Lung cancer is the leading cause of cancer death in Australia. Non-Small Cell Lung Cancer (NSCLC) is the commonest form, accounting for about 80% of all lung cancers. Surgery remains the gold standard treatment for early (stage I & II) NSCLC but only a small proportion of NSCLC patients are diagnosed in early stages. A significant number of these patients have cardiovascular and respiratory comorbidities and are therefore not suitable for surgery. Historically these patients were either treated with standard conventional radiotherapy or offered no treatment at all. However the outcomes after standard radiotherapy have been poor to modest (5 year survivals ranging from 0-42% with local control rates of up to 60%). Conventional radiotherapy is usually given over a 4-6 week period (20-30 visits) on a daily basis.
Stereotactic Ablative Body Radiotherapy (SABR), also known as stereotactic body radiotherapy (SBRT), is a relatively new technique, for treating small volume early stage NSCLC and small volume lung secondaries.
It is a complex and highly precise treatment that utilises specialised equipment to evaluate and account for tumour motion prior to and during radiation delivery.
Small lung tumours tend to move with respiration and this can be assessed using a 4D CT scan (time is the 4th dimension). A 4D CT scan during treatment planning ensures that the entire tumour pathway during respiration is mapped so that the tumour can be targeted with precision. Radiation planning for SABR is different to conventional radiotherapy and is done in such a way that there is less radiation dose spillage into the normal tissues surrounding the tumour.
Genesis CancerCare Queensland has installed modern 4D CT scanners on the Gold Coast (John Flynn Hospital and Premion place, Southport) as well a new state of the art Truebeam Linear Accelerator. The Truebeam Linac provides significantly faster radiation treatment when compared to conventional Linacs (approx 50% quicker) and permits conebeam CT imaging of a tumour for administering highly accurate radiation therapy.
In summary the potential advantages of SABR over conventional treatment include better local control (around 90%), fewer hospital visits (only 3-5 sessions over a two week period) and fewer side effects from the treatment.
For more information about Genesis CancerCare Queensland’s SABR program please call 07 5507 3600 or email
Dr Sagar Ramani and Mr William Wallace meeting for a follow up appointment one month after receiving SABR treatment for lung cancer.
