Do you prescribe steroids prior to each fraction of lung SBRT?

We do not use prophylactic steroids prior to treating patients with lung SBRT. With over a decade of experience with close to 1500 patients, we have never identified a routine clinical scenario where these have been required. Of note, however, when we have participated in clinical trials where the p...

Since I first started to treat patients with lung SBRT in 2004, I have not been using steroid. I cannot recall any patients developing radiation pneumonitis. I truly do not think concurrent steroid is necessary for lung SBRT.

Anecdotally I have found it helpful for patients with severe arthritis (specifically pain in their shoulders when their arms are up for an extended period of time), as well as for patients with severe COPD as noted above.