2017_SBRT_Course Book

Potential biological consequences of SBRT dose distributions

High doses Small volumes

Low doses Large volumes

Low dose bath

Endothelial damage

Anti-vascular effect

Immune effect

Ø Potential of altered toxicity profile in SRT

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Systematic review: SRT & targeted drugs

Patients

Cranial

Extracranial

Antibodies anti-EGFR / VEGF / HER2 Bevacizumab

215

201

14

Trastuzumab Cetuximab anti-CTLA-4 Ipilimumab anti-PD-1 Nivolumab

7

7 0

0

244

244

121

119

46

27

27

0

Small molecules EGFRi Sorafenib

61 76 71

45 75 43

61 62 48 39 20

Sunitinib

Gefitinib/Erlotinib

ALKi Crizotinib

39

15

BRAFi

129

128

MEKi Trametinib Total

4

4

0

994

664

534

• Very little data available considering large number of drugs, cancer types and treatment sites (Kroeze Cancer Treat Rev. 2017)

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