Recurrent Disease
Unfortunately, it is not unusual for bronchogenic carcinoma to recur squarely within a high-dose radiotherapy volume following attempted curative treatment.  These recurrent lesions typically prove unresectable, poorly responsive to chemotherapy, with additional conventional radiation usually proving dangerous and ineffective. Uncontrolled, they may cause serious local complications including post-obstructive pneumonia, hemorrhage and death.

Endobronchial high dose rate (HDR) brachytherapy has been used with reasonable success in these patients (21,22) but the dose distribution is uneven and coverage of the entire recurrent lesion with this technique is usually not achievable. 

CyberKnife® radiosurgery offers a new treatment alternative for these patients, providing spatially superior tumor coverage characteristics compared with HDR brachytherapy, and far better normal tissue sparing than conventional radiotherapy. As such, it offers a potentially valuable new approach to patients who have traditionally had very few effective options, and may be appropriately considered in selected cases for palliative use.