Central-Airway Necrosis after Stereotactic Body-Radiation Therapy

Abstract

Stereotactic body-radiation therapy is a novel technique that aims to deliver higher doses of radiation to cancers in a more focused way. However, adjacent tissues also get higher doses and fatal toxicities can emerge, as in one patient. TO THE EDITOR: Stereotactic body-radiation therapy (SBRT) delivers large doses of radiation with millimeter accuracy.1 With SBRT, control rates for stage I non–small-cell lung cancer are 90% or greater, and this effectiveness has led to its worldwide adoption in treating patients with inoperable disease.1,2 Despite technological advances that permit the precision required for SBRT, normal tissues near the tumor receive higher biologic doses of radiation than with standard treatment. Consequently, patients with tumors adjacent to radiation-sensitive structures, such as the large airways, great vessels, heart, phrenic nerves, and spinal cord, may be at an increased risk for severe radiation . . .