Electromagnetic Transponder Based Tracking and Gating in the Radiotherapeutic Treatment of Thoracic Malignancies.

Purpose: This report details our institutional workflow and technique for use of the Calypso electromagnetic transponder system with respiratory gating for localization and tracking of lung tumors during stereotactic radiation therapy for early stage thoracic malignancies.

Methods And Materials: Sixteen patients underwent bronchoscopic fiducial placement of 3 transponders in small airways in proximity to the primary tumor. Transponders were placed <19 cm from the most anterior skin location of the patient for appropriate tracking functionality.

Minimally invasive chest wall resection: sparing the overlying, uninvolved extrathoracic musculature of the chest.

Patients with non-small cell lung cancer (NSCLC) that invades the chest wall are often thought not to benefit from minimally invasive surgery. Frequently, open techniques involve cutting noninvolved extrathoracic muscles that lie over the cancer to gain access to resect the ribs that contain malignancy. We reviewed a new technique involving 21 patients that eliminates cutting of the extrathoracic (trapezius, rhomboids, serratus anterior) muscles.