Practical considerations of single-fraction stereotactic ablative radiotherapy to the lung

Therese M. J. Kang, Nicholas Hardcastle, Anurag K. Singh, Ben J. Slotman, Gregory M. M. Videtic, Kevin L. Stephans, Felipe Couñago, Alexander V. Louie, Matthias Guckenberger, Susan V. Harden, Nikki M. Plumridge, Shankar Siva*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review


Stereotactic ablative radiotherapy (SABR) is a well-established treatment for patients with medically inoperable early-stage non-small cell lung cancer (NSCLC) and pulmonary oligometastases. The use of single-fraction SABR in this setting is supported by excellent local control and safety profiles which appear equivalent to multi-fraction SABR based on the available data. The resource efficiency and reduction in hospital outpatient visits associated with single-fraction SABR have been particularly advantageous during the COVID-19 pandemic. Despite the increased interest, single-fraction SABR in subgroups of patients remains controversial, including those with centrally located tumours, synchronous targets, proximity to dose-limiting organs at risk, and concomitant severe respiratory illness. This review provides an overview of the published randomised evidence evaluating single-fraction SABR in primary lung cancer and pulmonary oligometastases, the common clinical challenges faced, immunogenic effect of SABR, as well as technical and cost-utility considerations.
Original languageEnglish
Pages (from-to)185-193
Number of pages9
JournalLung Cancer
Publication statusPublished - 1 Aug 2022

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