Lung stereotactic body radiotherapy (SBRT): a single institution’s outcomes and methodology in the context of a literature review
Lung cancer is the leading cause of cancer death in the United States and worldwide, with the incidence of early stage lung cancer anticipated to rise with increasing use of screening CT. Improvements in systemic therapy have increased the need for durable local control both in primary lung cancer as well as oligometastatic disease to the lung. Since 2007, the University of California San Diego (UCSD) has employed SBRT in the treatment of early stage primary non-small cell histology (NSCLC), intrapulmonary oligometastases, and multiple primary lung cancers (MPLCs) with high efficacy and low toxicity using a frameless technique that involves non-invasive image guidance. We review our center’s general approach to management including our experience with clinical outcomes and toxicity in the context of a review of the literature, details of our preferred technique (including simulation and real-time tumor tracking), as well as our results and strategy for patient follow-up using PET to monitor tumor response in the post-SBRT setting.