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Cancers (Basel). 2015 Jun 15;7(2):981-1004. doi: 10.3390/cancers7020820.

Complications from Stereotactic Body Radiotherapy for Lung Cancer.

Author information

1
School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA. Kylie.Kang@case.edu.
2
Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA. Christian.Okoye@uhhospitals.org.
3
Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA. Ravi.Patel@uhhospitals.org.
4
Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia. Shankar.Siva@petermac.org.
5
Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA. Tithi.Biswas@UHhospitals.org.
6
Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA. Rodney.Ellis@UHhospitals.org.
7
Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA. Min.Yao@UHhospitals.org.
8
Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA. Mitchell.Machtay@UHhospitals.org.
9
Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA. Simon.Lo@uhhospitals.org.

Abstract

Stereotactic body radiotherapy (SBRT) has become a standard treatment option for early stage, node negative non-small cell lung cancer (NSCLC) in patients who are either medically inoperable or refuse surgical resection. SBRT has high local control rates and a favorable toxicity profile relative to other surgical and non-surgical approaches. Given the excellent tumor control rates and increasing utilization of SBRT, recent efforts have focused on limiting toxicity while expanding treatment to increasingly complex patients. We review toxicities from SBRT for lung cancer, including central airway, esophageal, vascular (e.g., aorta), lung parenchyma (e.g., radiation pneumonitis), and chest wall toxicities, as well as radiation-induced neuropathies (e.g., brachial plexus, vagus nerve and recurrent laryngeal nerve). We summarize patient-related, tumor-related, dosimetric characteristics of these toxicities, review published dose constraints, and propose strategies to reduce such complications.

KEYWORDS:

complications; non-small cell lung cancer (NSCLC); stereotactic ablative radiotherapy (SABR); stereotactic body radiation therapy (SBRT); toxicity

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