Systematic review of stereotactic ablative radiotherapy (SABR)/stereotactic body radiation therapy (SBRT) for treatment of high-risk patients with stage I non-small cell lung cancer Review
| Authors: | Wolf, A.; Loo, B. W. Jr; Mak, R. H.; Liptay, M.; Pettiford, B.; Rocco, G.; Lanuti, M.; Merritt, R. E.; Keshavarz, H.; Suh, R. D.; Brunelli, A.; Criner, G. J.; Mazzone, P. J.; Walsh, G.; Wafford, Q. E.; Murthy, S.; Marshall, M. B.; Tong, B.; Luketich, J.; Schuchert, M. J.; Varghese, T. K. Jr; D'Amico, T. A.; Pennathur, A.; Swanson, S. J.; The AATS Clinical Practice Standards Committee: Thoracic Surgery |
| Review Title: | Systematic review of stereotactic ablative radiotherapy (SABR)/stereotactic body radiation therapy (SBRT) for treatment of high-risk patients with stage I non-small cell lung cancer |
| Abstract: | Stereotactic ablative radiotherapy (SABR) has emerged as an alternative, non-surgical treatment for high-risk patients with stage I non-small cell lung cancer (NSCLC) with increased use over time. The American Association for Thoracic Surgery (AATS) Clinical Practice Standards Committee (CPSC) assembled an expert panel and conducted a systematic review of the literature evaluating the results of SABR, which is also referred to as stereotactic body radiation therapy (SBRT) or stereotactic radiosurgery (SRS), prior to developing treatment recommendations for high-risk patients with stage I NSCLC based on expert consensus. Publications detailing the findings of 16 prospective studies of SABR and 14 retrospective studies of SABR for the management of early-stage lung cancer in 54,697 patients were identified by systematic review of the literature with further review by members of our expert panel. Medical inoperability (93–95%) was the primary reason for utilizing SABR. The median rate of histologically confirmed cancer in treated patients was 67% (range 57–86%). In retrospective studies and prospective studies, the most common dosing regimens were 48–54 Gy in 3–5 fractions and 44–66 Gy in 3–5 fractions respectively. The median follow-up after SABR was 30 months (range 15–50). The complications, oncological results and quality of life after SABR in high-risk patients with early-stage NSCLC are summarized in this Expert Review article. Further prospective randomized trials are needed and are currently underway to compare outcomes after SABR with outcomes after sublobar resection to fully evaluate treatment options applicable this high-risk group of patients. © 2024 |
| Keywords: | treatment outcome; overall survival; fatigue; mortality; review; image acquisition; cancer recurrence; disease free survival; radiation dose; cancer staging; outcome assessment; recurrence risk; neoplasm staging; prospective study; consensus; quality of life; esophagitis; lung disease; lung lobectomy; carcinoma, non-small-cell lung; lung neoplasms; radiotherapy; morbidity; risk factors; pathology; retrospective study; risk factor; histology; high risk patient; time factors; risk assessment; coughing; dyspnea; fibrosis; lung tumor; thorax pain; systematic review; radiation dose fractionation; radiosurgery; clinical evaluation; toxicity testing; surgery; pleura effusion; interstitial lung disease; skin disease; stereotactic radiosurgery; radiofrequency ablation; stereotactic body radiation therapy; radiation dose distribution; lobectomy; life expectancy; thorax disease; immobilization; breathing pattern; interstitial pneumonia; lung hemorrhage; non small cell lung cancer; high-risk; randomized controlled trial (topic); adverse event; phase 2 clinical trial (topic); time factor; chest wall toxicity; humans; human; radiation therapy oncology group; stereotactic ablative radiotherapy; positron emission tomography-computed tomography; distant recurrence free survival; expert consensus; stage i non-small cell lung cancer; dose fractionation, radiation; stereotactic body radiation treatment; american association for thoracic surgery; central lesion; clinical practice standards committee; inoperability; lung cancer specific survival; motion management technique; pathological complete response rate; radiation induced malformation; sabr target volume; stereotactic fractionated radiotherapy in patients with medically inoperable small lung tumor |
| Journal Title: | Seminars in Thoracic and Cardiovascular Surgery |
| Volume: | 37 |
| Issue: | 1 |
| ISSN: | 1043-0679 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2025-03-01 |
| Start Page: | 89 |
| End Page: | 98 |
| Language: | English |
| DOI: | 10.1053/j.semtcvs.2024.10.005 |
| PUBMED: | 39674443 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Review -- Source: Scopus |
