Kelley Tipton, MPH; Jason H. Launders, MSc; Rohit Inamdar, MSc, DABR; Curtis Miyamoto, MD; Karen Schoelles, MD, SM
Tipton K, Launders JH, Inamdar R, Miyamoto C, Schoelles K. Stereotactic Body Radiation Therapy: Scope of the Literature. Ann Intern Med. 2011;154:737-745. doi: 10.7326/0003-4819-154-11-201106070-00343
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Published: Ann Intern Med. 2011;154(11):737-745.
Stereotactic body radiation therapy (SBRT) is derived from the techniques of stereotactic radiosurgery used to treat lesions in the brain and spine. It combines multiple finely collimated radiation beams and stereotaxy to deliver a high dose of radiation to an extracranial target in the body in a single dose or a few fractions.
This review provides a broad overview of the current state of SBRT for solid malignant tumors. Reviewers identified a total of 124 relevant studies. To our knowledge, no published comparative studies address the relative effectiveness and safety of SBRT versus other forms of external-beam radiation therapy. Stereotactic body radiation therapy seems to be widely diffused as a treatment of various types of cancer, although most studies have focused only on its use for treating thoracic tumors.
Comparative studies are needed to provide evidence that the theoretical advantages of SBRT over other radiation therapies actually occur in the clinical setting; this area is currently being studied in only 1 small trial.
Advances in planning and delivering radiation treatment have led to greater interest and capabilities to treat smaller and hard-to-target tumors while reducing treatment time.
Stereotactic body radiation therapy (SBRT) is typically delivered in 1 to 5 fractions, with a typical total dose of 20 to 60 Gy.
Stereotactic body radiation therapy seems to be widely used for treating various types of cancer, although most studies have focused only on its use to treat thoracic tumors. Fewer than 10 studies each for tumors of the pancreas, liver, colon, uterus, pelvis, sacrum, kidney, and prostate were found in this technical brief.
The American Association of Physicists in Medicine Task Group on SBRT has emphasized the importance of having well-trained and dedicated staff for providing SBRT in a safe environment.
No published comparative studies address the relative effectiveness and safety of SBRT versus other forms of external-beam radiation therapy. Only 1 small, ongoing trial is making such a comparison.
Comparative studies are needed to provide evidence that the theoretical advantages of SBRT over other radiotherapies actually occur in the clinical setting.
Future studies may help to determine the optimal number of radiation fractions, minimum and maximum doses per fraction, maximum number and diameter of lesions for various locations, and radiobiological explanations for the efficacy of SBRT.
The system incorporates a high-definition, 120-leaf multileaf collimator; robotic couch; cone-beam computed tomography; and stereoradiograph target–verification system. (Photo courtesy of Varian Medical Systems, Palo Alto, California. All rights reserved.)
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