Treatment of central lung cancer with speed knife

The treatment of lung cancer mainly relies on surgery, radiotherapy, and chemotherapy, with surgery remaining the most effective method for early and middle-stage cases. However, central lung cancer — which occurs in the bronchi, lobular bronchus, and lung bronchus, and consists mostly of squamous carcinoma and undifferentiated carcinoma — presents a unique challenge due to its proximity to the hilum. Because of this special location, traditional surgical procedures are difficult to implement, the surgical effect is not ideal, and the risk of inducing bone metastasis is elevated, leaving clinicians with very limited options historically.

Even with improvements in lung surgery technology, such as the use of intrapericardial pneumonectomy to expand surgical indications and increase resection rates, the efficacy of surgical resection for central lung cancer remains poorly evaluated — particularly for patients with advanced disease, for whom surgery is generally discouraged. In most cases, even when a thoracotomy is performed, it amounts to exploratory or palliative surgery. Older patients with compromised cardiac function face additional risk, as surgical anesthesia itself becomes a serious concern.

The birth of EDGE technology has completely changed the treatment landscape for central lung cancer. Developed by American company Varian and approved by the US FDA on January 23, 2013, the EDGE Radiosurgery system is by far the most advanced non-invasive tumor removal technology available. It can effectively remove tumor lesions from within the body without any damage to the patient's body or immune system, delivering treatment outcomes comparable to surgery but without the associated trauma and side effects.

EDGE uses the FDA-approved Calypso GPS for the Body system combined with a surface beam monitoring system to dynamically track and lock tumors in real time at a frequency of up to 10 milliseconds — even when tumors shift position during treatment. Combined with a new generation of IGRT image guidance technologies and a unique high-intensity HD-MLC collimator operating at up to 2,400 MU/min, the system removes tumor tissue with near-complete precision and almost no residue. The world's first EDGE system was installed at Henry Ford Health System in the United States in September 2013, with the first operation performed in March 2014.

EDGE is particularly suitable for patients with tumors that were previously considered inoperable, including central lung cancer, brain tumors, spine tumors, head and neck tumors, pancreatic cancer, and prostate cancer. The entire treatment process is non-invasive, requires no anesthesia, and involves no hospitalization. Each treatment session lasts only 8 to 20 minutes, with a maximum of 5 sessions conducted once daily on consecutive days. It produces almost no side effects, causes minimal damage to important organs, and has virtually no impact on the body's anti-cancer immune system.

A compelling real-world example demonstrates the effectiveness of EDGE for central lung cancer with brain metastases. A 53-year-old male patient suffering from non-small cell lung cancer with multiple metastatic brain tumors underwent EDGE non-invasive radiosurgery at Henry Ford Hospital in early June 2014. He received three consecutive daily EDGE treatments, each lasting approximately 12 minutes. His headache was noticeably relieved after the very first session, and his general condition remained good thereafter. At his follow-up MRI examination conducted at a local hospital in Taipei in early September, brain tumors measuring 0.9 and 4 cm³ had almost completely disappeared, and the 6.5 cm³ lung tumor had decreased by more than 98% — a result that would have been extraordinarily difficult to achieve through conventional surgery or standard radiotherapy for a tumor of this location and complexity.