Review Article | | Peer-Reviewed

Stereotactic Body Radiation Therapy (SBRT) for Non-Small Cell Lung Cancer (NSCLC) Therapy

Received: 19 May 2024    Accepted: 31 May 2024    Published: 19 June 2024
Views:       Downloads:
Abstract

For patients with early-stage non-small cell lung cancer (NSCLC) who cannot undergo surgery, stereotactic body radiotherapy (SBRT), also known as stereotactic ablative radiotherapy (SABR), usually achieves good therapeutic effects. This new treatment method has the characteristics of low toxicity and high efficacy for peripheral lung cancer. However, in central type lung cancer, especially in lesions near structures such as bronchial trees or mediastinum, there is an increased risk of severity. This review summarizes the following areas: (1) the methods and indications of using SBRT to treat NSCLC patients in different areas; (2) the principle and advantages and disadvantages of targeted MRI linear accelerators; (3) the diagnostic and evaluation process of targeted MRI linear accelerator therapy for lung cancer; (4) the clinical process of targeted MRI linear accelerator treatment for lung cancer; (5) tracking and monitoring of targeted MRI linear accelerator therapy for lung cancer; (6) pulmonary MRI disorders may include the following situations; (7) how to evaluate stage I-IV non-small cell lung cancer with targeted MRI linear accelerator; (8) how to locate central and peripheral lung cancer using targeted MRI linear accelerators; (9) increase safety of SBRT in central locations.

Published in Cancer Research Journal (Volume 12, Issue 2)
DOI 10.11648/j.crj.20241202.12
Page(s) 27-35
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Non-Small Cell Lung Cancer, Stereotactic Body Radiotherapy, Stereotactic Ablative Radiotherapy, Central Type Lung Cancer, Peripheral Lung Cancer

References
[1] Fitzmaurice C, Abate D, Abbasi N, Abbastabar H, Abd‐Allah F, Abdel‐Rahman O, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability‐adjusted life‐years for 29 cancer groups, 1990 to 2017: a systematic analysis for the global burden of disease study. JAMA Oncol. 2019; 5(12): 1749–1768.
[2] Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021; 71(3):209–249. - PubMed.
[3] Dela Cruz CS, Tanoue LT, Matthay RA. Lung cancer: epidemiology, etiology, and prevention. Clin Chest Med. 2011; 32(4):605–644.
[4] Postmus PE, Kerr KM, Oudkerk M, Senan S, Waller DA, Vansteenkiste J, et al. Early and locally advanced non‐small‐cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow‐up. Ann Oncol. 2017; 28(suppl_4): iv1–iv21. - PubMed.
[5] Soldà F, Lodge M, Ashley S, Whitington A, Goldstraw P, Brada M. Stereotactic radiotherapy (SABR) for the treatment of primary non‐small cell lung cancer; systematic review and comparison with a surgical cohort. Radiother Oncol. 2013; 109(1): 1–7. - PubMed.
[6] Verstegen NE, Oosterhuis JWA, Palma DA, Rodrigues G, Lagerwaard FJ, van der Elst A, et al. Stage I–II non‐small‐cell lung cancer treated using either stereotactic ablative radiotherapy (SABR) or lobectomy by video‐assisted thoracoscopic surgery (VATS): outcomes of a propensity score‐matched analysis. Ann Oncol. 2013; 24(6): 1543–1548. - PubMed.
[7] Timmerman RD, Paulus R, Pass HI, Gore EM, Edelman MJ, Galvin J, et al. Stereotactic body radiation therapy for operable early‐stage lung cancer: findings from the NRG oncology RTOG 0618 trial. JAMA Oncol. 2018; 4(9): 1263–1266.
[8] Chang JY, Mehran RJ, Feng L, Verma V, Liao Z, Welsh JW, et al. Stereotactic ablative radiotherapy for operable stage I non‐small‐cell lung cancer (revised STARS): long‐term results of a single‐arm, prospective trial with prespecified comparison to surgery. Lancet Oncol. 2021; 22(10): 1448–1457.
[9] Roach MC, M Videtic GM, Bradley JD, behalf of the IASLC Advanced Radiation Technology Committee. Treatment of peripheral non‐small cell lung carcinoma with stereotactic body radiation therapy. J Thorac Oncol. 2015; 10: 1261–1267. - PubMed.
[10] Chaudhuri AA, Tang C, Binkley MS, Jin M, Wynne JF, von Eyben R, et al. Stereotactic ablative radiotherapy (SABR) for treatment of central and ultra‐central lung tumors. Lung Cancer. 2015; 89(1): 50–56. - PubMed.
[11] Timmerman R, McGarry R, Yiannoutsos C, Papiez L, Tudor K, DeLuca J, et al. Excessive toxicity when treating central tumors in a phase II study of stereotactic body radiation therapy for medically inoperable early‐stage lung cancer. J Clin Oncol. 2006; 24(30): 4833–4839. - PubMed.
[12] Bezjak A, Paulus R, Gaspar LE, Timmerman RD, Straube WL, Ryan WF, et al. Safety and Efficacy of a Five‐Fraction Stereotactic Body Radiotherapy Schedule for Centrally Located Non‐Small‐Cell Lung Cancer: NRG Oncology/RTOG 0813 Trial. J Clin Oncol. 2019; 37(15): 1316–1325.
[13] Yan M, Louie AV, Kotecha R, Ashfaq Ahmed M, Zhang Z, Guckenberger M, et al. Stereotactic body radiotherapy for Ultra‐Central lung Tumors: A systematic review and Meta‐Analysis and International Stereotactic Radiosurgery Society practice guidelines. Lung Cancer. 2023 Aug; 182: 107281. - PubMed.
[14] Ricardi U, Filippi AR, Guarneri A, Giglioli FR, Ciammella P, Franco P, et al. Stereotactic body radiation therapy for early stage non‐small cell lung cancer: results of a prospective trial. Lung Cancer. 2010; 68(1): 72–77. - PubMed.
[15] Nagata Y, Takayama K, Matsuo Y, Norihisa Y, Mizowaki T, Sakamoto T, et al. Clinical outcomes of a phase I/II study of 48 Gy of stereotactic body radiotherapy in 4 fractions for primary lung cancer using a stereotactic body frame. Int J Radiat Oncol Biol Phys. 2005; 63(5): 1427–1431. - PubMed.
[16] Guckenberger M, Andratschke N, Dieckmann K, Hoogeman MS, Hoyer M, Hurkmans C, et al. ESTRO‐ACROP consensus guideline ESTRO ACROP consensus guideline on implementation and practice of stereotactic body radiotherapy for peripherally located early stage non‐small cell lung cancer. Radiother Oncol. 2017. [cited 2022 May 14]; 124: 11–17.
[17] Wood A, Aynsley E, Kumar G, Masinghe S, Anderson M, Veeratterapillay J, et al. Long‐term overall survival outcomes in patients with early stage, peripherally located, non‐small cell lung cancer treated with stereotactic ablative radiotherapy in a non‐academic cancer Centre. Clin Oncol. 2021; 33(5): 283–291. - PubMed.
[18] Jain S, Poon I, Soliman H, Keller B, Kim A, Lochray F, et al. Lung stereotactic body radiation therapy (SBRT) delivered over 4 or 11 days: a comparison of acute toxicity and quality of life. Radiotherapy and Oncology. 2013. Aug 1; 108(2): 320–325. - PubMed.
[19] Jun S, Serra L, Syed Y, Hermann G, Gomez‐Suescun JA, Singh AK. Comparison of single‐and three‐fraction schedules of stereotactic body radiation therapy for peripheral early‐stage non‐small cell lung cancer HHS public access. Clin Lung Cancer. 2018; 19(2): 235–240.
[20] Singh AK, Gomez‐Suescun JA, Stephans KL, Bogart JA, Hermann GM, Tian L, et al. One versus three fractions of stereotactic body radiation therapy for peripheral stage I to II non‐small cell lung cancer: a randomized, multi‐institution, phase 2 trial. Int J Radiat Oncol Biol Phys. 2019. Nov 15; 105(4): 752–759.
[21] Videtic GMM, Hu C, Singh AK, Chang JY, Parker W, Olivier KR, et al. NRG oncology RTOG 0915 (NCCTG N0927): a randomized phase II study comparing 2 stereotactic body radiation therapy (SBRT) schedules for medically inoperable patients with stage I peripheral non‐small cell lung cancer HHS public access. Int J Radiat Oncol Biol Phys. 2013; 93(4): 757–764.
[22] Videtic GM, Paulus R, Singh AK, Chang JY, Parker W, Olivier KR, et al. Long term follow‐up on NRG oncology RTOG 0915 (NCCTG N0927): a randomized phase II study comparing 2 stereotactic body radiation therapy schedules for medically inoperable patients with stage I peripheral non‐small cell lung cancer. Int J Radiat Oncol Biol Phys. 2019. [cited 2022 Apr 24]
[23] Videtic GMM, Reddy CA, Woody NM, Stephans KL. Ten‐year experience in implementing single‐fraction lung SBRT for medically inoperable early‐stage lung cancer. Int J Radiat Oncol Biol Phys. 2021; 111(2): 436–442. - PubMed.
[24] Gensheimer MF, Gee HE, Von Eyben R, Shirato H, Taguchi H, Wong S, et al. A phase II trial of individualized stereotactic ablative radiotherapy for lung tumors (iSABR). Int J Radiat Oncol Biol Phys. 2021; 111(3): S89–S90.
[25] Bartl AJ, Mahoney M, Hennon MW, Yendamuri S, Videtic GMM, Stephans KL, et al. Systematic review of single‐fraction stereotactic body radiation therapy for early stage non‐small‐cell lung cancer and lung Oligometastases: how to stop worrying and love one and done. Cancers. MDPI. 2022; 14(3): 790.
[26] Chen H, Laba JM, Zayed S, Boldt RG, Palma DA, Louie AV. Safety and Effectiveness of Stereotactic Ablative Radiotherapy for Ultra‐Central Lung Lesions: A Systematic Review. J Thorac Oncol. Elsevier Inc. 2019; 14: 1332–1342. – PubMed.
[27] Videtic GMM, Donington J, Giuliani M, Heinzerling J, Karas TZ, Kelsey CR, et al. Stereotactic body radiation therapy for early‐stage non‐small cell lung cancer: executive summary of an ASTRO evidence‐based guideline. Pract Radiat Oncol. 2017; 7(5): 295–301. – PubMed.
[28] Rim CH, Kim Y, Kim CY, Yoon WS, Yang DS. Is stereotactic body radiotherapy for ultra‐central lung tumor a feasible option? A systemic review and meta‐analysis. Int J Radiat Biol. 2018; 95(3): 329–337. – PubMed.
[29] Roach MC, Robinson CG, Dewees TA, Ganachaud J, Przybysz D, Drzymala R, et al. Stereotactic body radiation therapy for central early‐stage NSCLC: results of a prospective phase I/II trial. J Thorac Oncol. 2018; 13(11): 1727–1732 [cited 2022 May 15].
[30] Lindberg K, Grozman V, Karlsson K, Lindberg S, Lax I, Wersäll P, et al. The HILUS‐trial—a prospective Nordic multicenter phase 2 study of Ultracentral lung tumors treated with stereotactic body radiotherapy. J Thorac Oncol. 2021. [cited 2022 May 15]; 16(7): 1200–1210.
[31] Cho WK, Noh JM, Ahn YC, Oh D, Pyo H. Radiation therapy alone in cT1‐3 N0 non‐small cell lung cancer patients who are unfit for surgical resection or stereotactic radiation therapy: comparison of risk‐adaptive dose schedules. Cancer Res Treat. 2016; 48(4): 1187–1195.
[32] Chang JY, Li QQ, Xu QY, Allen PK, Rebueno N, Gomez DR, et al. Stereotactic ablative radiation therapy for centrally located early stage or isolated parenchymal recurrences of non‐small cell lung cancer: How to fly in a “no fly zone”. Int J Radiat Oncol Biol Phys. 2014; 88(5): 1120–1128. – PubMed.
[33] Bogart JA, Hodgson L, Seagren SL, Blackstock AW, Wang X, Lenox R, et al. Phase I study of accelerated conformal radiotherapy for stage I non–small‐cell lung cancer in patients with pulmonary dysfunction: CALGB 39904. J Clin Oncol. 2010; 28(2): 202–206.
[34] Lodeweges JE, van Rossum PSN, Bartels MMTJ, van Lindert ASR, Pomp J, Peters M, et al. Ultra‐central lung tumors: safety and efficacy of protracted stereotactic body radiotherapy. Acta Oncol. 2021; 60(8): 1061–1068. – PubMed.
[35] Tekatli H, Haasbeek N, Dahele M, De Haan P, Verbakel W, Bongers E, et al. Outcomes of Hypofractionated High‐Dose Radiotherapy in Poor‐Risk Patients with “Ultracentral” Non–Small Cell Lung Cancer. J Thorac Oncol. 2016; 11(7): 1081–1089. – PubMed.
[36] Wang C, Rimner A, Gelblum DY, Dick‐Godfrey R, McKnight D, Torres D, et al. Analysis of pneumonitis and esophageal injury after stereotactic body radiation therapy for ultra‐central lung tumors. Lung Cancer. 2020; 147: 45–48.
[37] Giuliani M, Mathew AS, Bahig H, Bratman SV, Filion E, Glick D, et al. SUNSET: stereotactic radiation for Ultracentral non–small‐cell lung cancer—a safety and efficacy trial. Clin Lung Cancer. 2018; 19(4):e529–e532. – PubMed.
[38] Finazzi T, Haasbeek JA, Spoelstra FOB, Palacios MA, Admiraal MA, Bruynzeel AME, et al. Clinical investigation clinical outcomes of stereotactic MR‐Guided adaptive radiation therapy for high‐risk lung tumors. Int J Radiation Oncol Biol Phys. 2020; 107(2): 270–278. – PubMed.
[39] Rulach R, Ball D, Chua KLM, Dahele M, De Ruysscher D, Franks K, et al. An international expert survey on the indications and practice of radical thoracic Reirradiation for non‐small cell lung cancer. Adv. Radiat Oncol. 2021; 6(2): 100653.
[40] Hunter B, Crockett C, Faivre‐Finn C, Hiley C, Salem A. Re‐Irradiation of Recurrent Non‐Small Cell Lung Cancer. Semin Radiat Oncol. 2021; 31(2): 124–132. – PubMed.
[41] Ester EC, Jones DA, Vernon MR, Yuan J, Weaver RD, Shanley RM, et al. Lung reirradiation with stereotactic body radiotherapy (SBRT). J Radiosurg SBRT. 2013; 2(4): 325–331.
[42] Valakh V, Miyamoto C, Micaily B, Chan P, Neicu T, Li S. Repeat stereotactic body radiation therapy for patients with pulmonary malignancies who had previously received SBRT to the same or an adjacent tumor site. J Cancer Res Ther. 2013; 9(4): 680–685. – PubMed.
Cite This Article
  • APA Style

    Lyu, Z., Wei, C. (2024). Stereotactic Body Radiation Therapy (SBRT) for Non-Small Cell Lung Cancer (NSCLC) Therapy. Cancer Research Journal, 12(2), 27-35. https://doi.org/10.11648/j.crj.20241202.12

    Copy | Download

    ACS Style

    Lyu, Z.; Wei, C. Stereotactic Body Radiation Therapy (SBRT) for Non-Small Cell Lung Cancer (NSCLC) Therapy. Cancer Res. J. 2024, 12(2), 27-35. doi: 10.11648/j.crj.20241202.12

    Copy | Download

    AMA Style

    Lyu Z, Wei C. Stereotactic Body Radiation Therapy (SBRT) for Non-Small Cell Lung Cancer (NSCLC) Therapy. Cancer Res J. 2024;12(2):27-35. doi: 10.11648/j.crj.20241202.12

    Copy | Download

  • @article{10.11648/j.crj.20241202.12,
      author = {Zixuan Lyu and Chiming Wei},
      title = {Stereotactic Body Radiation Therapy (SBRT) for Non-Small Cell Lung Cancer (NSCLC) Therapy
    },
      journal = {Cancer Research Journal},
      volume = {12},
      number = {2},
      pages = {27-35},
      doi = {10.11648/j.crj.20241202.12},
      url = {https://doi.org/10.11648/j.crj.20241202.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.crj.20241202.12},
      abstract = {For patients with early-stage non-small cell lung cancer (NSCLC) who cannot undergo surgery, stereotactic body radiotherapy (SBRT), also known as stereotactic ablative radiotherapy (SABR), usually achieves good therapeutic effects. This new treatment method has the characteristics of low toxicity and high efficacy for peripheral lung cancer. However, in central type lung cancer, especially in lesions near structures such as bronchial trees or mediastinum, there is an increased risk of severity. This review summarizes the following areas: (1) the methods and indications of using SBRT to treat NSCLC patients in different areas; (2) the principle and advantages and disadvantages of targeted MRI linear accelerators; (3) the diagnostic and evaluation process of targeted MRI linear accelerator therapy for lung cancer; (4) the clinical process of targeted MRI linear accelerator treatment for lung cancer; (5) tracking and monitoring of targeted MRI linear accelerator therapy for lung cancer; (6) pulmonary MRI disorders may include the following situations; (7) how to evaluate stage I-IV non-small cell lung cancer with targeted MRI linear accelerator; (8) how to locate central and peripheral lung cancer using targeted MRI linear accelerators; (9) increase safety of SBRT in central locations.
    },
     year = {2024}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Stereotactic Body Radiation Therapy (SBRT) for Non-Small Cell Lung Cancer (NSCLC) Therapy
    
    AU  - Zixuan Lyu
    AU  - Chiming Wei
    Y1  - 2024/06/19
    PY  - 2024
    N1  - https://doi.org/10.11648/j.crj.20241202.12
    DO  - 10.11648/j.crj.20241202.12
    T2  - Cancer Research Journal
    JF  - Cancer Research Journal
    JO  - Cancer Research Journal
    SP  - 27
    EP  - 35
    PB  - Science Publishing Group
    SN  - 2330-8214
    UR  - https://doi.org/10.11648/j.crj.20241202.12
    AB  - For patients with early-stage non-small cell lung cancer (NSCLC) who cannot undergo surgery, stereotactic body radiotherapy (SBRT), also known as stereotactic ablative radiotherapy (SABR), usually achieves good therapeutic effects. This new treatment method has the characteristics of low toxicity and high efficacy for peripheral lung cancer. However, in central type lung cancer, especially in lesions near structures such as bronchial trees or mediastinum, there is an increased risk of severity. This review summarizes the following areas: (1) the methods and indications of using SBRT to treat NSCLC patients in different areas; (2) the principle and advantages and disadvantages of targeted MRI linear accelerators; (3) the diagnostic and evaluation process of targeted MRI linear accelerator therapy for lung cancer; (4) the clinical process of targeted MRI linear accelerator treatment for lung cancer; (5) tracking and monitoring of targeted MRI linear accelerator therapy for lung cancer; (6) pulmonary MRI disorders may include the following situations; (7) how to evaluate stage I-IV non-small cell lung cancer with targeted MRI linear accelerator; (8) how to locate central and peripheral lung cancer using targeted MRI linear accelerators; (9) increase safety of SBRT in central locations.
    
    VL  - 12
    IS  - 2
    ER  - 

    Copy | Download

Author Information
  • Department of Infectious Diseases, Chinese Academy of Biomedical Sciences, Hong Kong, China

  • Department of Infectious Diseases, Chinese Academy of Biomedical Sciences, Hong Kong, China; Department of Nano Medicine, American Nanomedicine Institute, Baltimore, USA

  • Sections