Stereotactic body radiation therapy

Stereotactic body radiotherapy (SBRT) is a noninvasive method to deliver high doses of precision radiotherapy to small tumors in the body using novel technologies developed over the last 15 years. Since its inception, this approach was initially developed to shorten therapy for patients with severe limitations making more prolonged courses of radiation a significant burden but investigators have discovered that this treatment not only is more efficacious than conventional therapy but also has lower side effect profile. In fact, the outcomes are so favorable that several cooperative groups are now challenging the paradigm that surgery is the standard of care for lung cancer. Inside this chapter, the authors paint the picture of the current landscape of SBRT and the important steps needed to consider as a clinical SBRT program is developed. This includes the definition of target volumes, the mechanism of action, patient selection, the appropriate use of immobilization, motion management, image guidance, and simulation. In addition, the last several sections try to go through the clinical data for the most commonly treated subsites with SBRT and discuss the potential future.​