Dr. Jeffrey Bradley, Radiation Oncologist at Washington University in St. Louis, describes the history and current use of stereotactic radiation therapy for inoperable lung lesions.
The classic example of the use of stereotactic radiation therapy in the body is for lesions of the lung. This technology started in the 1990s in Japan and in Germany where they were giving five or fewer fractions of radiation therapy to a solitary nodule in the lung in a patient who couldn’t have surgery because they had underlying problems like heart disease or lung disease that wouldn’t allow the patient to have surgery. So they were giving, let’s say 15 gray doses, up to 20 gray doses, in three fractions, to eradicate these tumors in the lung.
That spread to the United States in the 2000s, and it’s a very common treatment today for patients who have been evaluated for surgery but can’t have surgery, usually because their pulmonary function is too low. This technique is very effective, the local control of eradicating that lesion is better than 90%, and 95% in some series. It’s stood the test of time, results are available at five years, giving a good indication that it’s probably equivalent to surgery in the population that’s high risk.
A very controversial area today, are patients who are operable candidates for stereotactic body radiation therapy, and that’s the next topic.