Hypofractionation for Lung Tumors (Primary Malignant, Secondary Malignant)

Lung cancer remains the most common cause of cancer mortality worldwide. In addition, more lung cancer patients are being diagnosed at an earlier stage due to improved diagnostic imaging techniques in combination with the recommended guidelines for lung cancer screening. Stereotactic Body Radiation Treatment (SBRT) is a standard treatment option for patients with early-stage non-small cell lung cancer (NSCLC) and patients with lung metastases. However, SBRT could cause severe complications, especially in tumors located in the central thorax. In addition, less extreme hypofractionation (10–25 fractions of 2.5–6.0 Gy/fx) regimens are being evaluated to escalate the biologically effective dose (BED) of radiation for more advanced (stages III–IV) NSCLC. This chapter reviews the current body of literature for treating primary lung cancer and lung metastasis with SBRT and hypofractionation regimens and describes the technical considerations needed to properly execute these techniques.