TY - JOUR
T1 - Stereotactic ablative radiotherapy for centrally located early stage non-small-cell lung cancer
T2 - What we have learned
AU - Chang, Joe Y.
AU - Bezjak, Andrea
AU - Mornex, Françoise
N1 - Funding Information:
This study was supported in part by Cancer Center Support (Core) Grant CA016672 to The University of Texas MD Anderson Cancer Center from the National Cancer Institute, National Institutes of Health. The authors gratefully acknowledge the support and assistance of the members of the Advanced Radiation Technology Committee, of Steven Register and Jordan Sutton for figure preparation, and of Christine Wogan for manuscript editing.
Publisher Copyright:
© 2015 by the International Association for the Study of Lung Cancer.
PY - 2015/4/30
Y1 - 2015/4/30
N2 - Image-guided stereotactic ablative radiotherapy (SABR; also called stereotactic body radiotherapy or radiosurgery) has become a standard treatment for medically inoperable peripherally located stage I non-small-cell lung cancer (NSCLC) and can achieve local control rates in excess of 90%. However, the role of SABR for centrally located lesions remains controversial because of concerns about the potential for severe toxic effects. When cutting-edge technologies and knowledge-based optimization of SABR planning that considers both target coverage and normal tissue sparing are used, some patients with central lesions can be safely and effectively cured of early stage NSCLC. However, delivery of ablative doses of radiation to critical structures such as bronchial tree, esophagus, major vessels, heart, and the brachial plexus/phrenic nerve could produce severe, potentially lethal toxic effects. Here, we address the current understanding of indications, dose regimens, planning optimization, and normal tissue dose-volume constraints for using SABR to treat central NSCLC.
AB - Image-guided stereotactic ablative radiotherapy (SABR; also called stereotactic body radiotherapy or radiosurgery) has become a standard treatment for medically inoperable peripherally located stage I non-small-cell lung cancer (NSCLC) and can achieve local control rates in excess of 90%. However, the role of SABR for centrally located lesions remains controversial because of concerns about the potential for severe toxic effects. When cutting-edge technologies and knowledge-based optimization of SABR planning that considers both target coverage and normal tissue sparing are used, some patients with central lesions can be safely and effectively cured of early stage NSCLC. However, delivery of ablative doses of radiation to critical structures such as bronchial tree, esophagus, major vessels, heart, and the brachial plexus/phrenic nerve could produce severe, potentially lethal toxic effects. Here, we address the current understanding of indications, dose regimens, planning optimization, and normal tissue dose-volume constraints for using SABR to treat central NSCLC.
KW - Central lesion
KW - Dose-volume constraints
KW - Early stage lung cancer
KW - SABR
KW - SBRT
KW - Survival
KW - Toxicity
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U2 - 10.1097/JTO.0000000000000453
DO - 10.1097/JTO.0000000000000453
M3 - Review article
C2 - 25514807
AN - SCOPUS:84938290741
SN - 1556-0864
VL - 10
SP - 577
EP - 585
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
IS - 4
ER -