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Scalpel or SABR for Treatment of Early-Stage Lung Cancer: Clinical Considerations for the Multidisciplinary Team
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
* Author to whom correspondence should be addressed.
Received: 15 July 2011; in revised form: 17 August 2011 / Accepted: 22 August 2011 / Published: 1 September 2011
Abstract: Treatment options for early-stage (T1-2 N0) non-small cell lung cancer are often limited by the patient’s advanced age, poor performance status, and comorbidities. Despite these challenges, stereotactic ablative radiotherapy (SABR) provides a highly effective and safe therapy for intrathoracic tumors and has become the standard of care for delivering definitive treatment in medically inoperable patients. High-quality treatment, which includes reliable immobilization, accurate tumor targeting, and precise verification of dose delivery, is essential both to achieve successful cure and to avoid debilitating toxicities. Generally, SABR is well tolerated in patients with peripherally located tumors, but even centrally or superiorly located lesions can be treated if there is adequate conformal avoidance of normal structures and/or modified fractionation to meet dose constraints. While several preliminary studies suggest that SABR is as efficacious as surgery in operable patients, results of randomized data will illuminate whether the indications for SABR can be expanded to include patients who are candidates for surgical resection. Herein, we review the rationale for using SABR and its application in treating different patient populations with early-stage lung cancer.
Keywords: early-stage non-small cell lung cancer; stereotactic body radiation therapy; stereotactic ablative body radiotherapy
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MDPI and ACS Style
Shirvani, S.M.; Chang, J.Y. Scalpel or SABR for Treatment of Early-Stage Lung Cancer: Clinical Considerations for the Multidisciplinary Team. Cancers 2011, 3, 3432-3448.
Shirvani SM, Chang JY. Scalpel or SABR for Treatment of Early-Stage Lung Cancer: Clinical Considerations for the Multidisciplinary Team. Cancers. 2011; 3(3):3432-3448.
Shirvani, Shervin M.; Chang, Joe Y. 2011. "Scalpel or SABR for Treatment of Early-Stage Lung Cancer: Clinical Considerations for the Multidisciplinary Team." Cancers 3, no. 3: 3432-3448.