title: Stereotactic radiotherapy for pulmonary metastases.
abstract: The most common treatment of pulmonary metastasis for solid tumors employs systemic chemotherapy, hormonal therapy, or biologic agents. Some series have suggested that aggressive surgical resection of pulmonary metastasis may improve patient outcomes in terms of quality of life and overall survival. Recently, data from clinical trials and retrospective series support the use of aggressive local control with high conformal dose radiotherapy (stereotactic body radiation therapy) in patients with limited metastases or oligometastases. Further evidence suggests that these patients represent a distinct clinical and biological class of patients. This review focuses on the role of ablative doses of radiotherapy in the treatment of pulmonary metastases. Specifically we discuss the rationale, treatment delivery, and local control that have led to the ongoing randomized clinical trials attempting to demonstrate a benefit over the current palliative standard of care.
authors.affiliation: Ludwig Center for Metastasis Research, University of Chicago, Chicago, Illinois. Electronic address: schmura@radonc.uchicago.edu.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Chmura
authors.affiliation: Department of Radiation Oncology, Duke Cancer Institute, Durham, North Carolina.
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Salama
authors.affiliation: Department of Radiation Oncology, University of Chicago, Chicago, Illinois; Ludwig Center for Metastasis Research, University of Chicago, Chicago, Illinois.
authors.forename: Ralph R
authors.initials: RR
authors.lastname: Weichselbaum
mesh_terms: D019583:Dose Fractionation, Radiation; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D018579:Patient Selection; D016634:Radiosurgery / Q000009:adverse effects; D012307:Risk Factors; D016896:Treatment Outcome