Treatment of Peripheral Non-Small Cell Lung Carcinoma with Stereotactic Body Radiation Therapy

On behalf of the IASLC Advanced Radiation Technology Committee

    Research output: Contribution to journalReview articlepeer-review

    11 Scopus citations

    Abstract

    Stereotactic body radiation therapy (SBRT) is an effective and well-tolerated noninvasive treatment for medically inoperable patients with peripheral non-small cell lung carcinoma. The term "peripheral" refers to lesions that lie 2 cm or more from the mediastinum and proximal bronchial tree and was instituted based on results from a specific dose and fractionation schedule. Improvements in immobilization, respiratory motion management, and image guidance have allowed for SBRT's highly conformal and accurate delivery of large radiation doses per fraction. Results from prospective and retrospective studies suggest that lung SBRT has superior outcomes when compared with conventionally fractionated treatments and is comparable with surgical resection. Investigations into the optimal SBRT dosing regimen for peripheral lesions are ongoing, with recent trials suggesting comparable efficacy between single and multiple fraction schedules. Chest wall toxicity after peripheral treatment is common, but it usually resolves with conservative management. Pneumonitis is less often observed after treatment of peripheral lesions, and changes in pulmonary function tests are minimal. Studies in the frail and elderly suggest that neither baseline pulmonary function tests nor age should preclude treatment. Recent technical developments have reduced delivery time and resulted in more conformal treatments. This review is on behalf of the IASLC Advanced Radiation Technology Committee.

    Original languageEnglish
    Pages (from-to)1261-1267
    Number of pages7
    JournalJournal of Thoracic Oncology
    Volume10
    Issue number9
    DOIs
    StatePublished - Sep 26 2015

    Keywords

    • Lung cancer
    • NSCLC
    • SBRT

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