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Publications

Journal Article Review Epublish

PubMed: 40725565 DOI: 10.3390/jcm14144871

Lung Stereotactic Body Radiotherapy (SBRT): Challenging Scenarios and New Frontiers.

J Clin Med 14(14)

Authors: Serena Badellino, Francesco Cuccia, Marco Galaverni, Marianna Miele, Matteo Sepulcri, Maria Alessia Zerella, Ruggero Spoto, Emanuele Alì, Emanuela Olmetto, Luca Boldrini, Antonio Pontoriero, Paolo Borghetti

Affiliations

  • Radiation Oncology, Department of Oncology, University of Turin, 10125 Turin, Italy.
  • Radiation Oncology, ARNAS Civico Hospital-Palermo, 90145 Palermo, Italy.
  • Radiation Oncology Unit, University Hospital of Parma, 43126 Parma, Italy.
  • Operative Research Unit of Radiation Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
  • Radiotherapy, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy.
  • Division of Radiotherapy, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, 20141 Milan, Italy.
  • Department of Radiotherapy and Radiosurgery, Istituto di Ricovero e Cura a Carattere Scientifico Humanitas Research Hospital, 20089 Milan, Italy.
  • Radiation Oncology Unit, Azienda USL-Istituto di Ricovero e Cura a Carattere Scientifico Di Reggio Emilia, 42123 Reggio Emilia, Italy.
  • Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Largo GA Brambilla, 50134 Florence, Italy.
  • Department of Radiology, Radiation Oncology and Hematology, Fondazione Policlinico Universitario A. Gemelli"IRCCS, 00136 Rome, Italy.
  • Radiation Oncology Unit, Department of Biomedical, Dental and Morphological and Functional Imaging Sciences, University of Messina, 98125 Messina, Italy.
  • Radiation Oncology Department, ASST Spedali Civili and University of Brescia, P.le Spedali Civili, 1, 25123 Brescia, Italy.

Abstract

Stereotactic Body Radiotherapy (SBRT) has emerged as a pivotal treatment modality for early-stage non-small cell lung cancer (NSCLC), offering highly precise, high-dose radiation delivery. However, several clinical challenges remain, particularly in the treatment of central or ultracentral tumors, which are located near critical structures such as the heart, bronchi, and great vessels. The introduction of MRI-guided SBRT has significantly improved targeting precision, allowing for better assessment of tumor motion and adjacent organ structures. Additionally, SBRT has demonstrated efficacy in multifocal NSCLC, providing an effective option for patients with multiple primary tumors. Recent advances also highlight the role of SBRT in locally advanced NSCLC, where it is increasingly used as a complementary approach to concurrent chemotherapy or in cases where surgery is not feasible. Moreover, the combination of SBRT with immunotherapy has shown promising potential, enhancing tumor control and immunological responses. Furthermore, SBRTs application in SCLC is gaining momentum as a palliative and potentially curative option for selected patients. This narrative review explores these evolving clinical scenarios, the technical innovations supporting SBRT, and the integration of immunotherapy, providing an in-depth look at the new frontiers of SBRT in lung cancer treatment. Despite the challenges, the ongoing development of personalized approaches and technological advancements continues to push the boundaries of SBRTs clinical utility in lung cancer.

MeSH

Radiotherapy, Lung, Neoplasms, Carcinoma, Non-Small-Cell Lung, Immunotherapy, Lung Neoplasms, Therapeutics