Highlights
- •SBRT is the non-surgical standard option for patients with early stage lung cancer.
- •Risk-adapted SBRT is highly effective and low toxic for both peripheral and central tumors.
- •SBRT use is increasing for lung metastases, in combination with systemic agents.
- •Standardization of planning and delivery processes is essential in further developing SBRT.
- •Further technical advances are essential for safely expanding SBRT indications.
Abstract
Stereotactic Body Radiotherapy (SBRT) is a well established therapeutic option for
patients affected with peripheral early stage non-small cell lung cancer (NSCLC),
given the positive clinical evidence accumulated so far on its efficacy and safety.
SBRT is regarded as the best choice for inoperable patients, and could also be offered
as an alternative to surgery to selected operable patients. More recently, its use
for lung metastases progressively increased, and SBRT is now regarded as a low toxic
and highly effective local therapy for lung oligometastases from different primary
tumors, especially colorectal cancer. Improved planning and delivery techniques have
facilitated over the years its use on large and/or centrally located primary tumors,
and multiple nodules. Given the successful applications and the current wide dissemination
of this technique, clinicians are now faced with an increasingly complex and multi-variable
decision process. Some clinically relevant factors are still uncertain, and strategies
are needed to reduce the risk of both local and distant failures. Secondly, aspects
related to target delineation, dose prescription, image guidance and treatment planning
still need to be fully addressed; this may hamper, at least for now, the standardization
of SBRT procedures through different Institutions making any kind of direct outcomes
comparison difficult. We here aim to provide a perspective on the current role of
lung SBRT and its critical aspects, highlighting the potential future developments.
Keywords
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Article info
Publication history
Published online: December 01, 2016
Accepted:
November 17,
2016
Received in revised form:
November 11,
2016
Received:
October 14,
2016
Identification
Copyright
© 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
