Stereotactic Body Radiotherapy: A Review

Future of stereotactic intervention in lung cancer

“…These patients often present with poor pulmonary function which not only precludes lobectomy/pneumectomy but also curative external beam irradiation (EBRT) due to the large volume of doses which are far beyond lung tissue tolerance. In the past these functionally inoperable patients were either treated with EBRT using moderate doses which yielded poor local control or received no local therapy at all.Early results of SBRT in this vulnerable subset of patients have, across all borders, consistently shown its feasibility and its efficacy not only in terms of primary tumor control but also in survival, which has more than doubled when compared to the results achieved with conventionally fractionated "curative" EBRT.Meanwhile, several Phase II studies have confirmed these promising results with 3-year primary tumor control rates as high as 97.6 % and 3-year survival rates of 55.8 % in patients with peripheral stage T1-T2 N0 M0 non-small-cell lung cancer (NSCLC) less than 5 cm who were deemed inoperable due to their underlying medical conditions [3,4,5].It has to be stressed, however, that these highly encouraging results were obtained from carefully designed studies and participating centers, in which the necessary advanced technology with highly trained radiation oncologists, medical physicists, and radiation technologists was available-a definite prerequisite for SBRT.For selected patients with peripheral NSCLC with lesions less than 5 cm who are unfit or unwilling to undergo lobectomy/pneumectomy, SBRT offers primary tumor control and survival rates that cannot be met with conventional irradiation doses and techniques. These patients should be offered SBRT and referred to centers, which are equipped to meet all the above mentioned demands.…”

“…Meanwhile, several Phase II studies have confirmed these promising results with 3-year primary tumor control rates as high as 97.6 % and 3-year survival rates of 55.8 % in patients with peripheral stage T1-T2 N0 M0 non-small-cell lung cancer (NSCLC) less than 5 cm who were deemed inoperable due to their underlying medical conditions [3,4,5].…”

Retrospective Analysis Of Patients And Treatment Characteristics: Istanbul Cyberknife Coalition Data

“…Reviews mainly agree on the advantages of the system, such as the frameless usage, accuracy in less than 1mm, image fusion capability with multiple modalities, real time tumor tracking, and treatment possibility with linear accelerator [3,[6][7]. The majority of clinical trials using CK are mainly focused on intracranial lesions.…”

“…This form of treatment includes characteristics of both SRS and conventional RT. High ablative doses are delivered in every fraction to the tumor and fractionation gives the normal tissues around the treated site a chance for healing [3].…”

Stereotactic ablative radiotherapy in the UK: current status and developments

“…The radiobiological rationale for SABR is that in delivering a few large fractions over a short overall treatment time, a more potent biological effect is achieved [1]. However, using a high dose per fraction to treat extracranial lesions poses significant challenges owing to both the inter-and the intrafractional motion of the tumour and the organ at risk (OAR) [2].…”