Stereotactic radiotherapy in the management of early-stage lung cancer

Stereotactic radiotherapy (SRT), also known as stereotactic body radiotherapy (SBRT), is an advanced form of radiation therapy that delivers highly focused beams of radiation to a specific target within the body. Leading consultant clinical oncologist Dr Crispin Hiley tells us all about how it’s used in the management of early-stage lung cancer.

What is stereotactic radiotherapy?

In the management of early-stage lung cancer, SRT is a non-invasive treatment option that offers precision, reducing damage to surrounding healthy tissues while effectively targeting the tumour.

How does stereotactic radiotherapy work in treating early-stage lung cancer?

Stereotactic radiotherapy uses detailed imaging to create a three-dimensional model of the tumour. This allows the radiation to be delivered from multiple angles, converging on the cancerous tissue with great accuracy. The treatment is usually given over a few sessions (as opposed to the multiple treatments required in conventional radiotherapy), often in 3-5 doses over a period of one or two weeks. The high dose of radiation per session helps to destroy the cancer cells in the targeted area.

Who is suitable for stereotactic radiotherapy in lung cancer treatment?

SRT is most commonly used for patients with early-stage non-small cell lung cancer (NSCLC), particularly those who are not candidates for surgery due to age, medical conditions, or personal preference. It is often chosen when the tumour is small and confined to the lung, and the patient’s overall health may not allow for more invasive procedures like surgery.

What are the advantages of stereotactic radiotherapy?

The benefits of stereotactic radiotherapy in managing early-stage lung cancer include:

• Non-invasive: There is no need for incisions or surgical recovery.
• Precision: The high accuracy minimises damage to healthy lung tissue and surrounding organs.
• Short treatment duration: Fewer sessions are needed compared to conventional radiotherapy, reducing the overall treatment time.
• Outpatient treatment: Most patients receive the treatment as outpatients, allowing them to return home the same day.
• Low risk of complications: SRT is generally well-tolerated, with fewer side effects compared to surgery or traditional radiotherapy.

What are the potential side effects of stereotactic radiotherapy?

While SRT is less likely to cause severe side effects than traditional treatments, some patients may still experience:

• Fatigue
• Mild skin irritation
• Coughing
• Shortness of breath
• Chest wall discomfort

In most cases, these side effects are temporary and subside after the treatment is completed. However, more serious side effects such as radiation pneumonitis (inflammation of lung tissue) can occur but are relatively rare.

How effective is stereotactic radiotherapy for early-stage lung cancer?

SRT has been shown to offer excellent control of early-stage lung cancer. In many cases, the survival rates for patients treated with stereotactic radiotherapy are comparable to those who undergo surgery, particularly when surgery is not a viable option. Studies have shown that SRT can achieve high local control rates, meaning that the tumour is effectively destroyed or reduced, and the cancer does not spread from the targeted site.

What happens during a typical stereotactic radiotherapy session?

Before treatment, the patient undergoes a planning session, where a CT or PET scan is used to map the exact location of the tumour. During the actual treatment, the patient lies on a treatment couch, and the radiotherapy machine moves around them to deliver the precise doses of radiation. The treatment itself is painless and usually takes less than an hour per session.

What’s next after stereotactic radiotherapy?

After completing stereotactic radiotherapy, patients are closely monitored with follow-up scans and appointments to assess the response of the tumour and ensure that the cancer has not recurred. Ongoing follow-up is crucial to manage any potential side effects and to address any signs of recurrence early.

In summary, stereotactic radiotherapy is a highly effective, non-invasive option for patients with early-stage lung cancer, especially for those who are not surgical candidates. The precision, shorter treatment duration, and excellent outcomes make it an important tool in lung cancer management.

If you require expert SRT treatment, arrange a consultation with Dr Hiley via his Top Doctors profile.