Cyber Knife For Early Stage Lung Cancer: Ready for Prime Time and Beyond

So What’s Up with the Newest Study?

Treatment with the Cyber Knife is painless.

Treatment with the Cyber Knife is painless.

Researchers once a again showed that Cyber Knife if a superior choice for early stage lung cancer patients. In a landmark study recently published in The Lancet Oncology, physician-researchers reported that early stage lung cancer patients treated with stereotactic ablative body radiotherapy (SABR for short), like that delivered by Cyber Knife, had a 3 year overall survival of 95%.  Surprisingly, early stage lung cancer patients fared much worse with open surgery (lobectomy) with a 3 year overall survival of only 79%.  Cyber Knife treatment stands in stark contrast to lobectomy.  Cyber Knife is a highly specialized form of radiation therapy done on an outpatient basis in 3-5 visits, with no pain and no incisions.  Lobectomy on the other hand is a major operation where surgeons open the chest and remove an entire lobe of the lung, requiring a prolonged hospital stay with all the risks of chest surgery.

Importantly, there were 6 deaths in the surgery group and only one death in the SABR group (The Lancet Oncology June 2015 16(6) 630-637).

Dr. Joe Y Chang, a professor radiation oncology at the world-famous M.D. Anderson Cancer Center said “For the first time, we can say that the 2 therapies are at least equally effective, and that stereotactic ablative radiotherapy appears to be better tolerated and might lead to better survival outcomes for these patients.”

Admittedly, The Lancet Oncology study was small, but the results were stunning as these patients were healthy enough to undergo surgery.  Previously, the majority of early stage lung cancer patients treated by SABR, like that delivered by Cyber Knife, were “medically inoperable” or too sick for surgery. But the patients in the The Lancet Oncology study were part of “randomized trials” whereby patients are selected for surgery or SABR based on a computerized flip of the coin, not by their physicians.

But Can Only 1 Study Change How we Treat Lung Cancer?

This is not the only study that shows that treating early stage lung cancer with the Cyber Knife is far superior to surgery. The Lancet Oncology results complement those reported in a much larger group of early stage lung cancer patients.  Dr. Shirvani and coworkers looked at 9,093 patients with early stage lung cancer who were treated by lobectomy, wedge resection (more limited surgery) or SABR between 2003 to 2009 in the SEER-Medicare database (JAMA Surg Dec 2014 49(12) 1244-1253).

The key fact was that lobectomy was better than wedge resection but SABR appeared to be just as good as lobectomy.

So Why Is This Important for Patients and Physicians to Know?

Modern medicine is keeping people alive longer.  Coupled with advances in lung cancer screening, more and more senior patients will be found with early stage lung cancers.  I believe these studies are telling us that Cyber Knife is a good solution as compared to open surgery. And a solution that does not require a major operation.  No incisions, no pain, and no prolonged hospital stays with a difficult recovery.  By contrast, Cyber Knife is done as an outpatient in 3-5 visits. The patient does not feel anything during treatment. It is painless and quick. All that is required is to lay on a table listening to music.

For more information about early stage lung cancer and Cyber Knife treatments, call me today, Dr. Ed Hughes, at 855-DAYTON1 or email me at