SABR in the UK: Current status and developments

Stereotactic ablative body radiotherapy (SABR), also known as stereotactic body radiotherapy (SBRT), as defined by the American Society of Radiation Oncology and the American Society of Radiology is an external beam radiation therapy method used to very precisely deliver a high dose of radiation to an extra-cranial target within the body, using either a single dose or a small number of fractions. The UK National Radiotherapy
Implementation Group (NRIG) report defines SBRT as the precise irradiation of an image-defined extracranial lesion, using a high total radiation dose delivered in a small number of fractions (hypofractionation).

The most evidence for SABR in extracranial sites is available in early lung cancer where systematic reviews have shown two-year survival rates and local control as high as 70% and 90% respectively. Even with the increasing number of scientific publications on SABR, phase III evidence against surgery and conventional radiotherapy is limited. Despite this SABR is now a recognised standard of care in early inoperable lung cancer due to its ability to produce local control rates similar to surgery, its low toxicity and patient convenience as a result of reduced number of visits required for treatment when compared to conventionally fractionated radiotherapy. There is also an increasing evidence base/clinical experience for SABR in other sites such as prostate, pancreas, spinal metastases and oligometastatic disease.

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