Radiothérapie en conditions stéréotaxiques des patients inopérables

Stereotactic radiotherapy is a fundamental change from the conventional fractionated radiotherapy and represents a new therapeutic indication. Stereotactic radiotherapy is now a standard of care for inoperable patients or patients who refuse surgery. The results are encouraging with local control (80 to 100% at 2 years) and survival (56 to 80% at 2 years) rates very high in selected populations. The rate of late toxicity remains acceptable around 20% of grade ≥ 3 at 2 years. Good tolerability makes it appropriate even for elderly and frail patients. Compared to conventional radiation, stereotactic radiotherapy results in different radiological changes. It is necessary to standardize the clinical, radiological and functional endpoints to better differentiate a relapse from radiation-induced interstitial lung disease.