Single-Fraction Stereotactic Ablative Body Radiotherapy to the Lung – The Knockout Punch

This overview summarises the current evidence on efficacy and safety of single-fraction stereotactic ablative body radiotherapy (SABR) for primary lung cancers and lung metastases, in comparison with the more widely adapted multi-fraction SABR regimens. A literature search using the Medline database through PubMed was carried out using the following key words: (‘stereotactic’ or ‘sabr’ or ‘sbrt’), (‘radiotherapy’ or ‘radiation therapy’), (‘lung’ or ‘thorax’ or ‘thoracic’ or ‘chest’), (‘cancer’ or ‘metasta-’ or ‘oligometasta-’), alongside: (i) (‘single-fraction’ or ‘single-dose’) to identify trials and cohort studies with single-fraction SABR to lung malignant tumours and (ii) (‘fraction’ or ‘schedule’) limiting the search to ‘clinical trial’ and ‘randomized controlled trial’ to ensure thorough capture of lung SABR trials comparing different fractionations. The review discusses the radiobiological, technical and organ at risk considerations of single-fraction SABR to the lung.