A recently reported study (in the Journal of the American Medical Association, 2010) demonstrated the remarkable effectiveness of the latest radiation therapy technique (called “stereotactic body radiation therapy” or “SBRT”) in the treatment of early stage lung cancers (stage 1, T1-2N0M0, non-small cell carcinoma.) The study authors (Radiation Therapy Oncology Group), reported a 97.6% local tumor control rate, 3 years after a 3-day course of SBRT (3 doses of 20 Gy). These excellent results are comparable to those achievable by surgery, but SBRT has the advantage of being a non-invasive treatment.
A course of SBRT frequently involves 3-5 daily doses of external beam radiation. Each treatment session can last between 15-60 minutes, depending on the device/technology used.
SBRT is now considered the standard treatment option for patients with early stage lung cancer (stage 1, T1-2N0M0, non-small cell cancer) who are either elderly or have medical conditions (i.e. emphysema, COPD, diabetes, heart disease, etc.) that would place them at a high-risk from potential surgical complications.
Patients with early stage lung cancer who are healthy enough for surgery can select SBRT for early stage lung cancers, although to date, surgery remains the “gold standard” treatment. There are multiple clinical trials that are currently evaluating the role of SBRT in medically operable (healthy) patients with early stage lung cancers.
You can search for actively recruiting clinical trials through the U.S. National Cancer Institute website.
To find out if you are eligible for this short-course treatment, you will need to discuss this with your oncology team.
There are multiple devices/technologies that can be used to deliver stereotactic body radiation therapy (for example):
- Trilogy/iX/TrueBeam (with RapidArc)
- Novalis
- Tomotherapy
- CyberKnife
- Proton beam
All of these devices/technologies are essentially equivalent in terms of their ability to precisely and accurately deliver a high-dose to the tumor while minizing doses to the surrounding normal tissues. No clinical studies have demonstrated superiority among these machines, so don’t be swayed by the name of the machine (i.e. CyberKnife, Triology, TrueBeam, Tomotherapy, Novalis, etc.) when selecting the radiation oncology practice for your treatment. Again, they all do essentially the same thing, and no studies have demonstrated that any one of them is clinically superior.
The most important factors in selecting the right team are the reputation, training and experience of the radiation oncologists and their support staff (physicists, dosimetrists, therapists, nurses, etc.) in treating lung cancer using SBRT.
To ensure that you are receiving the highest quality of radiation oncology care, I recommend that you select a center that is accredited by either the American College of Radiology (ACR) or the the American College of Radiation Oncology (ACRO). To find a list of accredited centers in your area select the following links:
Learn more about radiation therapy.
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