open access

Vol 18, No 6 (2013)
SpeciaI issue papers
Published online: 2013-11-01
Submitted: 2013-05-03
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Extracranial stereotactic body radiotherapy. Review of main SBRT features and indications in primary tumors

Carmen Rubio, Rosa Morera, Ovidio Hernando, Thomas. Leroy, S. Eric Lartigau
DOI: 10.1016/j.rpor.2013.09.009
·
Rep Pract Oncol Radiother 2013;18(6):387-396.

open access

Vol 18, No 6 (2013)
SpeciaI issue papers
Published online: 2013-11-01
Submitted: 2013-05-03

Abstract

Aim

Review of main SBRT features and indications in primary tumors.

Background

Stereotactic body radiotherapy has been developed in the last few years. SBRT allows the hypofractionated treatment of extra cranial tumors, using either a single or limited number of dose fractions, and resulting in the delivery of a high biological effective dose with low toxicity.

Material and methods

SBRT requires a high level of accuracy for all phases of the treatment process: effective patient immobilization, precise target localization, highly conformed dosimetry and image guided systems for treatment verification. The implementation of SBRT in routine requires a careful considering of organ motion. Gating and tracking are effective ways to do so, and less invasive technologies “fiducials free” have been developed. Due to the hypofractionated scheme, the physician must pay attention to new dosimetric constraints in organ at risk and new radiobiological models are needed to assess the optimal fractionation and dose schemes.

Results

Currently, SBRT is safe and effective to treat primary tumors, which are otherwise untreatable with conventional radiotherapy or surgery. SBRT has quickly developed because of its excellent results in terms of tolerance and its high locoregional control rates. SBRT indications in primary tumors, such as lung primary tumors, have become a standard of care for inoperable patients. SBRT seems to be effective in many others indications in curative or palliative intent such as liver primary tumors, and novel indications and strategies are currently emerging in prostate cancer, head and neck tumor recurrences or pelvis reirradiations.

Conclusion

Currently, SBRT is mainly used when there is no other therapeutic alternative for the patient. This is due to the lack of randomized trials in these settings. However, the results shown in retrospective studies let us hope to impose SBRT as a new standard of care for many patients in the next few years.

Abstract

Aim

Review of main SBRT features and indications in primary tumors.

Background

Stereotactic body radiotherapy has been developed in the last few years. SBRT allows the hypofractionated treatment of extra cranial tumors, using either a single or limited number of dose fractions, and resulting in the delivery of a high biological effective dose with low toxicity.

Material and methods

SBRT requires a high level of accuracy for all phases of the treatment process: effective patient immobilization, precise target localization, highly conformed dosimetry and image guided systems for treatment verification. The implementation of SBRT in routine requires a careful considering of organ motion. Gating and tracking are effective ways to do so, and less invasive technologies “fiducials free” have been developed. Due to the hypofractionated scheme, the physician must pay attention to new dosimetric constraints in organ at risk and new radiobiological models are needed to assess the optimal fractionation and dose schemes.

Results

Currently, SBRT is safe and effective to treat primary tumors, which are otherwise untreatable with conventional radiotherapy or surgery. SBRT has quickly developed because of its excellent results in terms of tolerance and its high locoregional control rates. SBRT indications in primary tumors, such as lung primary tumors, have become a standard of care for inoperable patients. SBRT seems to be effective in many others indications in curative or palliative intent such as liver primary tumors, and novel indications and strategies are currently emerging in prostate cancer, head and neck tumor recurrences or pelvis reirradiations.

Conclusion

Currently, SBRT is mainly used when there is no other therapeutic alternative for the patient. This is due to the lack of randomized trials in these settings. However, the results shown in retrospective studies let us hope to impose SBRT as a new standard of care for many patients in the next few years.

Get Citation

Keywords

SBRT; Requirements; Organ motion; Early stage NCSLC; Hepatocellular carcinoma; Head and neck recurrences

About this article
Title

Extracranial stereotactic body radiotherapy. Review of main SBRT features and indications in primary tumors

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 18, No 6 (2013)

Pages

387-396

Published online

2013-11-01

DOI

10.1016/j.rpor.2013.09.009

Bibliographic record

Rep Pract Oncol Radiother 2013;18(6):387-396.

Keywords

SBRT
Requirements
Organ motion
Early stage NCSLC
Hepatocellular carcinoma
Head and neck recurrences

Authors

Carmen Rubio
Rosa Morera
Ovidio Hernando
Thomas. Leroy
S. Eric Lartigau

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