Motion management in a patient with tracheostomy during lung-SBRT - Breath-hold is worth a try!

Stereotactic body radiation therapy (SBRT) is an appropriate noninvasive treatment option with excellent tumor control rates and overall survival for patients with stage IA non-small cell lung cancer or oligometastases who are medically inoperable or have a high surgical risk.1-6 To ensure safe dose application during SBRT, a time-resolved motion management strategy is required. In case of breathing-induced uncertainties, possible motion management options include breath hold and free-breathing techniques in combination with either gated or continuous beam-delivery with an internal target volume (ITV) or dynamic tumor tracking.