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Stereotactic Body Radiation Therapy: Fractionated Radiation Therapy Perspective

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Principles and Practice of Stereotactic Radiosurgery

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Abstract

The introduction of intracranial stereotactic radiosurgery in 1951 is widely attributed to Lars Leksell [1]. As initially developed, the method delivered a single dose of radiation to a target lesion, which was localized using the principles of stereotaxy. Current treatment strategies in stereotactic body radiation therapy (SBRT) are an extension of these principles applied to extracranial sites. Techniques that allow precise targeting and treatment are used to deliver one or usually more large fractions of radiation to extracranial sites. SBRT incorporates two specific innovations: a variety of systems (ultrasound, computed tomography, beacons) that allow adequate visualization of targets, primarily to ensure accurate repositioning for repeat fractions, often referred to as image-guided radiotherapy, or IGRT; and systems that eliminate, minimize, or compensate for tumor motion, the latter often referred to as 4D radiotherapy. These critical advances facilitate single-fraction treatment or hypofractionation, with increased daily doses and decreased overall treatment times, and avoid the projected concomitant increase in toxicity by minimizing the volumes irradiated. SBRT is attractive because it allows the delivery of an ablative dose of radiation to tumor sites, with the potential to improve local tumor control. SBRT also shortens the length of the treatment course, making therapy more convenient for the patient and potentially further improving tumor control by overcoming accelerated repopulation. In this context, we will examine the benefits and disadvantages of SBRT relative to conventionally fractionated radiotherapy.

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Author information

Authors and Affiliations

  1. Department of Human Oncology, University of Wisconsin Hospital, Madison, WI, USA

    Gordon W. Wong MD, Rafael R. Mañon MD, Wolfgang Tomé PhD & Minesh Mehta MD (Professor and Chairman)

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  1. Gordon W. Wong MD
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  2. Rafael R. Mañon MD
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  3. Wolfgang Tomé PhD
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  4. Minesh Mehta MD
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Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Boston University School of Medicine, Boston, MA, USA

    Lawrence S. Chin MD (Professor and Chairman) (Professor and Chairman)

  2. Department of Radiation Oncology, University of Maryland Medical School, Baltimore, MD, USA

    William F. Regine MD (Professor and Chairman) (Professor and Chairman)

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Wong, G.W., Mañon, R.R., Tomé, W., Mehta, M. (2008). Stereotactic Body Radiation Therapy: Fractionated Radiation Therapy Perspective. In: Chin, L.S., Regine, W.F. (eds) Principles and Practice of Stereotactic Radiosurgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-71070-9_63

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  • DOI: https://doi.org/10.1007/978-0-387-71070-9_63

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-71069-3

  • Online ISBN: 978-0-387-71070-9

  • eBook Packages: MedicineMedicine (R0)

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