Role of Stereotactic Body Radiation Therapy and Proton/Carbon Nuclei Therapies

Locally advanced non-small cell lung cancer is a disease typified by poor clinical outcomes. Patients treated with definitive radiation or chemoradiation have high rates of local tumor progression and distant metastasis. Tumor dose escalation using conventionally fractionated radiation is limited by toxicity to adjacent normal tissues. Novel treatment modalities such as stereotactic body radiation therapy or charged particle therapies potentially represent methods to dose escalate without increasing the risk of normal tissue toxicity. Here, we review the technologies of stereotactic body radiation therapy and charged particles, the reported clinical success with these modalities, and potential implementation into treatment regimens for locally advanced non-small cell lung cancer.