Abstract:
Objective This work aimed to evaluate the clinical Results of the cyberknife stereotactic ablative radiotherapy (SABR) treatment of 39 patients suffering from mediastinal lymph-node metastases of malignant tumors.
Methods Cyberknife SABR was consecutively conducted on 39 cancer patients with 49 mediastinal nodal metastases. Planning target volume ranged from 3.7 ml to 78.5 ml (median 12.3 ml), and total prescribed dosage ranged from 12 Gv to 60 Gy with 1 fraction to 10 fractions.
Results Follow-up assessment was performed from 3 mos to 67 mos (median 20). The most commonly observed toxicity was Grade 1/2 tracheal and esophageal injuries, which occurred in 11 of the 39 patients. Grade 3/4 toxicity occurred in 3 of the 39 patients. Patients with dyspnea, superior vena cava syndrome, and chest pain achieved significant improvements in health status (response rate 83.3%). Total effective rate (complete and partial response) was 90% for the 49 discrete lesions (29 complete responses, 15 partial responses, and 5 stable diseases), The 1 and 2 yr overall survival rates were 84.6% and 68.3%, respectively. Patients with metastasized nodes below 3 cm in diameter attained superior overall survival times compared with those with metastasized nodes above 3 cm in diameter (P=0.029).
Conclusion Cyberknife SABR for the mediastinal metastases carcinoma showed a favourable outcome and minimal toxicity.