Preprint Review Version 1 This version is not peer-reviewed

Recent Advances and Current Challenges in Stereotactic Body Radiotherapy for Ultra-Central Lung Tumors

Viola Salvestrini
ORCID logo ,
Andrea Lastrucci
ORCID logo ,
Marco Banini
* ,
Mauro Loi
,
Maria Grazia Carnevale
,
Emanuela Olmetto
,
Pietro Garlatti
,
Gabriele Simontacchi
,
Giulio Francolini
ORCID logo ,
Pierluigi Bonomo
ORCID logo ,
Yannick Wandael
,
Isacco Desideri
ORCID logo ,
Renzo Ricci
,
Daniele Giansanti
,
Vieri Scotti
,
Lorenzo Livi
Version 1 : Received: 23 October 2024 / Approved: 24 October 2024 / Online: 24 October 2024 (14:15:15 CEST)

How to cite: Salvestrini, V.; Lastrucci, A.; Banini, M.; Loi, M.; Carnevale, M. G.; Olmetto, E.; Garlatti, P.; Simontacchi, G.; Francolini, G.; Bonomo, P.; Wandael, Y.; Desideri, I.; Ricci, R.; Giansanti, D.; Scotti, V.; Livi, L. Recent Advances and Current Challenges in Stereotactic Body Radiotherapy for Ultra-Central Lung Tumors. Preprints 2024, 2024101934. https://doi.org/10.20944/preprints202410.1934.v1 Salvestrini, V.; Lastrucci, A.; Banini, M.; Loi, M.; Carnevale, M. G.; Olmetto, E.; Garlatti, P.; Simontacchi, G.; Francolini, G.; Bonomo, P.; Wandael, Y.; Desideri, I.; Ricci, R.; Giansanti, D.; Scotti, V.; Livi, L. Recent Advances and Current Challenges in Stereotactic Body Radiotherapy for Ultra-Central Lung Tumors. Preprints 2024, 2024101934. https://doi.org/10.20944/preprints202410.1934.v1

Abstract

Stereotactic Body Radiotherapy has been established as a viable treatment option for inoperable early-stage Non-Small Cell Lung Cancer or secondary lesions mainly in oligoprogressive/oligometastatic scenarios. Treating lesions in the so-called “no flight zone” has always been challenging and conflicting data never cleared how to safely treat these lesions. This is truer considering ultra-central lesions, i.e. directly abutting or whose PTV is overlapping critical mediastinal organs. While historical retrospective data is abundant but mostly heterogenous in terms of definition of ultra-central lesions, dosing regimens and outcomes, prospective data remains scarce, even though recently published studies have given new encouraging results for such delicate treatment scenarios. For this reason, we aimed to review and summarize current knowledge on stereotactic radiation treatment for ultra-central thoracic lesions, highlighting the most recent advances and the messages that can be taken from them. Lastly, we propose a workflow of the necessary steps to identify and treat such patients, therefore helping in elucidating them with advantages and caveats of such treatment option.

Keywords

SBRT; ultra-central; NSCLC; oligometastasis; oligoprogression

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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