Patient Profile Xsight System

Breakthrough Tracking Technology for Tumors of the Spine and Neck

Bill Lehmann was living a life most people would admire. He was working as a graphic artist and, in his spare time, living on a farm, staying busy and spending time outdoors or with his family.

Then, in 1998, concerns developed overnight when he noticed a mass bulging on his abdomen. He immediately went to the hospital where it was revealed that he had a rare type of sarcoma.

"I was told that the condition was terminal, which was surprising because I had previously been healthy," Bill says. He was sent to Saint Louis University Hospital where he met with Frank Johnson, MD, SLUCare general surgeon at SLU Hospital and professor of surgery at Saint Louis University School of Medicine.

"When I first met Lehmann, his diagnosis was retroperitoneal sarcoma, a rare type of cancer in an unfavorable location," Dr. Johnson says. "With the radiation oncology team, we determined an aggressive treatment that included radiation therapy and excision of the tumor and organs adjacent to it."

Bill was tumor-free until 2002 when a lung metastasis was detected. The lesion was found and removed. He remained healthy until 2005, while on vacation in New Mexico, he began having bowel difficulties. He decided to return home and schedule another visit with Dr. Johnson. This time the results revealed that the cancer had recurred in his pelvis.

"At that time the recurrence appeared, Bill had a low probability of cure. After discussing his options, we removed the tumor except the portion attached to his sacrum," says Dr. Johnson.

Although a potentially curative radical surgical procedure was discussed, Bill decided to investigate other options. "In March of 2007, a PET/CT scan revealed that my cancer was spreading,' Bill says. "Although it was no longer operable, I was given the option of trying a new form of radiation, and Dr. Johnson referred me to Dr. Bruce Walz."

Bruce J. Walz, MD, chairman of the department of radiation oncology at Saint Louis University School of Medicine and director of radiation medicine at SLU Hospital offered an encouraging alternative to surgery. Software was being developed for use with the CyberKnife® Robotic Radiosurgery Systems that could help eradicate the cancer in Bill’s pelvis.

Bill became the first patient at SLU Hospital to use the breakthrough in tracking technology known as the Xsight™ tracking system. The Xsight system gave the needed dosage without using gold fiducials placed by invasive measures to orient the multiple radiation beams. Fully integrated with the CyberKnife, the Xsight system tracks lesions throughout the entire spinal region including cervical, thoracic, lumbar and sacral tumors accounting for the non-rigid nature of the spine.

"The Xsight System is the only system that uses internal anatomy to directly track targets with radiosurgery accuracy and precision, decreasing the need of external frames or implanted fiducials," Dr. Walz adds.

The Xsight System registers unique non-rigid and bony anatomy landmarks to track, detect and correct for movement of the spine in real-time throughout the treatment. This tracking innovation enables neurosurgeons, radiation oncologists and medical physicists to easily treat cancerous and benign tumors.

On May 11, Bill underwent the first of five treatments. After each one he was checked for damage to adjacent organs, and he did not have any problems. On July 19, Dr. Walz told Bill that he did not need continue treatments.

"This was a great success for me but it also is a success for so many others. It is important to know that if you are told you have an inoperable tumor, there may be options that can help," Bill says.

Bill had a history of being very active, so being cancer-free was not enough for him. He measured his success by his ability to do his favorite four-mile hike in Colorado. Two months after he has received his final treatments for cancer, Bill made the long trek, not certain if he would finish.

With his wife by his side, Lehmann completed the hike. He’s satisfied that Xsight System has helped him reach this milestone.

*Article can be found in: Together – Fall issue 2007