Stereotactic Body Radiation Therapy

Kylee McConnell
Dr. Evans
Rad Tech 200
Reaction Paper #1
1. Puri V, Crabtree TD, Kymes S, Gregory M, Bell J, et.al. A comparison of surgical intervention
and stereotactic body radiation therapy for stage I lung cancer in high-risk patients: a decision
analysis. J Thorac Cardiovasc Surg. 2012 Feb;143(2):428-36. Epub 2011 Dec 9. PubMed PMID:
22169443.
2. Urschel HC, Kresl JJ. Treating tumors that move with respiration. Berlin, Heidelberg:
Springer-Verlag; 2007;13:119.
This collection of resources discuss stereotactic body radiation therapy (SBRT) in
patients with a high risk of stage I lung cancer. Stereotactic body radiation therapy is a newer
preference for patients to undergo if they are considered inoperable for their early stage of lung
cancer. The procedure has been evaluated to determine how cost effective it really is. Compared
to radiofrequency ablation and external beam radiation therapy, stereotactic body radiation
therapy has proved to have greater effects and supremacy over the other two. In order to
conclude how cost effective it is, the results of the stereotactic body radiation therapy were
compared to surgical results. Seventy-six patients underwent SBRT, while four hundred and
sixty two patients underwent through the surgical intervention. Fifty-seven patients from each
procedure were opted by propensity score matching, which was used to adjust the ratios of
treatment hazards from age, stages of the clinical, and comorbidity index. The median survival
rate for SBRT was 2.9 years with a four year survival rate or 30.1%, while the surgical
intervention survival rate was 4.2 years with a four year survival rate of 51.4%. The mortality
rate was four out of fifty-seven (7%) of the patients in surgical intervention, and there was no
mortality rate for SBRT. Out of the fifty-three survivors of the surgery, thirteen were qualified
for chemotherapy, although only seven patients partook in the therapy. No patient in the SBRT

needed chemotherapy. At the end, stereotactic body radiation therapy costed $14,153 with a
survival rate of 2.93 years, while the surgical intervention costed $17,629 with a survival rate of
3.39 years. This is a $7,753 difference. Even though SBRT costs less, the surgical intervention
showed to be the most cost effective since it had a longer survival rate.1
Even though stereotactic body radiation therapy may have a lower survival rate, it is still
a very effective method and is being improved in order to irradiate the tumor without it moving
due to respiration. The main purpose of SBRT is to target the tumor as close as possible to block
the whole lung from becoming irradiated. Fractioned radiation used to be used on inoperable
stage I lung cancer patients. Typically, the dose given to a tumor is about 66-70 Gy, and
chemotherapy is not needed. SBRT is utilized to increase the dose given to the tumor without the
radiation hitting more of the lung than necessary. This is the main reason why stereotactic body
radiation therapy is becoming so popular, because it saves other important body parts around the
tumor from being irradiated while ridding of the tumor.2
Lung cancer is a very hard disease to try to treat with radiation since the lungs are
constantly moving from respiration. To me, I found stereotactic body radiation therapy to be a
very useful and appropriate alternative to external beam radiation therapy and surgery. If a
patient is inoperable in their stage I of lung cancer, I believe SBRT would be a noble procedure
to undergo. Not only is it very economical cost wise, it also is very beneficial in the survival
rate. Also, since you do not need to go through chemotherapy, I think it is a worthy choice.
Radiation is something that should not be taken easily. It is really serious, and the effects from it
can be severe. Radiation needs to be done carefully and correctly in order to treat a patient. I
believe that stereotactic body radiation therapy is the perfect example of a procedure that is done
cautiously and suitably in order to treat a tumor that cannot be operated on.

It would be interesting to me to see more studies done on the different radiation

techniques used to treat tumors and continue to see the success of SBRT. I would also like to see
the effects of this procedure and the results of different age groups. Additionally, the results of
treatment on other types of cancers, like the prostate or body parts that are constantly moving,
would be remarkable to see. I believe that stereotactic body radiation therapy would provide the
same results for all types of cancers since its main goal is to target the tumor so that the radiation
does not hit other areas around it. The patients who get diagnosed with lung cancer more
frequently are aged from 65-74, whereas men get it more than women. A fascinating study
would be to test about 100 men between the ages 65 and 74 and 100 women between those ages
and see the effects of stereotactic body radiation on genders. If I had the decision or was asked
my opinion on stereotactic radiation therapy, I would chose SBRT since I would have a decent
survival rate while saving money and not having to undergo chemotherapy.