Course Material 

Overview

Stereotactic body radiation therapy (SBRT) is commonly used for peripheral lung tumours with good outcomes and most radiation oncologists are comfortable in treating these lesions. However, when faced with a central/ultra-central lung tumour, SBRT becomes more challenging. Some trials have shown that SBRT is associated with excess toxicity following treatment of central lung tumors. This has caused radiation oncologists to shy away from treating these tumours with SBRT for fear of causing overt toxicity to the patient. Is this fear unfounded? Should we hand over the baton to our surgical colleagues in these cases? Some would opt for more conventional fractionations, but will this compromise local control of the tumour?  

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Risk-adapted fractionation appears to have mitigated this risk, but it remains controversial whether SBRT is safe for all tumors within the central lung zone. 

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Join us as we listen to our expert panel dissect the issues in managing central lung tumours. Professor Suresh Senan, who was a key investigator in the SABR-COMET trial, will take us through his considerations when faced with a central lung tumour. Dr Harish Mithiran, our cardiothoracic surgical colleague will enlighten us on how surgeons manage such tumours and Mr Cai Shao Bin, a principal dosimetrist, will guide us through the dosimetric techniques to tackle these tumours.