What do radiation oncologists require for future advancements in lung SBRT?

Area of Science:

• Radiation Oncology
• Medical Physics
• Thoracic Oncology

Background:

• Stereotactic Body Radiotherapy (SBRT) is a recognized treatment for early-stage, peripheral non-small cell lung cancer (NSCLC).
• SBRT is a preferred option for inoperable patients and an alternative to surgery for select operable cases.
• Its application has expanded to treat lung metastases, particularly from colorectal cancer, demonstrating low toxicity and high efficacy for oligometastases.

Purpose of the Study:

• To provide a perspective on the current role and critical aspects of lung SBRT.
• To highlight potential future developments in lung SBRT.
• To address uncertainties and the need for strategies to reduce local and distant failures in lung SBRT.

Main Methods:

• Review of current clinical evidence and applications of lung SBRT.
• Analysis of technical advancements in SBRT planning and delivery.
• Discussion of challenges in SBRT standardization and outcome comparison.

Main Results:

• SBRT is effective and safe for early-stage NSCLC and lung metastases.
• Technological improvements enable SBRT for larger, central, or multiple lung tumors.
• Clinical decision-making is complex due to uncertainties in treatment planning and outcomes.

Conclusions:

• Lung SBRT is a widely disseminated and effective technique for NSCLC and metastases.
• Standardization of target delineation, dose prescription, and image guidance is crucial for consistent outcomes.
• Future developments should focus on reducing failure risks and enhancing treatment protocols.