title: The role of stereotactic body radiotherapy in the management of non-small cell lung cancer: an emerging standard for the medically inoperable patient?
abstract: The standard of care for early-stage lung cancer is surgical resection. Many patients with this diagnosis have comorbidities that preclude oncologic resection. Randomized data show that limited resection is inadequate for local disease control and may negatively impact on survival. Stereotactic body radiotherapy (SBRT) has emerged as a novel radiation modality with significant applications in the inoperable, early-stage lung cancer population. Retrospective and prospective studies published in the past decade have established the feasibility, safety, and efficacy of SBRT in these patients using a variety of dose regimens and technologies. To date, lung SBRT results demonstrate excellent local control with very little acute toxicity, and suggest improved overall survival compared to historical controls of fractionated radiotherapy. Ongoing prospective trials are exploring dose and fractionation schedules in the inoperable population, and are starting to explore the role of SBRT for the operable patient.
authors.affiliation: Cleveland Clinic Lerner College of Medicine, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. videtig@ccf.org
authors.forename: Gregory M M
authors.initials: GM
authors.lastname: Videtic
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Stephans
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008168:Lung / Q000473:pathology / Q000528:radiation effects; D008175:Lung Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D016634:Radiosurgery / Q000379:methods*; D016896:Treatment Outcome
references.citation: Cancer. 1987 Jun 1;59(11):1874-81
references.pmid: 3032394
references.citation: Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3):789-95
references.pmid: 19473777
references.citation: J Thorac Cardiovasc Surg. 1973 Oct;66(4):563-72
references.pmid: 4356889
references.citation: Ann Thorac Surg. 2008 Feb;85(2):S733-6
references.pmid: 18222206
references.citation: Acta Oncol. 1994;33(6):677-83
references.pmid: 7946448
references.citation: Int J Radiat Oncol Biol Phys. 2009 May 1;74(1):47-54
references.pmid: 18977095
references.citation: Int J Radiat Oncol Biol Phys. 2009 Nov 1;75(3):677-82
references.pmid: 19251380
references.citation: J Thorac Oncol. 2009 Aug;4(8):976-82
references.pmid: 19633473
references.citation: Lung Cancer. 2001 Dec;34 Suppl 3:S39-43
references.pmid: 11740992
references.citation: Cancer. 1998 Feb 1;82(3):433-8
references.pmid: 9452258
references.citation: Radiother Oncol. 2005 Oct;77(1):83-7
references.pmid: 16209896
references.citation: CA Cancer J Clin. 2009 Jul-Aug;59(4):225-49
references.pmid: 19474385
references.citation: Int J Radiat Oncol Biol Phys. 2005 Dec 1;63(5):1427-31
references.pmid: 16169670
references.citation: J Clin Oncol. 2006 Oct 20;24(30):4833-9
references.pmid: 17050868
references.citation: J Thorac Cardiovasc Surg. 2005 Apr;129(4):813-8
references.pmid: 15821648
references.citation: Int J Radiat Oncol Biol Phys. 2004 Nov 15;60(4):1241-56
references.pmid: 15519797
references.citation: Int J Radiat Oncol Biol Phys. 2008 Mar 15;70(4):1057-65
references.pmid: 17905527
references.citation: Radiother Oncol. 2009 Dec;93(3):408-13
references.pmid: 19454366
references.citation: Int J Radiat Oncol Biol Phys. 2008 Dec 1;72(5):1283-6
references.pmid: 19028267
references.citation: Cancer. 2010 Jan 15;116(2):406-14
references.pmid: 19950125
references.citation: Int J Radiat Oncol Biol Phys. 2008 Oct 1;72(2):404-9
references.pmid: 18394819
references.citation: Oncology (Williston Park). 2004 Oct;18(11):1419-30; discussion 1430, 1432, 1435-6
references.pmid: 15609470
references.citation: Int J Radiat Oncol Biol Phys. 2009 Jun 1;74(2):349-54
references.pmid: 19427551
references.citation: Cancer. 2009 Feb 1;115(3):587-94
references.pmid: 19130457
references.citation: Lancet. 1997 Jul 19;350(9072):161-5
references.pmid: 9250182
references.citation: Chest. 2003 Nov;124(5):1946-55
references.pmid: 14605072
references.citation: Ann Thorac Surg. 2005 Dec;80(6):2051-6; discussion 2056
references.pmid: 16305843
references.citation: Lung Cancer. 1999 Apr;24(1):31-7
references.pmid: 10403692
references.citation: Thorac Surg Clin. 2007 May;17(2):251-9
references.pmid: 17626403
references.citation: Int J Radiat Oncol Biol Phys. 2001 Nov 1;51(3):666-70
references.pmid: 11597807
references.citation: Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3):796-801
references.pmid: 19427740
references.citation: JAMA. 2010 Mar 17;303(11):1070-6
references.pmid: 20233825
references.citation: Ann Thorac Surg. 1987 Oct;44(4):340-3
references.pmid: 2821937
references.citation: Lung Cancer. 2003 Jul;41(1):1-11
references.pmid: 12826306
references.citation: Ann Thorac Surg. 2006 Mar;81(3):1013-9; discussion 1019-20
references.pmid: 16488712
references.citation: Surgery. 2003 Oct;134(4):691-7; discussion 697
references.pmid: 14605631
references.citation: Int J Radiat Oncol Biol Phys. 2008 Mar 1;70(3):685-92
references.pmid: 18164849
references.citation: Ann Thorac Surg. 1995 Sep;60(3):615-22; discussion 622-3
references.pmid: 7677489
references.citation: J Thorac Oncol. 2007 Jul;2(7 Suppl 3):S118-24
references.pmid: 17603307
references.citation: J Thorac Oncol. 2009 Jul;4(7):838-44
references.pmid: 19487961
references.citation: Chest. 2002 Apr;121(4):1155-8
references.pmid: 11948046
references.citation: Acta Oncol. 2006;45(7):787-95
references.pmid: 16982541
references.citation: Radiother Oncol. 2009 Jun;91(3):360-8
references.pmid: 19410314
references.citation: J Thorac Oncol. 2007 Jul;2(7 Suppl 3):S94-100
references.pmid: 17603311