An optimal dose ‐fractionation for stereotactic body radiotherapy in peripherally, centrally and ultracentrally located early‐stage non‐small lung cancer

1.In peripheral tumors shorter interval between fractions does not increase toxicity. 2.Treatment on consecutive days is recommended. 3.In peripheral tumors up to 5  cm radiosurgery is recommended. In tumors abutting chest wall – 5 × 11 Gy 4.In central tumors>1  cm from main bronchi 5 × 10 Gy, in ultracentral tumors 8 × 7.5 Gy. In gross endobronchial infiltration the schedule of 8 × 7 Gy should be avoided. In coexistence of risk factors for inducing hemoptysis such patients should be treated with extreme caution. 5.In ultracentral tumors short schedules of<3 fractions should be avoided. 6.Re-SBRT is often used but it should be avoided in ILD and only>6  months after prior treatment. Stereotactic radiotherapy in early-stage non-small lung cancer has excellent local control and low toxicity in peripheral tumors. In central and ultracentral location this treatment may cause severe toxicity. Optimal dose-fractionation adopted to organs at risk increases the safety of radiotherapy in these localisations. AbstractStereotactic body radiotherapy (SBRT), also known as stereotactic ablative radiotherapy (SABR), is commonly used in inoperable patients with early-stage non-small lung cancer (NSCLC). This treatment has good outcomes and low toxicity in peripherally located tumors. However, in lesions which are located close to structures such as the bronchial tree or mediastinum the risk of severe toxicity increases. This review summarizes the evidence...
Source: Thoracic Cancer - Category: Cancer & Oncology Authors: Tags: REVIEW Source Type: research