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Emergence of stereotactic body radiation therapy and its impact on current and
future clinical practice
#MMPMID25113761
Timmerman RD
; Herman J
; Cho LC
J Clin Oncol
2014[Sep]; 32
(26
): 2847-54
PMID25113761
show ga
Stereotactic body radiation therapy (SBRT) is generally a tumor-ablative
radiation modality using essential technologies capable of accurately and
precisely damaging the target with a high dose while geometrically sparing
innocent normal tissues. The intent, conduct, and tissue biology are all
dramatically distinct from conventionally fractionated radiotherapy such that new
understanding is required for its optimization. It is most practical, tolerable,
and tumoricidal in its most potent form treating tumors in the lung and liver.
However, it is increasingly being used for tumors adjacent to bowels and nervous
tissue, albeit with somewhat less ablative potency. Its strengths include high
rates of tumor eradication via a noninvasive, convenient outpatient treatment.
Its weakness relates to the possibility of causing difficult-to-manage toxicity
(eg, ulceration, stenosis, fibrosis, and even necrosis) that may occur
considerably later after treatment, particularly in the vicinity of the body's
many tubular structures (eg, organ hila, bowel). However, clinical trials in a
variety of organs and sites have shown SBRT to result in good outcomes in
properly selected patients. Given its short course, lack of need for recovery,
and favorable overall toxicity profile, there is great hope that SBRT will find a
prominent place in the treatment of metastatic cancer as a consolidative partner
with systemic therapy. With considerable published experience, available required
technologies and training, and many patients in need of local therapy, SBRT has
found a place in the routine cancer-fighting arsenal.
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