scalpel or sabr for treatment of early-stage lung cancer clinical considerations for the multidisciplinary team手术刀或sabr治疗早期肺癌的临床因素的多学科团队.pdfVIP

Cancers 2011, 3, 3432-3448; doi:10.3390/cancers3033432 OPEN ACCESS cancers ISSN 2072-6694 /journal/cancers Review Scalpel or SABR for Treatment of Early-Stage Lung Cancer: Clinical Considerations for the Multidisciplinary Team Shervin M. Shirvani and Joe Y. Chang * Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; E-Mail: smshirvani@ * Author to whom correspondence should be addressed; E-Mail: jychang@; Tel.: +1-713-563-2337; Fax: +1-713-563-2331. Received: 15 July 2011; in revised form: 17 August 2011 / Accepted: 22 August 2011 / Published: 1 September 2011 Abstract: Treatment options for early-stage (T1-2 N0) non-small cell lung cancer are often limited by the patient’s advanced age, poor performance status, and comorbidities. Despite these challenges, stereotactic ablative radiotherapy (SABR) provides a highly effective and safe therapy for intrathoracic tumors and has become the standard of care for delivering definitive treatment in medically inoperable patients. High-quality treatment, which includes reliable immobilization, accurate tumor targeting, and precise verification of dose delivery, is essential both to achieve successful cure and to avoid debilitating toxicities. Generally, SABR is well tolerated in patients with peripherally located tumors, but even centrally or superiorly located lesions can be treated if there is adequate conformal avoi