The Benefits of Single Fraction Stereotactic Body Radiation Therapy (SBRT)

Recent research at Roswell Park Comprehensive Cancer Center led by Anurag Singh, MD, Director of Radiation Research, has shown that for patients with peripherally located lung cancer, one treatment of stereotactic body radiation therapy (SBRT) is equally effective as longer courses radiation therapy.  

This finding on SBRT – also known as stereotactic ablative body radiation (SABR) or radio surgery – offers two significant advantages to patients: lower cost of treatment – one fraction is one-third the price of three – and convenience – during the current pandemic, treating patients in one visit as opposed to several is much safer. 

This one-dose strategy, which also has been shown to benefit many patients with kidney cancer, also reduces patients’ overall exposure to radiation and can be less taxing for patients and their caregivers. The study was published in the International Journal of Radiation Oncology · Biology · Physics.  Numerous international guidelines, including those of the National Comprehensive Cancer Network, support and recommend broader adoption of single-fraction treatment plans for patients with this disease.

Dr. Singh’s team began this work after noticing that literature did not support doing five treatments of SBRT. Prospective had been done on three fractions. The team did a clinical trial on patients with peripheral non-small cell lung cancer, comparing one versus four fractions, and found no significant difference. 

In a follow-up study, they compared one versus three fractions of radiation; again, one was just as good as three. Finally, they compared their data to that of another cancer center that treated patients with five fractions. Again, though this was not a prospective trial, they found no significant difference. 

The key takeaway is that one fraction is as good as three, four or five fractions, and as more physicians get comfortable with treating single-fraction SBRT, this will become the way patients are treated in the future in increasing numbers.  

Dr. Singh plans to continue this work by exploring single-fraction radiation for patients with metastases to the lung, regardless of primary site.