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Stereotactic Body Radiation Therapy (SBRT)

Stereotactic body radiation therapy (SBRT), also called stereotactic ablative radiotherapy (SABR), is a type of radiation therapy in which a few very high doses of radiation are delivered to small, well-defined tumors. The goal is to deliver a radiation dose that is high enough to kill the cancer while minimizing exposure to surrounding healthy organs.

MD Anderson's stereotactic body radiation treatment suite. 

SBRT is typically used to treat small, early-stage tumors of the lung, or isolated recurrences or metastases from various types of cancer. SBRT has also been used successfully to treat early-stage non-small cell lung cancer, recurrent lung parenchyma cancer, pancreatic cancer, and metastatic cancers in the:

SBRT is being tested at MD Anderson to treat other types of cancer. In some cases, it can be used instead of surgery.

SBRT begins with one or more sessions of treatment planning, which involves using imaging (computerized tomography, magnetic resonance imaging, positron emission tomography scanning and X-rays) to precisely map the exact position of the tumor to be treated. These images are then used to create customized treatment plans in which sophisticated computerized devices direct several radiation beams of different intensities at different angles, so that the radiation is directed precisely to the tumor. 

Treatments are usually given once a day for about a week, although this can vary depending on the type of tumor and the condition of the patient. Other images are also taken during the treatment period to account for shrinkage of the tumor or other changes that might affect its position. 

Stereotactic body radiation therapy is not appropriate for everyone. The most important considerations are the type of cancer and where it is located, as well as the physical condition of the patient. Meticulous treatment planning and image-guided treatment delivery are crucial for the success of SBRT and for keeping side effects to the lowest possible level. Your radiation oncologist will discuss whether SBRT is suitable for you and what kinds of side effects may result from your treatment.

Publications

Chang JY. Stereotactic ablative radiotherapy for stage I NSCLC: Successes and existing challenges. J Thorac Dis. 2011 Sep;3(3):144-6. 

Chang JY, Balter PA, Dong L, Yang Q, Liao Z, Jeter M, Bucci MK, McAleer MF, Mehran RJ, Roth JA, Komaki R. Stereotactic body radiation therapy in centrally and superiorly located stage I or isolated recurrent non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2008 Nov 15;72(4):967-71.

Kelly P, Balter PA, Rebueno N, Sharp HJ, Liao Z, Komaki R, Chang JY. Stereotactic body radiation therapy for patients with lung cancer previously treated with thoracic radiation. Int J Radiat Oncol Biol Phys. 2010 Dec 1;78(5):1387-93. Epub 2010 Apr 8.

Welsh J, Thomas J, Shah D, Allen PK, Wei X, Mitchell K, Gao S, Balter P, Komaki R, Chang JY. Obesity increases the risk of chest wall pain from thoracic stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys. 2011 Sep 1;81(1):91-6. Epub 2010 Jun 11.

Zhang X, Liu H, Balter P, Allen PK, Komaki R, Pan T, Chuang HH, Chang JY. Positron Emission Tomography for Assessing Local Failure After Stereotactic Body Radiotherapy for Non-Small-Cell Lung Cancer. Int J Radiat Oncol Biol Phys. 2012 May 7. PMID: 22572078.  

Liu H, Zhang X, Vinogradskiy YY, Swisher SG, Komaki R, Chang JY. Predicting Radiation Pneumonitis After Stereotactic Ablative Radiation Therapy in Patients Previously Treated With Conventional Thoracic Radiation Therapy. Int J Radiat Oncol Biol Phys. 2012 Apr 27. [Epub ahead of print] PMID: 22543216 


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