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Stereotactic body radiation therapy (SBRT) has evolved significantly from early frame-based treatments to advanced image-guided techniques. This review covers the principles, technologies, and applications of SBRT in managing various cancers.

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Cancer Treatment

Background:

  • Stereotactic Body Radiation Therapy (SBRT) evolved from Stereotactic Radiosurgery (SRS).
  • Early SBRT used body frames and X-ray verification; current methods employ image guidance (cone-beam CT, stereoscopic X-ray) and non-rigid immobilization.
  • Advancements in linac systems, multi-leaf collimators, and treatment planning (IMRT, VMAT) have facilitated SBRT's widespread adoption.

Purpose of the Study:

  • To review the physical principles and paradigms driving SBRT adoption.
  • To discuss technical considerations for various SBRT technologies.
  • To categorize and describe different SBRT delivery systems.

Main Methods:

  • Review of physical principles and technological advancements in SBRT.
  • Categorization of SBRT technologies based on delivery systems.
  • Discussion of image-guidance and immobilization techniques.

Main Results:

  • SBRT has transformed cancer treatment with high tumoricidal doses and normal tissue sparing.
  • Image-guided SBRT is now standard for diverse sites including lung, prostate, liver, and spine lesions.
  • Key technologies include C-arm linac-based systems, CyberKnife®, and emerging MRI-linacs and Gamma Knife Icon.

Conclusions:

  • SBRT's evolution, driven by technological integration, has enabled its broad clinical application.
  • Understanding the nuances of different SBRT technologies is crucial for effective treatment delivery.
  • Future developments include integrated systems like MRI-linacs for enhanced SBRT precision.