Stereotactic radiosurgery of lung – pro

Stereotactic body radiation therapy (SBRT) is a technique that utilizes precisely targeted radiation to a tumor while minimizing radiation to adjacent normal tissue. This targeting allows treatment of small- or moderate-sized tumors in either a single or limited number of dose fractions.Stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) initially was used successfully for intracranial, orbital, and base of skull tumors, as well as benign conditions that can use the skull as a reference system. The success of SRS for intracranial indications led to the development of techniques to extend this approach to extracranial targets, such as lung cancer. Stereotactic radiation therapy for extracranial sites is aided by technical advances including tumor imaging to guide radiation administration, patient immobilization, and conformal radiation delivery techniques.

The usual use for SBRT is to attempt a cure or occasionally to control symptomatic lung metastases. It should be realized that this is not a treatment that is free from potential side effects. American Society for Therapeutic Radiation and Oncology (ASTRO, 2007) stated that SBRT is considered appropriate for the treatment of the following conditions:

Lung or liver metastases not amenable to surgery
Medically inoperable early stage lung cancer
Primary liver cancer not amenable to surgery
Recurrent lung cancer amenable to salvage therapy
Recurrent pelvic tumors
Retroperitoneal tumors
Spinal and para-spinous tumors
Other recurrent cancers or tumors.
Arjun Pennathur, MD et al, Stereotactic Radiosurgery for the Treatment of Lung Neoplasm: Experience in 100 Consecutive Patients Ann Thorac Surg 2009;88:1594-1600

H. C. Fernando, M. Schuchert, R. Landreneau, and B. T. Daly
Approaching the High-Risk Patient: Sublobar Resection, Stereotactic Body Radiation Therapy, or Radiofrequency Ablation Ann. Thorac. Surg., June 1, 2010; 89(6): S2123 – S2127.

Dunlap NE, Cai J, Biedermann GB, et al. Chest wall volume receiving >30 Gy predicts risk of severe pain and/or rib fracture after lung stereotactic body radiotherapy. Int J Radiat Oncol Biol Phys 2010; 76:796.

Andolino DL, Forquer JA, Henderson MA, et al. Chest wall toxicity after stereotactic body radiotherapy for malignant lesions of the lung and liver. Int J Radiat Oncol Biol Phys 2011; 80:692.

Haute Autorite de sante/French National Authority for Health (HAS). Value of extra-cranial stereotactic radiotherapy [summary]. Saint-Denis La Plaine, France: HAS; 2007.

American Society for Therapeutic Radiation and Oncology (ASTRO). The ASTRO/ACR Guide to Radiation Oncology Coding 2007. Fairfax, VA: ASTRO; 2007.

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