Skip to main content
SpringerLink
Log in

Stereotactic Ablative Radiotherapy for Early-Stage Lung Cancer

  • Chapter
  • First Online:
Advances in Radiation Oncology in Lung Cancer

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

  • 339 Accesses

Abstract

Stereotactic ablative radiotherapy (SAbR), also known as stereotactic body radiation therapy (SBRT), utilizes advanced techniques of immobilization, image guidance, and unique field arrangements to deliver precise, oligofractionated radiotherapy to a variety of tumor types. SAbR has been established as a technologically innovative therapy for early-stage non-small cell lung cancer (NSCLC) and has emerged as the standard treatment option for medically inoperable patients through completion of prospective, multi-institutional trials. Recent trials continue to evaluate the role of SAbR in the medically operable and borderline operable population and will compare surgical resection and SAbR as treatment modalities in these patients. This chapter reviews the techniques utilized in SAbR, the evidence for use of SAbR in early-stage lung cancer, its extension of use to medically operable patients, and the toxicities associated with this technique.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Abelson JA, Murphy JD, Loo BW Jr, Chang DT, Daly ME, Wiegner EA, Hancock S, Chang SD, Le QT, Soltys SG, Gibbs IC (2012) Esophageal tolerance to high-dose stereotactic ablative radiotherapy. Dis Esophagus 25:623–629

    Google Scholar 

  • Adebahr S, Collette S, Shash E, Lambrecht M, Le Pechoux C, Faivre-Finn C, De Ruysscher D, Peulen H, Belderbos J, Dziadziuszko R, Fink C, Guckenberger M, Hurkmans C, Nestle U (2015) LungTech, an EORTC phase II trial of stereotactic body radiotherapy for centrally located lung tumours: a clinical perspective. Br J Radiol 88:20150036

    Google Scholar 

  • Ball D, Mai GT, Vinod S, Babington S, Ruben J, Kron T, Chesson B, Herschtal A, Vanevski M, Rezo A, Elder C, Skala M, Wirth A, Wheeler G, Lim A, Shaw M, Schofield P, Irving L, Solomon B, Trog Chisel Investigators (2019) Stereotactic ablative radiotherapy versus standard radiotherapy in stage 1 non-small-cell lung cancer (TROG 09.02 CHISEL): a phase 3, open-label, randomised controlled trial. Lancet Oncol 20:494–503

    Google Scholar 

  • Balter JM, Wright JN, Newell LJ, Friemel B, Dimmer S, Cheng Y, Wong J, Vertatschitsch E, Mate TP (2005) Accuracy of a wireless localization system for radiotherapy. Int J Radiat Oncol Biol Phys 61:933–937

    Google Scholar 

  • Baumann P, Nyman J, Hoyer M, Wennberg B, Gagliardi G, Lax I, Drugge N, Ekberg L, Friesland S, Johansson KA, Lund JA, Morhed E, Nilsson K, Levin N, Paludan M, Sederholm C, Traberg A, Wittgren L, Lewensohn R (2009) Outcome in a prospective phase II trial of medically inoperable stage I non-small-cell lung cancer patients treated with stereotactic body radiotherapy. J Clin Oncol 27:3290–3296

    Google Scholar 

  • Benedict SH, Lin PS, Zwicker RD, Huang DT, Schmidt-Ullrich RK (1997) The biological effectiveness of intermittent irradiation as a function of overall treatment time: development of correction factors for linac-based stereotactic radiotherapy. Int J Radiat Oncol Biol Phys 37:765–769

    Google Scholar 

  • Benedict SH, Yenice KM, Followill D, Galvin JM, Hinson W, Kavanagh B, Keall P, Lovelock M, Meeks S, Papiez L, Purdie T, Sadagopan R, Schell MC, Salter B, Schlesinger DJ, Shiu AS, Solberg T, Song DY, Stieber V, Timmerman R, Tome WA, Verellen D, Wang L, Yin FF (2010) Stereotactic body radiation therapy: the report of AAPM Task Group 101. Med Phys 37:4078–4101

    Google Scholar 

  • Bezjak A, Paulus R, Gaspar LE, Timmerman RD, Straube WL, Ryan WF, Garces YI, Pu AT, Singh AK, Videtic GM, McGarry RC, Iyengar P, Pantarotto JR, Urbanic JJ, Sun AY, Daly ME, Grills IS, Sperduto P, Normolle DP, Bradley JD, Choy H (2019) Safety and efficacy of a five-fraction stereotactic body radiotherapy schedule for centrally located non-small-cell lung cancer: NRG oncology/RTOG 0813 trial. J Clin Oncol 37:1316–1325

    Google Scholar 

  • Bibault JE, Prevost B, Dansin E, Mirabel X, Lacornerie T, Lartigau E (2012) Image-guided robotic stereotactic radiation therapy with fiducial-free tumor tracking for lung cancer. Radiat Oncol 7:102

    Google Scholar 

  • Blomgren H, Lax I, Naslund I, Svanstrom R (1995) Stereotactic high dose fraction radiation therapy of extracranial tumors using an accelerator. Clinical experience of the first thirty-one patients. Acta Oncol 34:861–870

    Google Scholar 

  • Bouilhol G, Ayadi M, Rit S, Thengumpallil S, Schaerer J, Vandemeulebroucke J, Claude L, Sarrut D (2013) Is abdominal compression useful in lung stereotactic body radiation therapy? A 4DCT and dosimetric lobe-dependent study. Phys Med 29:333–340

    Google Scholar 

  • Brown JM, Diehn M, Loo BW Jr (2010) Stereotactic ablative radiotherapy should be combined with a hypoxic cell radiosensitizer. Int J Radiat Oncol Biol Phys 78:323–327

    Google Scholar 

  • Brown JM, Brenner DJ, Carlson DJ (2013) Dose escalation, not “new biology,” can account for the efficacy of stereotactic body radiation therapy with non-small cell lung cancer. Int J Radiat Oncol Biol Phys 85:1159–1160

    Google Scholar 

  • Cardinale RM, Wu Q, Benedict SH, Kavanagh BD, Bump E, Mohan R (1999) Determining the optimal block margin on the planning target volume for extracranial stereotactic radiotherapy. Int J Radiat Oncol Biol Phys 45:515–520

    Google Scholar 

  • Chang SD, Main W, Martin DP, Gibbs IC, Heilbrun MP (2003) An analysis of the accuracy of the CyberKnife: a robotic frameless stereotactic radiosurgical system. Neurosurgery 52:140–146; discussion 46–47

    Google Scholar 

  • Chang JY, Senan S, Paul MA, Mehran RJ, Louie AV, Balter P, Groen HJ, McRae SE, Widder J, Feng L, van den Borne BE, Munsell MF, Hurkmans C, Berry DA, van Werkhoven E, Kresl JJ, Dingemans AM, Dawood O, Haasbeek CJ, Carpenter LS, De Jaeger K, Komaki R, Slotman BJ, Smit EF, Roth JA (2015) Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomised trials. Lancet Oncol 16:630–637

    Google Scholar 

  • Chao ST, Dad LK, Dawson LA, Desai NB, Pacella M, Rengan R, Xiao Y, Yenice KM, Rosenthal SA, Hartford A (2020) ACR-ASTRO practice parameter for the performance of stereotactic body radiation therapy. Am J Clin Oncol 43:545–552

    Google Scholar 

  • Chen GT, Kung JH, Beaudette KP (2004) Artifacts in computed tomography scanning of moving objects. Semin Radiat Oncol 14:19–26

    Google Scholar 

  • Connolly JG, Jones GD, Caso R, Jones DR (2019) Stereotactic ablative radiotherapy for operable stage I non-small cell lung cancer: not ready for prime time. Ann Transl Med 7:S234

    Google Scholar 

  • Corradetti MN, Mitra N, Bonner Millar LP, Byun J, Wan F, Apisarnthanarax S, Christodouleas J, Anderson N, Simone CB 2nd, Teo BK, Rengan R (2013) A moving target: image guidance for stereotactic body radiation therapy for early-stage non-small cell lung cancer. Pract Radiat Oncol 3:307–315

    Google Scholar 

  • Curiel TJ (2007) Tregs and rethinking cancer immunotherapy. J Clin Invest 117:1167–1174

    Google Scholar 

  • Dahele M, Verbakel W, Cuijpers J, Slotman B, Senan S (2012) An analysis of patient positioning during stereotactic lung radiotherapy performed without rigid external immobilization. Radiother Oncol 104:28–32

    Google Scholar 

  • Dunlap NE, Cai J, Biedermann GB, Yang W, Benedict SH, Sheng K, Schefter TE, Kavanagh BD, Larner JM (2010) Chest wall volume receiving >30 Gy predicts risk of severe pain and/or rib fracture after lung stereotactic body radiotherapy. Int J Radiat Oncol Biol Phys 76:796–801

    Google Scholar 

  • Fakiris AJ, McGarry RC, Yiannoutsos CT, Papiez L, Williams M, Henderson MA, Timmerman R (2009) Stereotactic body radiation therapy for early-stage non-small-cell lung carcinoma: four-year results of a prospective phase II study. Int J Radiat Oncol Biol Phys 75:677–682

    Google Scholar 

  • Feddock J, Arnold SM, Shelton BJ, Sinha P, Conrad G, Chen L, Rinehart J, McGarry RC (2013) Stereotactic body radiation therapy can be used safely to boost residual disease in locally advanced non-small cell lung cancer: a prospective study. Int J Radiat Oncol Biol Phys 85:1325–1331

    Google Scholar 

  • Fernando HC, Timmerman R (2012) American College of Surgeons oncology group Z4099/radiation therapy oncology group 1021: a randomized study of sublobar resection compared with stereotactic body radiotherapy for high-risk stage I non-small cell lung cancer. J Thorac Cardiovasc Surg 144:S35–S38

    Google Scholar 

  • Foster R, Meyer J, Iyengar P, Pistenmaa D, Timmerman R, Choy H, Solberg T (2013) Localization accuracy and immobilization effectiveness of a stereotactic body frame for a variety of treatment sites. Int J Radiat Oncol Biol Phys 87:911–916

    Google Scholar 

  • Fowler JF, Welsh JS, Howard SP (2004) Loss of biological effect in prolonged fraction delivery. Int J Radiat Oncol Biol Phys 59:242–249

    Google Scholar 

  • Franks KN, McParland L, Webster J, Baldwin DR, Sebag-Montefiore D, Evison M, Booton R, Faivre-Finn C, Naidu B, Ferguson J, Peedell C, Callister MEJ, Kennedy M, Hewison J, Bestall J, Gregory WM, Hall P, Collinson F, Olivier C, Naylor R, Bell S, Allen P, Sloss A, Snee M (2020) SABRTOOTH: a randomised controlled feasibility study of stereotactic ablative radiotherapy (SABR) with surgery in patients with peripheral stage I non-small cell lung cancer (NSCLC) considered to be at higher risk of complications from surgical resection. Eur Respir J 56:2000118

    Google Scholar 

  • Fuks Z, Kolesnick R (2005) Engaging the vascular component of the tumor response. Cancer Cell 8:89–91

    Google Scholar 

  • Fuss M, Salter BJ, Cheek D, Sadeghi A, Hevezi JM, Herman TS (2004) Repositioning accuracy of a commercially available thermoplastic mask system. Radiother Oncol 71:339–345

    Google Scholar 

  • Garcia-Barros M, Paris F, Cordon-Cardo C, Lyden D, Rafii S, Haimovitz-Friedman A, Fuks Z, Kolesnick R (2003) Tumor response to radiotherapy regulated by endothelial cell apoptosis. Science 300:1155–1159

    Google Scholar 

  • Giglioli FR, Clemente S, Esposito M, Fiandra C, Marino C, Russo S, Strigari L, Villaggi E, Stasi M, Mancosu P (2017) Frontiers in planning optimization for lung SBRT. Phys Med 44:163–170

    Google Scholar 

  • Ginsberg RJ, Rubinstein LV (1995) Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung cancer study group. Ann Thorac Surg 60:615–622; discussion 22–23

    Google Scholar 

  • Golden EB, Pellicciotta I, Demaria S, Barcellos-Hoff MH, Formenti SC (2012) The convergence of radiation and immunogenic cell death signaling pathways. Front Oncol 2:88

    Google Scholar 

  • Guckenberger M, Klement RJ, Kestin LL, Hope AJ, Belderbos J, Werner-Wasik M, Yan D, Sonke JJ, Bissonnette JP, Xiao Y, Grills IS (2013) Lack of a dose-effect relationship for pulmonary function changes after stereotactic body radiation therapy for early-stage non-small cell lung cancer. Int J Radiat Oncol Biol Phys 85:1074–1081

    Google Scholar 

  • Guerrero M, Li XA (2004) Extending the linear-quadratic model for large fraction doses pertinent to stereotactic radiotherapy. Phys Med Biol 49:4825–4835

    Google Scholar 

  • Haikerwal SJ, Hagekyriakou J, MacManus M, Martin OA, Haynes NM (2015) Building immunity to cancer with radiation therapy. Cancer Lett 368:198–208

    Google Scholar 

  • Hall EJ, Gross W, Dvorak RF, Kellerer AM, Rossi HH (1972) Survival curves and age response functions for Chinese hamster cells exposed to x-rays or high LET alpha-particles. Radiat Res 52:88–98

    Google Scholar 

  • Hamilton AJ, Lulu BA, Fosmire H, Stea B, Cassady JR (1995) Preliminary clinical experience with linear accelerator-based spinal stereotactic radiosurgery. Neurosurgery 36:311–319

    Google Scholar 

  • Haque W, Verma V, Polamraju P, Farach A, Butler EB, Teh BS (2018) Stereotactic body radiation therapy versus conventionally fractionated radiation therapy for early stage non-small cell lung cancer. Radiother Oncol 129:264–269

    Google Scholar 

  • Haseltine JM, Rimner A, Gelblum DY, Modh A, Rosenzweig KE, Jackson A, Yorke ED, Wu AJ (2016) Fatal complications after stereotactic body radiation therapy for central lung tumors abutting the proximal bronchial tree. Pract Radiat Oncol 6:e27–e33

    Google Scholar 

  • Hegi F, D’Souza M, Azzi M, De Ruysscher D (2018) Comparing the outcomes of stereotactic ablative radiotherapy and non-stereotactic ablative radiotherapy definitive radiotherapy approaches to thoracic malignancy: a systematic review and meta-analysis. Clin Lung Cancer 19:199–212

    Google Scholar 

  • Heinzerling JH, Anderson JF, Papiez L, Boike T, Chien S, Zhang G, Abdulrahman R, Timmerman R (2008) Four-dimensional computed tomography scan analysis of tumor and organ motion at varying levels of abdominal compression during stereotactic treatment of lung and liver. Int J Radiat Oncol Biol Phys 70:1571–1578

    Google Scholar 

  • Hepel JT, Leonard KL, Safran H, Ng T, Taber A, Khurshid H, Birnbaum A, Group Brown University Oncology Research, Wazer DE, DiPetrillo T (2016) Stereotactic body radiation therapy boost after concurrent chemoradiation for locally advanced non-small cell lung cancer: a phase 1 dose escalation study. Int J Radiat Oncol Biol Phys 96:1021–1027

    Google Scholar 

  • Herfarth KK, Debus J, Lohr F, Bahner ML, Rhein B, Fritz P, Hoss A, Schlegel W, Wannenmacher MF (2001) Stereotactic single-dose radiation therapy of liver tumors: results of a phase I/II trial. J Clin Oncol 19:164–170

    Google Scholar 

  • Higgins KA, Pillai RN, Chen Z, Tian S, Zhang C, Patel P, Pakkala S, Shelton J, Force SD, Fernandez FG, Steuer CE, Owonikoko TK, Ramalingam SS, Bradley JD, Curran WJ (2017) Concomitant chemotherapy and radiotherapy with SBRT boost for unresectable stage III non-small cell lung cancer: a phase I study. J Thorac Oncol 12:1687–1695

    Google Scholar 

  • Horne ZD, Richman AH, Dohopolski MJ, Clump DA, Burton SA, Heron DE (2018) Stereotactic body radiation therapy for isolated hilar and mediastinal non-small cell lung cancers. Lung Cancer 115:1–4

    Google Scholar 

  • Inoue T, Katoh N, Onimaru R, Shimizu S, Tsuchiya K, Suzuki R, Sakakibara-Konishi J, Shinagawa N, Oizumi S, Shirato H (2013) Stereotactic body radiotherapy using gated radiotherapy with real-time tumor-tracking for stage I non-small cell lung cancer. Radiat Oncol 8:69

    Google Scholar 

  • Jaffray DA, Siewerdsen JH, Wong JW, Martinez AA (2002) Flat-panel cone-beam computed tomography for image-guided radiation therapy. Int J Radiat Oncol Biol Phys 53:1337–1349

    Google Scholar 

  • Jang SS, Huh GJ, Park SY, Yang PS, Cho EY (2014) The impact of respiratory gating on lung dosimetry in stereotactic body radiotherapy for lung cancer. Phys Med 30:682–689

    Google Scholar 

  • Josipovic M, Persson GF, Logadottir A, Smulders B, Westmann G, Bangsgaard JP (2012) Translational and rotational intra- and inter-fractional errors in patient and target position during a short course of frameless stereotactic body radiotherapy. Acta Oncol 51:610–617

    Google Scholar 

  • Josipovic M, Aznar MC, Thomsen JB, Scherman J, Damkjaer SM, Nygard L, Specht L, Pohl M, Persson GF (2019) Deep inspiration breath hold in locally advanced lung cancer radiotherapy: validation of intrafractional geometric uncertainties in the INHALE trial. Br J Radiol 92:20190569

    Google Scholar 

  • Joyner M, Salter BJ, Papanikolaou N, Fuss M (2006) Stereotactic body radiation therapy for centrally located lung lesions. Acta Oncol 45:802–807

    Google Scholar 

  • Kaskowitz L, Graham MV, Emami B, Halverson KJ, Rush C (1993) Radiation therapy alone for stage I non-small cell lung cancer. Int J Radiat Oncol Biol Phys 27:517–523

    Google Scholar 

  • Kawahara D, Ozawa S, Kimura T, Saito A, Nishio T, Nakashima T, Ohno Y, Murakami Y, Nagata Y (2017) Marginal prescription equivalent to the isocenter prescription in lung stereotactic body radiotherapy: preliminary study for Japan clinical oncology group trial (JCOG1408). J Radiat Res 58:149–154

    Google Scholar 

  • Kestin L, Grills I, Guckenberger M, Belderbos J, Hope AJ, Werner-Wasik M, Sonke JJ, Bissonnette JP, Xiao Y, Yan D, Group Elekta Lung Research (2014) Dose-response relationship with clinical outcome for lung stereotactic body radiotherapy (SBRT) delivered via online image guidance. Radiother Oncol 110:499–504

    Google Scholar 

  • Kim DWN, Medin PM, Timmerman RD (2017) Emphasis on repair, not just avoidance of injury, facilitates prudent stereotactic ablative radiotherapy. Semin Radiat Oncol 27:378–392

    Google Scholar 

  • Kimura T, Nagata Y, Eba J, Ozawa S, Ishikura S, Shibata T, Ito Y, Hiraoka M, Nishimura Y, Group Radiation Oncology Study Group of the Japan Clinical Oncology (2017) A randomized phase III trial of comparing two dose-fractionations stereotactic body radiotherapy (SBRT) for medically inoperable stage IA non-small cell lung cancer or small lung lesions clinically diagnosed as primary lung cancer: Japan Clinical Oncology Group Study JCOG1408 (J-SBRT trial). Jpn J Clin Oncol 47:277–281

    Google Scholar 

  • Kini VR, Vedam SS, Keall PJ, Patil S, Chen C, Mohan R (2003) Patient training in respiratory-gated radiotherapy. Med Dosim 28:7–11

    Google Scholar 

  • Kirkpatrick JP, Dewhirst MW (2008) Analytic solution to steady-state radial diffusion of a substrate with first-order reaction kinetics in the tissue of a Krogh’s cylinder. Radiat Res 169:350–354

    Google Scholar 

  • Koch N, Liu HH, Starkschall G, Jacobson M, Forster K, Liao Z, Komaki R, Stevens CW (2004) Evaluation of internal lung motion for respiratory-gated radiotherapy using MRI: part I—correlating internal lung motion with skin fiducial motion. Int J Radiat Oncol Biol Phys 60:1459–1472

    Google Scholar 

  • Kuriyama K, Onishi H, Sano N, Komiyama T, Aikawa Y, Tateda Y, Araki T, Uematsu M (2003) A new irradiation unit constructed of self-moving gantry-CT and linac. Int J Radiat Oncol Biol Phys 55:428–435

    Google Scholar 

  • Lagerwaard FJ, Van Sornsen de Koste JR, Nijssen-Visser MR, Schuchhard-Schipper RH, Oei SS, Munne A, Senan S (2001) Multiple “slow” CT scans for incorporating lung tumor mobility in radiotherapy planning. Int J Radiat Oncol Biol Phys 51:932–937

    Google Scholar 

  • Lagerwaard FJ, Haasbeek CJ, Smit EF, Slotman BJ, Senan S (2008) Outcomes of risk-adapted fractionated stereotactic radiotherapy for stage I non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 70:685–692

    Google Scholar 

  • Lambrecht M, Melidis C, Sonke JJ, Adebahr S, Boellaard R, Verheij M, Guckenberger M, Nestle U, Hurkmans C (2016) Lungtech, a phase II EORTC trial of SBRT for centrally located lung tumours—a clinical physics perspective. Radiat Oncol 11:7

    Google Scholar 

  • Lax I, Blomgren H, Naslund I, Svanstrom R (1994) Stereotactic radiotherapy of malignancies in the abdomen. Methodological aspects. Acta Oncol 33:677–683

    Google Scholar 

  • Lee Y, Auh SL, Wang Y, Burnette B, Wang Y, Meng Y, Beckett M, Sharma R, Chin R, Tu T, Weichselbaum RR, Fu YX (2009) Therapeutic effects of ablative radiation on local tumor require CD8+ T cells: changing strategies for cancer treatment. Blood 114:589–595

    Google Scholar 

  • Lee D, Greer PB, Ludbrook J, Arm J, Hunter P, Pollock S, Makhija K, O’Brien RT, Kim T, Keall P (2016) Audiovisual biofeedback improves cine-magnetic resonance imaging measured lung tumor motion consistency. Int J Radiat Oncol Biol Phys 94:628–636

    Google Scholar 

  • Leksell L (1951) The stereotaxic method and radiosurgery of the brain. Acta Chir Scand 102:316–319

    Google Scholar 

  • Lindberg K, Bergstrom P, Brustugun OT, Engelholm S, Grozman V, Hoyer M, Karlsson K, Khalil A, Kristiansen C, Lax I, Loden B, Nyman J, Persson G, Rogg L, Wersall P, Lewensohn R (2017) The Nordic HILUS-trial—first report of a phase II trial of SBRT of centrally located lung tumors. J Thorac Oncol 12:S340

    Google Scholar 

  • Lindberg K, Grozman V, Lindberg S, Onjukka E, Lax I, Lewensohn R, Wersall P (2019) Radiation-induced brachial plexus toxicity after SBRT of apically located lung lesions. Acta Oncol 58:1178–1186

    Google Scholar 

  • Liu R, Buatti JM, Howes TL, Dill J, Modrick JM, Meeks SL (2006) Optimal number of beams for stereotactic body radiotherapy of lung and liver lesions. Int J Radiat Oncol Biol Phys 66:906–912

    Google Scholar 

  • Loo BW Jr, Chang JY, Dawson LA, Kavanagh BD, Koong AC, Senan S, Timmerman RD (2011) Stereotactic ablative radiotherapy: what’s in a name? Pract Radiat Oncol 1:38–39

    Google Scholar 

  • Mageras GS, Pevsner A, Yorke ED, Rosenzweig KE, Ford EC, Hertanto A, Larson SM, Lovelock DM, Erdi YE, Nehmeh SA, Humm JL, Ling CC (2004) Measurement of lung tumor motion using respiration-correlated CT. Int J Radiat Oncol Biol Phys 60:933–941

    Google Scholar 

  • Manyam BV, Verdecchia K, Rogacki K, Reddy CA, Zhuang T, Videtic GMM, Azok JT, Stephans KL (2019) Investigation of brachial plexus dose that exceeds RTOG constraints for apical lung tumors treated with four- or five-fraction stereotactic body radiation therapy. J Radiosurg SBRT 6:189–197

    Google Scholar 

  • Marks LB (1995) Extrapolating hypofractionated radiation schemes from radiosurgery data: regarding Hall et al., IJROBP 21:819–824; 1991 and Hall and Brenner, IJROBP 25:381–385; 1993. Int J Radiat Oncol Biol Phys 32:274–276

    Google Scholar 

  • Matsuo Y, Nagata Y, Mizowaki T, Takayama K, Sakamoto T, Sakamoto M, Norihisa Y, Hiraoka M (2007) Evaluation of mass-like consolidation after stereotactic body radiation therapy for lung tumors. Int J Clin Oncol 12:356–362

    Google Scholar 

  • McGarry RC, Papiez L, Williams M, Whitford T, Timmerman RD (2005) Stereotactic body radiation therapy of early-stage non-small-cell lung carcinoma: phase I study. Int J Radiat Oncol Biol Phys 63:1010–1015

    Google Scholar 

  • Mehta N, King CR, Agazaryan N, Steinberg M, Hua A, Lee P (2012) Stereotactic body radiation therapy and 3-dimensional conformal radiotherapy for stage I non-small cell lung cancer: a pooled analysis of biological equivalent dose and local control. Pract Radiat Oncol 2:288–295

    Google Scholar 

  • Menten MJ, Fast MF, Nill S, Kamerling CP, McDonald F, Oelfke U (2016) Lung stereotactic body radiotherapy with an MR-linac—quantifying the impact of the magnetic field and real-time tumor tracking. Radiother Oncol 119:461–466

    Google Scholar 

  • Meyer J, Timmerman R (2011) Stereotactic ablative radiotherapy in the framework of classical radiobiology: response to Drs. Brown, Diehn, and Loo. Int J Radiat Oncol Biol Phys 79:1599–1600; author reply 600

    Google Scholar 

  • Murphy MJ (1997) An automatic six-degree-of-freedom image registration algorithm for image-guided frameless stereotaxic radiosurgery. Med Phys 24:857–866

    Google Scholar 

  • Murphy MJ, Martin D, Whyte R, Hai J, Ozhasoglu C, Le QT (2002) The effectiveness of breath-holding to stabilize lung and pancreas tumors during radiosurgery. Int J Radiat Oncol Biol Phys 53:475–482

    Google Scholar 

  • Murray B, Forster K, Timmerman R (2007) Frame-based immobilization and targeting for stereotactic body radiation therapy. Med Dosim 32:86–91

    Google Scholar 

  • Nagata Y, Takayama K, Matsuo Y, Norihisa Y, Mizowaki T, Sakamoto T, Sakamoto M, Mitsumori M, Shibuya K, Araki N, Yano S, Hiraoka M (2005) Clinical outcomes of a phase I/II study of 48 Gy of stereotactic body radiotherapy in 4 fractions for primary lung cancer using a stereotactic body frame. Int J Radiat Oncol Biol Phys 63:1427–1431

    Google Scholar 

  • Nagata Y, Hiraoka M, Shibata T, Onishi H, Kokubo M, Karasawa K, Shioyama Y, Onimaru R, Kozuka T, Kunieda E, Saito T, Nakagawa K, Hareyama M, Takai Y, Hayakawa K, Mitsuhashi N, Ishikura S (2015) Prospective trial of stereotactic body radiation therapy for both operable and inoperable T1N0M0 non-small cell lung cancer: Japan clinical oncology group study JCOG0403. Int J Radiat Oncol Biol Phys 93:989–996

    Google Scholar 

  • Nakagawa K, Haga A, Kida S, Masutani Y, Yamashita H, Takahashi W, Sakumi A, Saotome N, Shiraki T, Ohtomo K, Iwai Y, Yoda K (2013) 4D registration and 4D verification of lung tumor position for stereotactic volumetric modulated arc therapy using respiratory-correlated cone-beam CT. J Radiat Res 54:152–156

    Google Scholar 

  • Nantavithya C, Gomez DR, Wei X, Komaki R, Liao Z, Lin SH, Jeter M, Nguyen QN, Li H, Zhang X, Poenisch F, Zhu XR, Balter PA, Feng L, Choi NC, Mohan R, Chang JY (2018) Phase 2 study of stereotactic body radiation therapy and stereotactic body proton therapy for high-risk, medically inoperable, early-stage non-small cell lung cancer. Int J Radiat Oncol Biol Phys 101:558–563

    Google Scholar 

  • Naruke T, Goya T, Tsuchiya R, Suemasu K (1988) Prognosis and survival in resected lung carcinoma based on the new international staging system. J Thorac Cardiovasc Surg 96:440–447

    Google Scholar 

  • Negoro Y, Nagata Y, Aoki T, Mizowaki T, Araki N, Takayama K, Kokubo M, Yano S, Koga S, Sasai K, Shibamoto Y, Hiraoka M (2001) The effectiveness of an immobilization device in conformal radiotherapy for lung tumor: reduction of respiratory tumor movement and evaluation of the daily setup accuracy. Int J Radiat Oncol Biol Phys 50:889–898

    Google Scholar 

  • Nesbitt JC, Putnam JB Jr, Walsh GL, Roth JA, Mountain CF (1995) Survival in early-stage non-small cell lung cancer. Ann Thorac Surg 60:466–472

    Google Scholar 

  • Nguyen TK, Senan S, Bradley JD, Franks K, Giuliani M, Guckenberger M, Landis M, Loo BW Jr, Louie AV, Onishi H, Schmidt H, Timmerman R, Videtic GMM, Palma DA (2018) Optimal imaging surveillance after stereotactic ablative radiation therapy for early-stage non-small cell lung cancer: findings of an international Delphi consensus study. Pract Radiat Oncol 8:e71–e78

    Google Scholar 

  • Nuyttens JJ, Moiseenko V, McLaughlin M, Jain S, Herbert S, Grimm J (2016) Esophageal dose tolerance in patients treated with stereotactic body radiation therapy. Semin Radiat Oncol 26:120–128

    Google Scholar 

  • Nyman J, Johansson KA, Hulten U (2006) Stereotactic hypofractionated radiotherapy for stage I non-small cell lung cancer—mature results for medically inoperable patients. Lung Cancer 51:97–103

    Google Scholar 

  • Nyman J, Hallqvist A, Lund JA, Brustugun OT, Bergman B, Bergstrom P, Friesland S, Lewensohn R, Holmberg E, Lax I (2016) SPACE—a randomized study of SBRT vs conventional fractionated radiotherapy in medically inoperable stage I NSCLC. Radiother Oncol 121:1–8

    Google Scholar 

  • Oliver JA, Budzevich M, Zhang GG, Dilling TJ, Latifi K, Moros EG (2015) Variability of image features computed from conventional and respiratory-gated PET/CT images of lung cancer. Transl Oncol 8:524–534

    Google Scholar 

  • Onishi H, Araki T, Shirato H, Nagata Y, Hiraoka M, Gomi K, Yamashita T, Niibe Y, Karasawa K, Hayakawa K, Takai Y, Kimura T, Hirokawa Y, Takeda A, Ouchi A, Hareyama M, Kokubo M, Hara R, Itami J, Yamada K (2004) Stereotactic hypofractionated high-dose irradiation for stage I nonsmall cell lung carcinoma: clinical outcomes in 245 subjects in a Japanese multiinstitutional study. Cancer 101:1623–1631

    Google Scholar 

  • Ozsahin M, Slotman BJ, Bourhis J (2019) Reproductive viability of cells following preoperative stereotactic ablative radiotherapy. Int J Radiat Oncol Biol Phys 105:233–234

    Google Scholar 

  • Paganelli C, Lee D, Greer PB, Baroni G, Riboldi M, Keall P (2015) Quantification of lung tumor rotation with automated landmark extraction using orthogonal cine MRI images. Phys Med Biol 60:7165–7178

    Google Scholar 

  • Palma DA, Nguyen TK, Louie AV, Malthaner R, Fortin D, Rodrigues GB, Yaremko B, Laba J, Kwan K, Gaede S, Lee T, Ward A, Warner A, Inculet R (2019) Measuring the integration of stereotactic ablative radiotherapy plus surgery for early-stage non-small cell lung cancer: a phase 2 clinical trial. JAMA Oncol 5:681–688

    Google Scholar 

  • Papiez L, Timmerman R, DesRosiers C, Randall M (2003) Extracranial stereotactic radioablation: physical principles. Acta Oncol 42:882–894

    Google Scholar 

  • Park C, Papiez L, Zhang S, Story M, Timmerman RD (2008) Universal survival curve and single fraction equivalent dose: useful tools in understanding potency of ablative radiotherapy. Int J Radiat Oncol Biol Phys 70:847–852

    Google Scholar 

  • Park HJ, Griffin RJ, Hui S, Levitt SH, Song CW (2012) Radiation-induced vascular damage in tumors: implications of vascular damage in ablative hypofractionated radiotherapy (SBRT and SRS). Radiat Res 177:311–327

    Google Scholar 

  • Peguret N, Dahele M, Cuijpers JP, Slotman BJ, Verbakel WF (2013) Frameless high dose rate stereotactic lung radiotherapy: intrafraction tumor position and delivery time. Radiother Oncol 107:419–422

    Google Scholar 

  • Ritter TA, Matuszak M, Chetty IJ, Mayo CS, Wu J, Iyengar P, Weldon M, Robinson C, Xiao Y, Timmerman RD (2017) Application of critical volume-dose constraints for stereotactic body radiation therapy in NRG radiation therapy trials. Int J Radiat Oncol Biol Phys 98:34–36

    Google Scholar 

  • Rossi HH, Kellerer AM (1972) Radiation carcinogenesis at low doses. Science 175:200–202

    Google Scholar 

  • Saito T, Matsuyama T, Toya R, Fukugawa Y, Toyofuku T, Semba A, Oya N (2014) Respiratory gating during stereotactic body radiotherapy for lung cancer reduces tumor position variability. PLoS One 9:e112824

    Google Scholar 

  • Scherman Rydhog J, Riisgaard de Blanck S, Josipovic M, Irming Jolck R, Larsen KR, Clementsen P, Lars Andersen T, Poulsen PR, Fredberg Persson G, Munck Af Rosenschold P (2017) Target position uncertainty during visually guided deep-inspiration breath-hold radiotherapy in locally advanced lung cancer. Radiother Oncol 123:78–84

    Google Scholar 

  • Shaikh T, Turaka A (2014) Predictors and management of chest wall toxicity after lung stereotactic body radiotherapy. Cancer Treat Rev 40:1215–1220

    Google Scholar 

  • Sharp GC, Jiang SB, Shimizu S, Shirato H (2004) Prediction of respiratory tumour motion for real-time image-guided radiotherapy. Phys Med Biol 49:425–440

    Google Scholar 

  • Shibamoto Y, Miyakawa A, Otsuka S, Iwata H (2016) Radiobiology of hypofractionated stereotactic radiotherapy: what are the optimal fractionation schedules? J Radiat Res 57(Suppl 1):i76–i82

    Google Scholar 

  • Shirato H, Shimizu S, Shimizu T, Nishioka T, Miyasaka K (1999) Real-time tumour-tracking radiotherapy. Lancet 353:1331–1332

    Google Scholar 

  • Shirato H, Shimizu S, Kunieda T, Kitamura K, van Herk M, Kagei K, Nishioka T, Hashimoto S, Fujita K, Aoyama H, Tsuchiya K, Kudo K, Miyasaka K (2000) Physical aspects of a real-time tumor-tracking system for gated radiotherapy. Int J Radiat Oncol Biol Phys 48:1187–1195

    Google Scholar 

  • Siegel RL, Miller KD, Jemal A (2020) Cancer statistics, 2020. CA Cancer J Clin 70:7–30

    Google Scholar 

  • Snee MP, McParland L, Collinson F, Lowe CM, Striha A, Baldwin DR, Naidu B, Sebag-Montefiore D, Gregory WM, Bestall J, Hewison J, Hinsley S, Franks K (2016) The SABRTooth feasibility trial protocol: a study to determine the feasibility and acceptability of conducting a phase III randomised controlled trial comparing stereotactic ablative radiotherapy (SABR) with surgery in patients with peripheral stage I non-small cell lung cancer (NSCLC) considered to be at higher risk of complications from surgical resection. Pilot Feasibility Stud 2:5

    Google Scholar 

  • Song CW, Glatstein E, Marks LB, Emami B, Grimm J, Sperduto PW, Kim MS, Hui S, Dusenbery KE, Cho LC (2019) Biological principles of stereotactic body radiation therapy (SBRT) and stereotactic radiation surgery (SRS): indirect cell death. Int J Radiat Oncol Biol Phys. https://doi.org/10.1016/j.ijrobp.2019.02.047

  • Sonke JJ, Zijp L, Remeijer P, van Herk M (2005) Respiratory correlated cone beam CT. Med Phys 32:1176–1186

    Google Scholar 

  • Stanic S, Paulus R, Timmerman RD, Michalski JM, Barriger RB, Bezjak A, Videtic GM, Bradley J (2014) No clinically significant changes in pulmonary function following stereotactic body radiation therapy for early- stage peripheral non-small cell lung cancer: an analysis of RTOG 0236. Int J Radiat Oncol Biol Phys 88:1092–1099

    Google Scholar 

  • Stephans KL, Djemil T, Reddy CA, Gajdos SM, Kolar M, Machuzak M, Mazzone P, Videtic GM (2009) Comprehensive analysis of pulmonary function test (PFT) changes after stereotactic body radiotherapy (SBRT) for stage I lung cancer in medically inoperable patients. J Thorac Oncol 4:838–844

    Google Scholar 

  • Stephans KL, Djemil T, Tendulkar RD, Robinson CG, Reddy CA, Videtic GM (2012) Prediction of chest wall toxicity from lung stereotactic body radiotherapy (SBRT). Int J Radiat Oncol Biol Phys 82:974–980

    Google Scholar 

  • Stevens CW, Munden RF, Forster KM, Kelly JF, Liao Z, Starkschall G, Tucker S, Komaki R (2001) Respiratory-driven lung tumor motion is independent of tumor size, tumor location, and pulmonary function. Int J Radiat Oncol Biol Phys 51:62–68

    Google Scholar 

  • Sun B, Brooks ED, Komaki RU, Liao Z, Jeter MD, McAleer MF, Allen PK, Balter PA, Welsh JD, O’Reilly MS, Gomez D, Hahn SM, Roth JA, Mehran RJ, Heymach JV, Chang JY (2017) 7-year follow-up after stereotactic ablative radiotherapy for patients with stage I non-small cell lung cancer: results of a phase 2 clinical trial. Cancer 123:3031–3039

    Google Scholar 

  • Swaminath A, Wierzbicki M, Parpia S, Wright JR, Tsakiridis TK, Okawara GS, Kundapur V, Bujold A, Ahmed N, Hirmiz K, Kurien E, Filion E, Gabos Z, Faria S, Louie AV, Owen T, Wai E, Ramchandar K, Chan EK, Julian J, Cline K, Whelan TJ (2017) Canadian phase III randomized trial of stereotactic body radiotherapy versus conventionally hypofractionated radiotherapy for stage I, medically inoperable non-small-cell lung cancer—rationale and protocol design for the Ontario Clinical Oncology Group (OCOG)-LUSTRE trial. Clin Lung Cancer 18:250–254

    Google Scholar 

  • Takeda A, Kunieda E, Takeda T, Tanaka M, Sanuki N, Fujii H, Shigematsu N, Kubo A (2008) Possible misinterpretation of demarcated solid patterns of radiation fibrosis on CT scans as tumor recurrence in patients receiving hypofractionated stereotactic radiotherapy for lung cancer. Int J Radiat Oncol Biol Phys 70:1057–1065

    Google Scholar 

  • Timmerman RD, Story M (2006) Stereotactic body radiation therapy: a treatment in need of basic biological research. Cancer J 12:19–20

    Google Scholar 

  • Timmerman R, Papiez L, McGarry R, Likes L, DesRosiers C, Frost S, Williams M (2003a) Extracranial stereotactic radioablation: results of a phase I study in medically inoperable stage I non-small cell lung cancer. Chest 124:1946–1955

    Google Scholar 

  • Timmerman R, Papiez L, Suntharalingam M (2003b) Extracranial stereotactic radiation delivery: expansion of technology beyond the brain. Technol Cancer Res Treat 2:153–160

    Google Scholar 

  • Timmerman R, McGarry R, Yiannoutsos C, Papiez L, Tudor K, DeLuca J, Ewing M, Abdulrahman R, DesRosiers C, Williams M, Fletcher J (2006) Excessive toxicity when treating central tumors in a phase II study of stereotactic body radiation therapy for medically inoperable early-stage lung cancer. J Clin Oncol 24:4833–4839

    Google Scholar 

  • Timmerman R, Paulus R, Galvin J, Michalski J, Straube W, Bradley J, Fakiris A, Bezjak A, Videtic G, Johnstone D, Fowler J, Gore E, Choy H (2010) Stereotactic body radiation therapy for inoperable early stage lung cancer. JAMA 303:1070–1076

    Google Scholar 

  • Timmerman RD, Hu C, Michalski JM, Bradley JC, Galvin J, Johnstone DW, Choy H (2018a) Long-term results of stereotactic body radiation therapy in medically inoperable stage I non-small cell lung cancer. JAMA Oncol 4:1287–1288

    Google Scholar 

  • Timmerman RD, Paulus R, Pass HI, Gore EM, Edelman MJ, Galvin J, Straube WL, Nedzi LA, McGarry RC, Robinson CG, Schiff PB, Chang G, Loo BW Jr, Bradley JD, Choy H (2018b) Stereotactic body radiation therapy for operable early-stage lung cancer: findings from the NRG oncology RTOG 0618 trial. JAMA Oncol 4:1263–1266

    Google Scholar 

  • Uematsu M, Shioda A, Tahara K, Fukui T, Yamamoto F, Tsumatori G, Ozeki Y, Aoki T, Watanabe M, Kusano S (1998) Focal, high dose, and fractionated modified stereotactic radiation therapy for lung carcinoma patients: a preliminary experience. Cancer 82:1062–1070

    Google Scholar 

  • Uematsu M, Shioda A, Suda A, Fukui T, Ozeki Y, Hama Y, Wong JR, Kusano S (2001) Computed tomography-guided frameless stereotactic radiotherapy for stage I non-small cell lung cancer: a 5-year experience. Int J Radiat Oncol Biol Phys 51:666–670

    Google Scholar 

  • Vedam SS, Keall PJ, Kini VR, Mohan R (2001) Determining parameters for respiration-gated radiotherapy. Med Phys 28:2139–2146

    Google Scholar 

  • Verellen D, Soete G, Linthout N, Van Acker S, De Roover P, Vinh-Hung V, Van de Steene J, Storme G (2003) Quality assurance of a system for improved target localization and patient set-up that combines real-time infrared tracking and stereoscopic X-ray imaging. Radiother Oncol 67:129–141

    Google Scholar 

  • Videtic GM, Hu C, Singh AK, Chang JY, Parker W, Olivier KR, Schild SE, Komaki R, Urbanic JJ, Timmerman RD, Choy H (2015) A randomized phase 2 study comparing 2 stereotactic body radiation therapy schedules for medically inoperable patients with stage I peripheral non-small cell lung cancer: NRG oncology RTOG 0915 (NCCTG N0927). Int J Radiat Oncol Biol Phys 93:757–764

    Google Scholar 

  • Videtic GMM, Donington J, Giuliani M, Heinzerling J, Karas TZ, Kelsey CR, Lally BE, Latzka K, Lo SS, Moghanaki D, Movsas B, Rimner A, Roach M, Rodrigues G, Shirvani SM, Simone CB 2nd, Timmerman R, Daly ME (2017) Stereotactic body radiation therapy for early-stage non-small cell lung cancer: executive summary of an ASTRO evidence-based guideline. Pract Radiat Oncol 7:295–301

    Google Scholar 

  • Videtic GM, Paulus R, Singh AK, Chang JY, Parker W, Olivier KR, Timmerman RD, Komaki RR, Urbanic JJ, Stephans KL, Yom SS, Robinson CG, Belani CP, Iyengar P, Ajlouni MI, Gopaul DD, Gomez Suescun JB, McGarry RC, Choy H, Bradley JD (2019) Long-term follow-up on NRG oncology RTOG 0915 (NCCTG N0927): a randomized phase 2 study comparing 2 stereotactic body radiation therapy schedules for medically inoperable patients with stage I peripheral non-small cell lung cancer. Int J Radiat Oncol Biol Phys 103:1077–1084

    Google Scholar 

  • von Reibnitz D, Shaikh F, Wu AJ, Treharne GC, Dick-Godfrey R, Foster A, Woo KM, Shi W, Zhang Z, Din SU, Gelblum DY, Yorke ED, Rosenzweig KE, Rimner A (2018) Stereotactic body radiation therapy (SBRT) improves local control and overall survival compared to conventionally fractionated radiation for stage I non-small cell lung cancer (NSCLC). Acta Oncol 57:1567–1573

    Google Scholar 

  • Voruganti IS, Donovan E, Walker-Dilks C, Swaminath A (2020) Chest wall toxicity after stereotactic radiation in early lung cancer: a systematic review. Curr Oncol 27:179–189

    Google Scholar 

  • Wang L, Feigenberg S, Chen L, Pasklev K, Ma CC (2006) Benefit of three-dimensional image-guided stereotactic localization in the hypofractionated treatment of lung cancer. Int J Radiat Oncol Biol Phys 66:738–747

    Google Scholar 

  • Wang Z, Wu QJ, Marks LB, Larrier N, Yin FF (2007) Cone-beam CT localization of internal target volumes for stereotactic body radiotherapy of lung lesions. Int J Radiat Oncol Biol Phys 69:1618–1624

    Google Scholar 

  • Wang C, Rimner A, Gelblum DY, Dick-Godfrey R, McKnight D, Torres D, Flynn J, Zhang Z, Sidiqi B, Jackson A, Yorke E, Wu AJ (2020) Analysis of pneumonitis and esophageal injury after stereotactic body radiation therapy for ultra-central lung tumors. Lung Cancer 147:45–48

    Google Scholar 

  • Wisnivesky JP, Bonomi M, Henschke C, Iannuzzi M, McGinn T (2005) Radiation therapy for the treatment of unresected stage I-II non-small cell lung cancer. Chest 128:1461–1467

    Google Scholar 

  • Wulf J, Hadinger U, Oppitz U, Olshausen B, Flentje M (2000) Stereotactic radiotherapy of extracranial targets: CT-simulation and accuracy of treatment in the stereotactic body frame. Radiother Oncol 57:225–236

    Google Scholar 

  • Wulf J, Baier K, Mueller G, Flentje MP (2005) Dose-response in stereotactic irradiation of lung tumors. Radiother Oncol 77:83–87

    Google Scholar 

  • Yang M, Timmerman R (2018) Stereotactic ablative radiotherapy uncertainties: delineation, setup and motion. Semin Radiat Oncol 28:207–217

    Google Scholar 

  • Yin F, Kim JG, Haughton C, Brown SL, Ajlouni M, Stronati M, Pamukov N, Kim JH (2001) Extracranial radiosurgery: immobilizing liver motion in dogs using high-frequency jet ventilation and total intravenous anesthesia. Int J Radiat Oncol Biol Phys 49:211–216

    Google Scholar 

  • Yoon SM, Choi EK, Lee SW, Yi BY, Ahn SD, Shin SS, Park HJ, Kim SS, Park JH, Song SY, Park CI, Kim JH (2006) Clinical results of stereotactic body frame based fractionated radiation therapy for primary or metastatic thoracic tumors. Acta Oncol 45:1108–1114

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX, USA

    Dat T. Vo & Robert D. Timmerman

  2. Levine Cancer Institute, Atrium Health, Southeast Radiation Oncology Group, Charlotte, NC, USA

    John H. Heinzerling

Authors
  1. Dat T. Vo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. John H. Heinzerling
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert D. Timmerman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert D. Timmerman .

Editor information

Editors and Affiliations

  1. School of Medicine, University of Kragujevac, Kragujevac, Serbia

    Branislav Jeremić

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Vo, D.T., Heinzerling, J.H., Timmerman, R.D. (2022). Stereotactic Ablative Radiotherapy for Early-Stage Lung Cancer. In: Jeremić, B. (eds) Advances in Radiation Oncology in Lung Cancer. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2022_318

Download citation

  • DOI: https://doi.org/10.1007/174_2022_318

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-34846-4

  • Online ISBN: 978-3-031-34847-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation