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Updated: Aug 22, 2026
Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy
Published on: June 7, 2015
Spatially Fractionated Induction Radiotherapy to Widen the Therapeutic Window in Locally Advanced Non-Small-Cell Lung
Sebastian Regnery1, Markus Ehle1, David Neugebauer2
1Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany; National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany; Department of Radiation Oncology, Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg University Hospital, Heidelberg, Germany; National Center for Tumor diseases (NCT), Heidelberg, Germany; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Background:
Inoperable, locally advanced non-small-cell lung cancer (LA-NSCLC) remains associated with high rates of locoregional failure despite concurrent chemoradiotherapy and consolidation immunotherapy. Uniform dose escalation has failed to improve outcomes. We propose to address intra- and interindividual tumor heterogeneity by spatially fractionated radiotherapy (SFRT) and stereotactic body radiotherapy (SBRT).
Patients & Methods:
SPARROW is a prospective, multicenter, open-label seamless phase I/II randomized clinical trial. In phase I, up to 32 patients with inoperable LA-NSCLC receive induction SFRT (Lattice or central boost, 1 × 18 Gy), followed by a 4-week interval and adaptive consolidation radiotherapy (25 × 2.4 Gy). Tumor volume reduction (primary endpoint), safety, and feasibility guide selection of the optimal SFRT approach. A "backup arm" allows SBRT of small primary tumors with mediastinal fractionated radiotherapy (25 × 2.4 Gy). In phase II, 100 patients are randomized (1:1) to this personalized treatment (induction SFRT or SBRT of the primary) versus standard fractionated radiotherapy (30-35 × 2 Gy). Both treatment arms employ intensity-modulated and adaptive radiation techniques. The primary endpoint is progression-free survival (PFS). Secondary and translational endpoints include overall survival, locoregional control, patient-reported outcomes, circulating tumor DNA and immune profiling.
Discussion:
SPARROW investigates whether personalized and novel radiotherapy techniques can overcome tumor heterogeneity and radioresistance in LA-NSCLC. The embedded translational program aims to characterize potential antitumor immune responses. Thus, SPARROW could redefine dose concepts in radiation oncology beyond lung cancer.
Trial Registration:
https://www.drks.de:DRKS00037163.