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Stereotactic body radiation therapy: a novel treatment modality

Nature Reviews Clinical Oncology volume 7, pages 44–54 (2010)Cite this article

A Correction to this article was published on 01 August 2010

Abstract

Stereotactic body radiation therapy (SBRT) involves the delivery of a small number of ultra-high doses of radiation to a target volume using very advanced technology and has emerged as a novel treatment modality for cancer. The role of SBRT is most important at two cancer stages—in early primary cancer and in oligometastatic disease. This modality has been used in the treatment of early-stage non-small-cell lung cancer, prostate cancer, renal-cell carcinoma, and liver cancer, and in the treatment of oligometastases in the lung, liver, and spine. A large body of evidence on the use of SBRT for the treatment of primary and metastatic tumors in various sites has accumulated over the past 10–15 years, and efficacy and safety have been demonstrated. Several prospective clinical trials of SBRT for various sites have been conducted, and several other trials are currently being planned. The results of these clinical trials will better define the role of SBRT in cancer management. This article will review the radiobiologic, technical, and clinical aspects of SBRT.

Key Points

  • Stereotactic body radiation therapy (SBRT) is a novel treatment modality that involves the high-precision delivery of very high individual doses of radiation to tumors in various extracranial sites

  • The most common indications for SBRT are nonmetastatic primary cancer and oligometastasis

  • SBRT has been used to treat patients with various primary tumors in the lung, liver, prostate, kidney and pancreas, and those with oligometastases in the lung, liver, and spine

  • Phase I and II trials of SBRT for various primary tumors and oligometastases have demonstrated feasibility, safety, and efficacy with good to excellent local control in most studies

  • Most SBRT studies, retrospective and prospective, have relatively short-term follow-up

  • Well-controlled prospective clinical trials with long-term follow-up, especially randomized trials that compare SBRT with other treatments, are needed to define the role of SBRT fully in various settings and organ sites

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Figure 1: SBRT plan of a 62-year-old patient with metastatic renal cell carcinoma involving the posterior elements from C3 to C5.
Figure 2: A patient with medically inoperable T2N0M0 non-small-cell lung cancer treated in the Indiana University phase II trial who demonstrated a complete pathologic response after SBRT.

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Acknowledgements

The authors would like to thank Ms Sharon Rhymaun-Croyle from Ohio State University, OH, USA, for her help in the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Radiation Oncology, Arthur G. James Cancer Hospital, Ohio State University College of Medicine, 300 West 10th Avenue, Suite 088A, Columbus, 43210, OH, USA.

    Simon S. Lo, Nina A. Mayr & Jian Z. Wang

  2. Department of Radiation Oncology, Indiana University Medical Center, 535 Barnhill Drive, Indianapolis, 46202, IN, USA.

    Achilles J. Fakiris & Higinia R. Cardenes

  3. Department of Radiation Oncology, M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, 77030, TX, USA.

    Eric L. Chang

  4. Department of Radiation Oncology, University of Texas Southwestern Medical Center, 5801 Forest Park Road, Dallas, 75390, TX, USA.

    Lech Papiez & Robert D. Timmerman

  5. Department of Radiation Oncology, The Methodist Hospital, 6565 Fannin Street, Houston, 77030, TX, USA.

    Bin S. Teh

  6. Department of Radiation Medicine, University of Kentucky, 800 Rose Street, Lexington, 40536, KY, USA.

    Ronald C. McGarry

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R. Timmerman receives grant/research support from Elekta Oncology and Varian Medical Systems. The other authors declare no competing interests.

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Lo, S., Fakiris, A., Chang, E. et al. Stereotactic body radiation therapy: a novel treatment modality. Nat Rev Clin Oncol 7, 44–54 (2010). https://doi.org/10.1038/nrclinonc.2009.188

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