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theijcs.com The IJCS / Vol 1 / Issue 1

SBRT, Revolutionary Cancer Management

Dr Swarupa Mitra
Senior Consultant Radiation Oncologist.

Contributing Authors Affiliations:
N/A

ABSTRACT-

Stereotactic body radiotherapy (SBRT) allows high dose delivery to a particular target, with highly conformal high
radiation beams in a limited number of fractions, resulting in significant ablative or near ablative effects. Besides the
obvious reduction of the treatment burden for the patient by reducing the total number of fractions, this dose schedule

results in a 70% to 90% probability of local tumour control at two years which translates in an actuarial survival of about
60%.The key to success for SBRT is optimal delineation of the target, based on high resolution multi-modal imaging,
combining morphological and metabolic information and precise motion management. This produces limited risk of

toxicities as the dose fall-off is extremely sharp outside of the volume encompassed by the prescription isodose.
There are many situations where SBRT is considered to be a treatment option, as an alternative to open surgery for
removal of small to moderately-sized cancers. This avoids the need for anaesthetic and the risks of an surgery,

especially for patients who are elderly, frail or have other health issues that might make surgery risky or impossible.
This is the reason why sometimes SBRT is referred to as a 'minimally invasive' cancer treatment technique. It is likely
that this special type of radiation therapy will become much more prevalent over the next few years.

To quote some examples of use of SBRT in clinical ,practice, Lung SBRT is a promising treatment option for early
stage non-small cell lung cancer and patients with one or a few metastasis. Spine SBRT has been used for metastatic

disease in the vertebrae. The aim is to improve symptoms, such as pain, and quality of life by controlling the cancer in
the spine. There is also developing experience with the use of SBRT for the treatment of cancer in the liver, pancreas,
renal cell carcinoma, prostate, where conventionally radiation was thought to be ineffective.

Radiation-induced activation of the immune system has been increasingly recognized in recent years, an indication
that RT could also elicit immune-mediated anti-tumor responses.
Since the emergence of immunotherapy, especially with immune checkpoint inhibitors, that can enhance the systemic

anti-tumor response of RT, the combination of RT and immunotherapy has drawn extensive attention by oncologists.
More and more trials and Research are needed to make this modality more popular and acceptable.

Corresponding Author
Dr Swarupa Mitra
Senior Consultant Radiation Oncologist.
Chief ---- Unit of Gastrointestinal and Genitourinary Services
Rajiv Gandhi Cancer Institute and Research Centre
sector-5, Rohini. New Delhi 110085

The Integrated Indian Journal of Cancer Sciences