Normal tissue toxicity after small field hypofractionated stereotactic body radiation.
Stereotactic body radiation (SBRT) is an emerging tool in radiation oncology in which the targeting accuracy is improved via the detection and processing of a three-dimensional coordinate system that is aligned to the target. With improved targeting accuracy, SBRT allows for the minimization of normal tissue volume exposed to high radiation dose as well as the escalation of fractional dose delivery. The goal of SBRT is to minimize toxicity while maximizing tumor control. This review will discuss the basic principles of SBRT, the radiobiology of hypofractionated radiation and the outcome from published clinical trials of SBRT, with a focus on late toxicity after SBRT. While clinical data has shown SBRT to be safe in most circumstances, more data is needed to refine the ideal dose-volume metrics.
Milano
Michael T
MT
Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY 14642, USA. mtmilano@yahoo.com
Constine
Louis S
LS
Okunieff
Paul
P
D002986:Clinical Trials as Topic; D019583:Dose Fractionation, Radiation; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy; D008175:Lung Neoplasms / Q000532:radiotherapy; D009369:Neoplasms / Q000532:radiotherapy*; D018787:Radiation Oncology / Q000379:methods*; D017564:Radiation Pneumonitis / Q000209:etiology; D011853:Radiobiology; D011878:Radiotherapy / Q000379:methods*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D015203:Reproducibility of Results; D016896:Treatment Outcome