife Lung Tumor Treatment
Explained by Physicians

Video - Learn More About How CyberKnife Treats Lung Cancer

Lung Tumor Treatment – Cyberknife Patient Education

 CyberKnife M6 Always On Target

Lung Tumor Treatment – Truebeam Patient Education

CyberKnife Case Studies

Radical Cyberknife Radiosurgery with Real-Time Tumor
MotionTracking  for small peripheral Lung Tumors
Georgetown University Hospital – Case Study

Role of Cyberknife SBRT for Lung Tumor Treatment
Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center 
- Rotterdam-The Netherlands