Onkológia 1/2021

Stereotactic radiotherapy in the treatment of non-small cell lung cancer

Advances in precise tumor imaging in diagnosis and irradiation made it possible to deliver the sharply defined high dose of radiation in one or a few fractions with maximal protection of adjacent healthy tissues. Both primary and metastatic lesions could be treated by the non-invasive means with a radiobiologically high dose of radiation followed by the high local control comparable with a surgery resection even in a radioresistant tumor like the non-small cell carcinoma of the lung. The prerequisite of the save delivery of stereotactic radiotherapy is the precise technology enabling to meet dose limits for heathy tissues. Clinical application of stereotactic radiotherapy in the management of non-small cell lung cancer involves non-surgical treatment of an early primary tumor, metastases of the brain and oligometastatic disease including spinal metastatic involvement. We provide an overview of the medical evidence supporting respective indications, comparison to and combination of radiotherapy with other modalities, pragmatic guidelines for the proper patient selection and the basic overview of the technology of administering stereotactic radiotherapy.

Keywords: stereotactic radiotherapy, non-small cell lung cancer, brain metastases, spinal metastases