In lung cancer treatment, Stereotactic Ablative Radiotherapy (SABR) is rapidly been used as an important radiation tool. SABR is being evaluated for treatment of medically inoperable lung cancer, operable lung cancers, metastases from primary tumors to the lungs and lung disease as well. SABR is an external beam treatment modality that has the ability to deliver with high precision large doses of radiation over a limited number of fractions. It is a state-of-the-art therapy to use intensity modulation to increase the fractional dose, target tumors and decrease the number of fractions.
SABR is a standard care treatment of early-stage primary non-small cell lung cancers. Patients with resectable lung primaries are also looking to SABR as a non-invasive means of therapy. SABR is expected to reduce the tumor burden by eradicating gross tumors which are identified through imaging and controlling microscopic cancer with systematic treatment. It is also expected that SABR is also beneficial for life preservation in older adults or those who are heavily treated.
Many studies nationally and internationally are trying to address several questions related to SABR for non-small cell lung cancer. They are using various dose fractionation schemes to identify an optimal dose and dose per fraction. Also, they are investigating the limits of tumor size and dose per fraction.
Researchers at Stanford University have developed an individualized approach for lung SABR by using dose and fractionation regimens. Their clinical trial was published in JAMA Oncology. Vivek Verma from the University of Texas MD Anderson Cancer Center notes that “among the most common misconceptions of lung SABR is that virtually all patients experience high local control.”
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