Posts Tagged ‘non-small cell cancer’
First use of Symmetry motion management software in Australasia makes 75-year-old’s treatment more precise
To successfully irradiate a moving lung tumor requires doctors to find a way either to stop the tumor from moving or a means to compensate for its motion. On September 8, clinicians at Prince of Wales Hospital Cancer Centre (Randwick, New South Wales) chose the second option, using Elekta’s Symmetry™ respiratory motion management software for the first time to treat a 75-year-old male patient with a tumor that moved back and forth with his breathing. Symmetry enables physicians to visualize the tumor’s complete range of motion and then ensures that the tumor is always positioned in the treatment beam regardless of its movement.
Accurate treatment of this patient’s tumor, a primary, malignant non-small cell cancer (NSCLC) in the upper lobe of the left lung, was critical due to the therapy approach used. Prince of Wales Hospital clinicians used hypofractionated Stereotactic Body Radiation Therapy (SBRT), which called for precise immobilization of the patient’s body to enable just three treatment sessions (i.e., fractions), each using a highly potent radiation dose.
“The whole concept of hypofractionated stereotactic treatment relies on accurate and precise planning datasets and treatment verification systems,” says Wenchang Wong, M.D., radiation oncologist at Prince of Wales Hospital. “Symmetry afforded us clear visualization of the tumor at the treatment couch and gave me confidence that treatment delivery would be safe and reproducible for this patient.”
Symmetry, a feature set of Elekta’s X-ray Volume Imaging (XVI) software package, enables clear visualization of moving lung tumors by providing a dynamic fourth dimension (4D) of motion to enhance image guidance with the patient in the treatment position.
“Conventional cone beam CT provides only a static, blurred image of a moving lung tumor that cannot tell us in which part of the respiratory cycle it was captured,” Dr. Wong explains. “Conversely, Symmetry provides a dynamic 4D cine/picture of the movement of the tumor mass throughout the entire respiratory cycle. This is especially important in lung cancer treatment given the natural excursion of the tumor with the breathing cycle. Symmetry enables us to see the tumor’s movement in real time.”
Read more: http://www.elekta.com/healthcare_international_press_release_20071314.php.
Non-Small Cell Cancer of the Lung
Adenocarcinoma is the most common non-small cell cancer of the lung that occurs in the United States. The majority of these cancers develop in the periphery (outer part) of the lung. Since these cancers are in the outer portion of the lung, the patient often does not have any symptoms when the cancer is found on a chest x-ray. Adenocarcinomas tend to metastasize (spread to other parts of the body) to the bone, the central nervous system (the brain and spinal cord), the adrenal glands, the liver and the opposite lung.
Frequently, there is scarring in adenocarcinomas. Sometimes, the cancer arises in an area of old scarring of the lung. In other cases, the scar appears to arise secondary to the growth of the cancer.
Bronchoalveolar carcinoma or alveolar cell carcinoma is a non-small cell carcinoma that can be found throughout the respiratory tract. When it is discovered as a single mass on a patient’s x-ray, this type of lung cancer has an excellent prognosis. Five year survival after surgery is in the 75-90% range. If, however, it is found in its diffuse form (meaning it has spread beyond a single mass), the prognosis is quite poor.
Squamous cell carcinomas comprise 30-40% of non-small cell carcinomas of the lung. This type of cancer tends to be located in the more central portion of the lung. Often, this is in a bronchus (a large airway of the lung). Since these cancers are located near or in these airways, they can cause symptoms earlier in their growth. Coughing and production of phlegm (sputum) that is bloody are common symptoms. The cancer can block airways which can lead to shortness of breath or pneumonia.
Large cell carcinomas represent about 10% of non-small cell cancers of the lung. This form of lung cancer has fewer structural characteristics when viewed under a microscope. It is sometimes difficult to distinguish this form of lung cancer from cancers which have spread to the lung from another place in the body.
Patient history and diagnosis
53-year-old woman presented in February 2005 with repeated chest infection. A CT scan showed a left lung mass and a soft tissue mass in relation to the left hilum. A biopsy showed consistency with non-small cell lung cancer.
The patient had no breathing difficulties and was commenced on down staging chemotherapy to which she had a partial response, with complete disappearance of left hilar mass and reduction of the apical tumor. Surgery was not possible as the tumor lay close to the pericardium and vital structures, primarily spinal cord. The patient was then referred for radiation therapy.
Non-Small Cell Lung Tumor
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This guide contains information on frequently asked questions and information on the treatment process. While this information will not necessarily correspond to the exact process adopted by an individual hospital, we hope it will provide general background information and an indication of a typical treatment process.
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