Stereotactic body radiotherapy - Current indications

Abstract

Background: Stereotactic body radiotherapy (SBRT) is used to treat localized tumor lesions and consists of apply ing high doses of radiation to a small number of fractions us ing specially equipped linear accelerators, modern immobilization devices, and imag ing methods, which are considered special, advanced techniques in modern day radiotherapy. SBRT is a very well tolerated, non-invasive, short-term treatment that does not require hospitalization or any complicated preparation. Compared to standard radiotherapy techniques, SBRT allows, due to its precision, signifi - cantly higher doses to be applied to the target with less damage to surround ing healthy tissues. If dose constraints are not exceeded, the risk of damage to tissues and organs around the irradiated volume is reduced to minimum. The principle of SBRT is the application of ablative doses of radiation that cause necrosis of the irradiated tissue. Purpose: The aim of this review is to provide a basic overview of SBRT indications, radiation doses used, and potential side eff ects. It is not intended to be a detailed description of treatment itself (such as discussion of patient fi xation systems, management of respiratory movements, or image guided strategies of treatment). This review also discusses rarer indications for SBRT, such as pancreatic carcinoma or hepatocellular carcinoma. Conclusion: Advances in image navigation, radiation planning, and dose application have enabled successful introduction of SBRT as a treatment regimen for many primary tumors and oligometastatic dis ease. If surgery is not possible or the patient refuses surgery, it is always reasonable to consider SBRT. SBRT has curative potential for the treatment of primary lung or prostate tumors. High-dose irradiation of oligometastases of various primary tumors can lead to long-term survival without dis ease symp toms, delay administration of toxic systemic ther apies, and improve the quality of life of oncological patients.