ARLINGTON, Va., June 12, 2017 -- The American Society for Radiation Oncology (ASTRO) issued a new clinical guideline for the use of stereotactic body radiation therapy (SBRT) in early-stage lung cancer today. While SBRT is the current standard of care for peripherally located tumors in patients who cannot undergo surgery, the new guideline addresses the appropriateness of SBRT for medically inoperable patients with high-risk clinical scenarios requiring curative focused therapy. The guideline also reviews the role of SBRT for centrally located tumors because of their unique risks compared to peripheral tumors. The guideline is available as a free access article (link will be live after embargo lifts) in Practical Radiation Oncology, ASTRO's clinical practice journal.

SBRT is an advanced type of external beam radiation therapy that uses sophisticated planning techniques to deliver an extremely high dose of radiation very precisely to a tumor. This high degree of precision makes SBRT notably effective at sparing healthy tissues surrounding the tumor, which is particularly important with lung tumors. For patients who are not fit enough for early-stage lung cancer surgery, SBRT presents a viable option for curative-intent treatment since it provides excellent outcomes with low toxicity. Compared to conventional external beam radiation therapy, which is delivered over several weeks, SBRT is typically administered in five or fewer treatment sessions, or fractions.

Drawing on data from retrospective and prospective studies and the available randomized clinical trials, the guideline provides evidence-based recommendations regarding the appropriate use of SBRT for early-stage non-small cell lung cancer (NSCLC). The principal goal of the guideline was to address SBRT for patients unable to tolerate surgery who require customization of SBRT in high-risk clinical scenarios, such as for salvage therapy after previous surgery or radiation therapy, for tumors invading the chest wall or for very large tumors. The guideline also details principles of SBRT directed toward centrally located lung tumors, since treating these tumors carries unique and significant risks when compared to treatment directed at peripherally located tumors. Additionally, although the focus of the guideline was the inoperable patient, the appropriateness of SBRT in the operable patient also was addressed, since it is an area of debate and controversy.

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