Appendix A: Clinical Examples

A 79 year old male presented with increased shortness of breath and mass on a chest xray in February 2015. The mass was located in the left middle lobe and had a diameter of 12mm on a CTscan. Bronchoscopy revealed a squamous cell carcinoma and the PET(CT) scan showed a solitary PET-positive nodule in the lung. The patient had a history of COPD GOLD class III with a FEV1 (forced expiratory volume) of 1130ml (46 % of the predicted value) and a history of cerebrovascular accidents and transient ischemic attack. The ventilation/perfusion scan showed that the right lung contributed 48 % of the ventilation/perfusion capacity while the left lung contributed 42 %. As the patient had mediocre lung function, he was considered inoperable. This patient was referred for curative stereotactic treatment with the CyberKnife.