Advancements in treatment options for lung cancer have expanded greatly in recent years from lobectomy, chemotherapy and traditional radiation therapy to robotic-assisted thoracic surgery, stereotactic ablative radiotherapy, targeted therapy and immunotherapy.
At McLeod Regional Medical Center, one form of lung cancer treatment that is improving patient outcomes involves stereotactic ablative radiotherapy (SABR). This promising treatment option allows the radiation oncology team to deliver precisely targeted radiation with submillimeter accuracy in a fewer number of treatments, offering patients more convenience and a better quality of life.
SABR also provides a potential curative treatment option for patients with early stage lung cancer who might not be candidates for surgery because of other medical conditions, such as heart disease, or the tumor is inoperable because of its location.
During stereotactic ablative radiotherapy, the radiation is focused onto the area of disease to completely cover it with the dose necessary to overwhelm all of the abilities of a cancer cell to defend itself. This noninvasive, painless treatment utilizes a set of multiple beams that intersect at a single point on the tumor. With pinpoint precision, the beams remain focused on the area as the linear accelerator rotates 360 degrees around the patient.
Precise patient setup, tumor targeting and continuous tracking of patient movement is accomplished through image guided radiotherapy (IGRT). For example, when treating non-small-cell lung cancer, we can track and freeze a tumor’s motion as the patient breathes to accurately treat the tumor in the lung with a very high dose of radiation while sparing the normal tissue surrounding it.
Utilizing this system offers a benefit to the patient with lung cancer, because it requires fewer treatment sessions, and that saves patients time. This form of radiation therapy can be performed in as few as three to five sessions as opposed to 25 to 30 treatments with conventional radiation.
Another advantage of SABR for patients includes the ability to receive treatment close to home. Understanding that a cancer diagnosis is a life-changing event for all of our patients, the decision by McLeod to invest in the technology to plan and accurately deliver this type of cancer treatment means patients do not have to leave home to receive the highest level of care.
During the past five years, McLeod has installed three TrueBeam linear accelerators. Advantages of these linear accelerators include the degree of precision offered; the submillimeter accuracy that minimizes harm to healthy tissue and adjacent critical structures, such as the spinal cord or lungs; and a platform that moves in six dimensions to position the patient in the best possible way for treatment.
Featuring advanced imaging capabilities such as cone-beam CT, these linear accelerators also allow the team to conform the radiation dose to the tumor target, verify the location and shape of the tumor and make adjustments during treatment. This drastically decreases the treatment time, which increases patient comfort without compromising the quality of the treatment delivered.
In addition to treating primary cancers such as small lesions in the lung, adrenal gland, prostate and liver, SABR is used to treat metastatic cancer. Metastatic disease occurs when cancer cells break away from where they were first formed, travel through the blood or lymph system and form new tumors (mets) in other parts of the body, such as the brain, lung, spine and liver. The met is the same type of cancer (i.e., lung or breast) but in an area away from the location of the primary disease.
Recently, a study published in The Lancet Oncologydetailed how SABR nearly doubles survival in patients with Stage 1 inoperable lung cancer when compared with standard radiation treatment. Additionally, when treating lung cancer, SABR has been shown to be comparable to surgery and less traumatic to the body. This is promising news, and we believe in the not too distant future SABR will become a less-invasive alternative to lung cancer surgery.
In April of this year, our radiation oncology team received international recognition for the highest level of safety and effectiveness in care. Following a rigorous and voluntary audit conducted by an independent third-party panel of experts in radiation oncology, McLeod is now distinguished as a cancer center that exceeds standard measurements for delivery of quality care. One of only eight Novalis Certified Cancer Centers in the United States, McLeod is the only such cancer center in South Carolina. The hospital also represents one of only 46 certified centers worldwide.
In addition to this certification, McLeod Radiation Oncology has been accredited by the American College of Radiology-Radiation Oncology Practice Accreditation program (ACR ROPA) since 2013. Of the roughly 2,500 radiation centers in the United States, only 710 of those, or 26 percent, are accredited by the American College of Radiology.
Dr. Larry D. Grubb has been caring for patients at the McLeod Center for Cancer Treatment and Research since 1992.