title: 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.
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.
authors.affiliation: Department of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: henkenberens.christoph@mh-hannover.de.
authors.forename: C
authors.initials: C
authors.lastname: Henkenberens
authors.affiliation: Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: zinne.norman@mh-hannover.de.
authors.forename: N
authors.initials: N
authors.lastname: Zinne
authors.affiliation: Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: biancosino.christian@mh-hannover.de.
authors.forename: C
authors.initials: C
authors.lastname: Biancosino
authors.affiliation: Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: hoeffler.klaus@mh-Hannover.de.
authors.forename: K
authors.initials: K
authors.lastname: Höffler
authors.affiliation: Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: Schmitto.Jan@mh-hannover.de.
authors.forename: J D
authors.initials: JD
authors.lastname: Schmitto
authors.affiliation: Department of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: bremer.michael@mh-hannover.de.
authors.forename: M
authors.initials: M
authors.lastname: Bremer
authors.affiliation: Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: haverich.axel@mh-hannover.de.
authors.forename: A
authors.initials: A
authors.lastname: Haverich
authors.affiliation: Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: krueger.Marcus@mh-Hannover.de.
authors.forename: M
authors.initials: M
authors.lastname: Krüger
mesh_terms: D000818:Animals; D004867:Equipment Design; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008495:Medical Oncology / Q000295:instrumentation* / Q000379:methods*; D009362:Neoplasm Metastasis; D010477:Perfusion; D019904:Polymethyl Methacrylate / Q000737:chemistry; D016634:Radiosurgery / Q000379:methods*; D013552:Swine; D014057:Tomography, X-Ray Computed
chemical_list: D019904:Polymethyl Methacrylate