Stereotactic Ablative Radiotherapy for Early-Stage Lung Cancer

Stereotactic ablative radiotherapy (SAbR), also known as stereotactic body radiation therapy (SBRT), utilizes advanced techniques of immobilization, image guidance, and unique field arrangements to deliver precise, oligofractionated radiotherapy to a variety of tumor types. SAbR has been established as a technologically innovative therapy for early-stage non-small cell lung cancer (NSCLC) and has emerged as the standard treatment option for medically inoperable patients through completion of prospective, multi-institutional trials. Recent trials continue to evaluate the role of SAbR in the medically operable and borderline operable population and will compare surgical resection and SAbR as treatment modalities in these patients. This chapter reviews the techniques utilized in SAbR, the evidence for use of SAbR in early-stage lung cancer, its extension of use to medically operable patients, and the toxicities associated with this technique.