The effect of CyberKnife therapy on pulmonary function tests used for treating non-small cell lung cancer: a retrospective, observational cohort pilot study

Abstract

Introduction

The current standard for treating operable early stage non-small cell lung cancer is surgical resection and for inoperable cases it is external beam radiotherapy. Lung functions are adversely affected with both the above treatments. CyberKnife treatment limits radiation damage by tracking targets moving with each breath. The effect of CyberKnife treatment on pulmonary function tests has not been well documented.

Methods

Lung cancer patients who underwent CyberKnife treatment and had pre- and post-treatment pulmonary function tests were included. Paired t-tests were conducted. We also conducted subgroup analysis.

Results

Thirty-seven patients were included. Median age was 73 years. No statistical difference between mean pre- and post-CyberKnife pulmonary function tests was found.

Discussion

We observed that CyberKnife better preserves lung function status compared to current standards of care. It has shown to have very minimal side effects.

Keywords:

• non-small cell lung cancer
• radiation pneumonitis
• radiotherapy
• pulmonary function tests

Acknowledgments

Rishi Agarwal wishes to thank Dr Babu Paidipaty, a pulmonologist who helped in the understanding of PFTs and was instrumental in manuscript writing. RA also wants to thank Dr Ernie Balcueva who helped in manuscript writing, and Carol Wahl, an administrator at Seton Cancer Institute who was instrumental in data collection.

Authors’ contributions

YHK is the principal author and designed the study. RA is the first author and contributed in data collection, literature search, and manuscript writing. AP, KL, SB, and SV contributed in study design and data collection. PS contributed in data collection and manuscript writing. JC contributed in study design and data analysis.

Authors’ information

YHK is a radiation oncologist at Seton Cancer Institute in Saginaw, Michigan. RA and PS are third year internal medicine residents at Synergy Medical Education Alliance/MSUCHM. AP, KL, SB, and SV are medical students at Michigan State University. JC is a research manager at Synergy Medical Education Alliance/MSUCHM.

Disclosure

Dr Kim is a radiation oncologist at Seton Cancer Institute and uses CyberKnife for his patients. The authors report no conflicts of interest in this work.