Stereotactic Body Radiation and Other Ablative Therapies

Abstract

Lung cancer is the leading cause of cancer death in both men and women. This is related to the high prevalence and high mortality particularly when presenting at an advanced stage. Surgical resection remains the standard curative therapy for early-stage lung cancer. However, many patients are not able to tolerate resection secondary to poor respiratory reserve and other comorbid diseases. Stereotactic body radiation therapy (SBRT) and percutaneous thermal ablation are minimally invasive techniques that have been used to treat other solid tumors with curative intent. Over the past decade, there has been an expansion in the roles of both SBRT and thermal ablation in the treatment of early-stage lung tumors. The encouraging results from several studies have led to the incorporation of these therapies, particularly SBRT, as the standard of care for curative-intent treatment of patients with medically inoperable early-stage lung cancer. This chapter presents an overview of the approach to patient selection as well as provides a review of the current evidence for SBRT, percutaneous thermal ablation, and bronchoscopic ablation for early-stage nonsmall cell lung cancers. This review contains 3 figures, 4 tables, and 28 references Key Words: stereotactic body radiation therapy, percutaneous thermal ablation, cryoablation, microwave ablation, endoscopic ablation, bronchoscopic ablation, radiofrequency ablation, early stage NSCLC therapy