Stereotactic radiation for lung cancer: a practical approach to challenging scenarios

Abstract

Stereotactic body radiation therapy (SBRT) is an effective and well-tolerated treatment for medically inoperable patients with early-stage non-small cell lung carcinoma (NSCLC). SBRT is a noninvasive treatment involving the delivery of ablative radiation doses with high precision over the course of a few treatments. Relative to conventionally fractionated radiation, SBRT achieves superior local control and survival. SBRT utilization has increased dramatically over the past 15 years and is currently considered the standard-of-care in cases of inoperable early-stage NSCLC. It is being increasingly applied to more complex patient populations at higher risk of treatment-related toxicity. In these more complex patients, there is an increasing need to balance patient and treatment factors in selecting the optimal patients for SBRT. Here we review several challenging clinical scenarios commonly encountered in thoracic multidisciplinary tumor boards.