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Management Perspective

Results of stereotactic radiotherapy for stage I non-small-cell lung cancer: is there a need for image guidance and highly sophisticated devices?

    Frank Zimmermann

    * Author for correspondence

    Clinic of Radiation Oncology, Petersgraben 4, University Hospital, University Basel, 4031 Basel, Switzerland.

    ,
    Katarzyna Mosna-Firlejczyk

    Clinic of Radiation Oncology, Petersgraben 4, University Hospital, University Basel, 4031 Basel, Switzerland

    ,
    Alexandros Papachristofilou

    Clinic of Radiation Oncology, Petersgraben 4, University Hospital, University Basel, 4031 Basel, Switzerland

    &
    Markus Groß

    Clinic of Radiation Oncology, Petersgraben 4, University Hospital, University Basel, 4031 Basel, Switzerland

    Published Online:https://doi.org/10.2217/lmt.12.27

    SUMMARY In stage I non-small-cell lung cancer, stereotactic body radiation therapy achieves a local control of 90%, by accurate dose delivery with stereotactic beam navigation and/or image-guided techniques, and extremely dose-escalated hypofractionated radiotherapy. Three-to-ten fractions over 1–2 weeks or one single fraction as radiosurgery are used. A broad spectrum of different techniques have also been introduced, some encouraged by electric companies, and heavily commercialized by institutions and physicians. Although a direct comparison of these techniques has been carried out only in technical and not within clinical trials; clinical data from the few prospective Phase I and II trials and the majority of retrospective evaluations have not shown superiority of either technique. Based on personal experiences, there are nearly no limitations for the use of very simple and cheap techniques, and the broad and increasing disposition of dedicated systems is questionable.

    Papers of special note have been highlighted as: ▪ of interest

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