Treatment of lung lesions by stereotactic body radiation therapy after computed tomography guided placement of a Visicoil(®) marker: initial experience

• Published in: Radiologia Vol. 55; no. 3; p. 225
• Main Authors: Fernández-Velilla Peña, M, Rubio Rodríguez, C, Allona Krauel, M, Hernando Requejo, O, Sánchez Saugar, E, Muro de la Fuente, A, Torres Sánchez, M I
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.05.2013
• Subjects: Adult; Aged; Female; Humans; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - surgery; Male; Middle Aged; Radiosurgery - methods; Retrospective Studies; Surgery, Computer-Assisted; Tomography, X-Ray Computed
• ISSN: 1578-178X
• DOI: 10.1016/j.rx.2011.09.020

To describe the technique of stereotactic body radiation therapy (SBRT) of lung lesions after the computed tomography (CT) guided placement of an internal fiducial marker and to assess the results, complications and secondary effects of these procedures. A series of 39 lesions (8 primary and 31 metastases) in 25 patients treated using this procedure were analysed. A CT-guided percutaneous transthoracic puncture was performed for placing the internal marker in the lesion or near to it. The procedure did not require sedation. The marker serves as a guide for the treatment of the lesion using SBRT with respiratory synchronism, which allows the movement of the tumour to be controlled and to decrease the radiation volume, giving high doses with precision to the tumour, and minimal to the surrounding healthy tissue. The only complication of the percutaneous fiducial placement was a pneumothorax in 6 (24%) patients. A pleural drain had to be placed in 3 patients. Local control was achieved in 96.7% of the lesions. The radiation produced a grade 1 asthenia in 1 patient, a grade 2 pneumonitis in one patient and a grade 1 pneumonitis in the remainder. The CT-guided placement of internal markers in lung lesions is a safe technique that may be performed as ambulatory procedure. SBRT with respiratory synchronism allows the dose to the tumour to be increased, and reduces the volume of healthy lung treated, with few secondary effects.