Stereotactic Ablative Radiotherapy for Early-stage Lung Cancer in Patients With Left Ventricular Assist Device: A...

Area of Science:

• Cardiology
• Radiation Oncology
• Medical Physics

Background:

• Radiotherapy can malfunction cardiac devices; guidelines exist for pacemakers and defibrillators.
• Safety of radiotherapy in patients with implantable left ventricular assist devices (LVADs) is not well-established.
• Early-stage lung cancer patients with LVADs often have comorbidities making them inoperable.

Purpose of the Study:

• To evaluate the safety and efficacy of stereotactic ablative radiotherapy (SABR) using CyberKnife in patients with LVADs.
• To report outcomes of early-stage lung cancer treatment in patients with LVADs.
• To assess LVAD function and adverse events following SABR.

Main Methods:

• Three patients with LVADs and early-stage lung cancer underwent SABR with CyberKnife.
• Total radiation dose ranged from 42-52 Gy in four fractions.
• Treatment plans aimed to limit LVAD radiation dose to below 2 Gy.

Main Results:

• SABR was completed in all patients without acute adverse events or LVAD malfunction.
• No disease progression or chronic adverse events were observed during 3-29 months follow-up.
• LVAD radiation dose was successfully kept below 2 Gy in all cases.

Conclusions:

• SABR using CyberKnife is a safe treatment option for early-stage lung cancer in patients with LVADs.
• Minimizing radiation dose to the LVAD is crucial for patient safety.
• This approach offers a viable treatment for inoperable lung cancer patients with LVADs.