ACCP: Robotic radiosurgery may alleviate hilar tumor symptoms

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The use of robotic radiosurgery to treat hilar tumors relieved pain and improved breathing for patients, while leaving overall survival unaffected, according to a study presented Nov. 2 at the annual meeting for the American College of Chest Physicians (ACCP) in Vancouver, Canada.

The research represents the first study to use robotic radiosurgery for the treatment of hilar lung tumors, which abut or invade the main stem bronchus.

Twenty-four patients, four with inoperable primary lung tumors and 20 with hilar lung metastases, were followed for a median of 12 months. Mean esophageal radiation dose administered was 27 Gy and mean lung dose was 45 Gy, delivered across five fractions. Patients were followed up using PET/CT imaging at three to six month intervals.

Overall one year survival was 61 percent, with local tumor control measured at 71 percent. The majority of deaths were attributed to metastatic disease.

Acknowledging the poor one-year control and survival rates, the authors did cite symptomatic relief reported by patients during and after therapy. "Patients reported improvement with coughing, breathing, and they reported less pain," stated the study's lead author Brian Collins, MD, a radiation oncologist at Lombardi Comprehensive Cancer Center at Georgetown University in Washington, D.C.

"We'd like to investigate outcomes with increased radiation doses to see if we can improve local control and overall survival rates," explained Collins. "And we'd like to study the impact of administering a drug to make the tumors more sensitive to radiation."

"This is an important first step that gives us a new option to treat potentially morbid hilar tumors," Collins concluded.