Confronting Complexity: Stereotactic Body Radiation Therapy for Localized Lung Cancer with a Pacemaker.

Introduction: Lung cancer management in patients with pacemakers presents unique challenges. This report examines the utilization of stereotactic body radiation therapy (SBRT) in such a patient population.

Case presentation: A 75-year-old former smoker with a dual-chamber pacemaker presented with inoperable lung adenocarcinoma. SBRT (48 Gy in 4 fractions) was chosen following multidisciplinary consultation and thorough pretreatment evaluation by a rhythmologist to assess pacemaker integrity. Continuous cardiac monitoring during SBRT detected no arrhythmias. Adjuvant therapy consisted of radiotherapy alone due to the patient's health status and limited evidence supporting chemotherapy in this context. At the 18-month follow-up, no cancer recurrence was observed, and regular device checks confirmed pacemaker integrity.

Conclusion: This case demonstrates the successful management of inoperable lung adenocarcinoma with SBRT in a patient with a pacemaker. It underscores the significance of interdisciplinary cooperation and careful patient assessment to optimize treatment outcomes in this challenging clinical scenario.