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Practical considerations of single-fraction stereotactic ablative radiotherapy to the lung

Journal Article


Abstract


  • Stereotactic ablative radiotherapy (SABR) is a well-established treatment for patients with medically inoperable early-stage non-small cell lung cancer (NSCLC) and pulmonary oligometastases. The use of single-fraction SABR in this setting is supported by excellent local control and safety profiles which appear equivalent to multi-fraction SABR based on the available data. The resource efficiency and reduction in hospital outpatient visits associated with single-fraction SABR have been particularly advantageous during the COVID-19 pandemic. Despite the increased interest, single-fraction SABR in subgroups of patients remains controversial, including those with centrally located tumours, synchronous targets, proximity to dose-limiting organs at risk, and concomitant severe respiratory illness. This review provides an overview of the published randomised evidence evaluating single-fraction SABR in primary lung cancer and pulmonary oligometastases, the common clinical challenges faced, immunogenic effect of SABR, as well as technical and cost-utility considerations.

UOW Authors


  •   Hardcastle, Nicholas (external author)

Publication Date


  • 2022

Citation


  • Kang, T. M., Hardcastle, N., Singh, A. K., Slotman, B. J., Videtic, G. M. M., Stephans, K. L., . . . Siva, S. (2022). Practical considerations of single-fraction stereotactic ablative radiotherapy to the lung. Lung Cancer, 170, 185-193. doi:10.1016/j.lungcan.2022.06.014

Scopus Eid


  • 2-s2.0-85134333650

Web Of Science Accession Number


Start Page


  • 185

End Page


  • 193

Volume


  • 170

Abstract


  • Stereotactic ablative radiotherapy (SABR) is a well-established treatment for patients with medically inoperable early-stage non-small cell lung cancer (NSCLC) and pulmonary oligometastases. The use of single-fraction SABR in this setting is supported by excellent local control and safety profiles which appear equivalent to multi-fraction SABR based on the available data. The resource efficiency and reduction in hospital outpatient visits associated with single-fraction SABR have been particularly advantageous during the COVID-19 pandemic. Despite the increased interest, single-fraction SABR in subgroups of patients remains controversial, including those with centrally located tumours, synchronous targets, proximity to dose-limiting organs at risk, and concomitant severe respiratory illness. This review provides an overview of the published randomised evidence evaluating single-fraction SABR in primary lung cancer and pulmonary oligometastases, the common clinical challenges faced, immunogenic effect of SABR, as well as technical and cost-utility considerations.

UOW Authors


  •   Hardcastle, Nicholas (external author)

Publication Date


  • 2022

Citation


  • Kang, T. M., Hardcastle, N., Singh, A. K., Slotman, B. J., Videtic, G. M. M., Stephans, K. L., . . . Siva, S. (2022). Practical considerations of single-fraction stereotactic ablative radiotherapy to the lung. Lung Cancer, 170, 185-193. doi:10.1016/j.lungcan.2022.06.014

Scopus Eid


  • 2-s2.0-85134333650

Web Of Science Accession Number


Start Page


  • 185

End Page


  • 193

Volume


  • 170