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Stereotactic body radiotherapy in patients with chronic obstructive pulmonary disease and interstitial pneumonia: a review

  • Hiroshi DoiEmail author
  • Kiyoshi Nakamatsu
  • Yasumasa Nishimura
Review Article
  • 53 Downloads

Abstract

Stereotactic body radiation therapy (SBRT) can yield excellent local tumor control, as well as survival benefit comparable to that of surgery for early-stage lung cancer. However, in terms of toxicity, SBRT might lead to fatal radiation pneumonitis. Lung diseases, such as chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD), are major risk factors for lung cancer. However, these patients are typically not candidates for the gold-standard treatment option, lobectomy, because of the perioperative risks. In addition, patients with poor respiratory function can be excluded in prospective clinical trials. Thus, SBRT for patients with pulmonary diseases is still challenging, but there appears to be a clinical role for this modality as an alternative treatment. However, there are few well-documented review articles on SBRT for patients with pulmonary diseases. Therefore, we aimed to review SBRT in the context of important patient-related factors, including COPD and ILD. SBRT is an acceptable alternative treatment option for patients with lung cancer who also have COPD with an equivalent risk of radiation pneumonitis to normal lung. However, latent ILD should be detected prior to treatment. The indication for SBRT should be decided by carefully considering the risks and benefit for patients with ILD.

Keywords

Chronic obstructive pulmonary disease Interstitial lung disease Interstitial pneumonia Lung cancer Stereotactic body radiotherapy Stereotactic ablative radiotherapy 

Notes

Acknowledgements

The authors would like to acknowledge Editage (http://www.editage.jp) for English language editing.

Compliance with ethical standards

Conflict of interest

None declared.

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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  1. 1.Department of Radiation OncologyKindai University Faculty of MedicineOsaka-SayamaJapan

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