Can stereotactic fractionated radiation therapy become the standard of care for early stage non-small cell lung carcinoma

Inoperable early stage non-small cell lung cancer: Comorbidity, patterns of care and survival

“…There has been a shift in the RT treatment paradigm, with a move towards even more dramatically hypofractionated, highly conformal radiotherapy. For stage I NSCLC, stereotactic body radiation therapy (SBRT) delivers large ablative doses, such as 60 Gy in 3 fractions in about 1 week, with local control rates reported as 90% or higher in most studies using sufficient doses [21][22][23][24], with a favorable toxicity profile. Oncologic outcomes after SBRT may be superior to wedge resection [25], and implementation of SBRT has been associated with increased radiotherapy utilization and survival in elderly patients [26].…”

Treatment outcomes and patterns of radiologic appearance after hypofractionated image-guided radiotherapy delivered with helical tomotherapy (HHT) for lung tumours

“…This might account for the relatively lower rate of local control, which compares unfavourably with the current non-HT-SABR experience whereby, with higher doses, local control rates in excess of 90% have been widely reported. 36,37 In addition, due to its retrospective nature and the relatively short FU, it cannot be excluded that some findings are biased with patient selection and that some structural changes may theoretically occur later, since the fibrotic evolution after high-dose irradiation is a dynamic process that might continue for many years. 38,39 A further limitation is that the scoring of CT changes after lung HHT adopted herein 23,24 is qualitative and may be subjective.…”

Radiological and Clinical Pneumonitis After Stereotactic Lung Radiotherapy: A Matched Analysis of Three-Dimensional Conformal and Volumetric-modulated Arc Therapy Techniques

“…However, clinical pneumonitis is uncommon, with an incidence of less than 10% in many series (1)(2)(3)(4). Acute computed tomography (CT) changes occurring within 6 months of treatment include development of consolidation and ground-glass opacities (GGO) in the region of the tumor (2,5,6).…”