A new era of thoracic oncology? Ex-vivo stereotactic ablative radiosurgery within Ex-vivo Lung Treatment System as a hybrid therapy for unresectable locally advanced pulmonary malignancies

C Henkenberens; N Zinne; C Biancosino; K Höffler; J D Schmitto; M Bremer; A Haverich; M Krüger

doi:10.1016/j.mehy.2016.04.029

A new era of thoracic oncology? Ex-vivo stereotactic ablative radiosurgery within Ex-vivo Lung Treatment System as a hybrid therapy for unresectable locally advanced pulmonary malignancies

Med Hypotheses. 2016 Jul:92:31-4. doi: 10.1016/j.mehy.2016.04.029. Epub 2016 Apr 16.

Authors

C Henkenberens¹, N Zinne², C Biancosino³, K Höffler⁴, J D Schmitto⁵, M Bremer⁶, A Haverich⁷, M Krüger⁸

Affiliations

¹ Department of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: [email protected].
² Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: [email protected].
³ Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: [email protected].
⁴ Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: [email protected].
⁵ Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: [email protected].
⁶ Department of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: [email protected].
⁷ Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: [email protected].
⁸ Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: [email protected].

PMID: 27241251
DOI: 10.1016/j.mehy.2016.04.029

Abstract

The concept of oligometastases is the medical rationale for a local treatment of a limited number of metastatic tumor manifestations. Patients with pulmonary oligometastases are candidates for surgery or radiotherapy, however there are a number of technical issues that limit treatment. Technical issues relating to radiotherapy include organs at risk of irradiation, chest wall toxicity and decreased precision of tumor targeting because of breathing movements. Technical issues relating to surgery include loss of lung parenchyma and unresectability. We propose the hypothesis that ex-vivo radiosurgery as new hybrid technique in thoracic oncology has the capability to overcome these technical issues and will expand the medical spectrum in thoracic oncology. The proposed - highly complex - technique consists of surgical lung explantation, followed by stereotactic radiotherapy during ex-vivo perfusion followed by surgical re-implantation.

MeSH terms

Animals
Equipment Design
Humans
Lung Neoplasms / radiotherapy*
Lung Neoplasms / surgery*
Magnetic Resonance Imaging
Medical Oncology / instrumentation*
Medical Oncology / methods*
Neoplasm Metastasis
Perfusion
Polymethyl Methacrylate / chemistry
Radiosurgery / methods*
Swine
Tomography, X-Ray Computed

Substances

Polymethyl Methacrylate