Stereotactic Body Radiation Therapy for Medically Inoperable Early-Stage Lung Cancer Patients

Lung cancer is the leading cause of cancer deaths in the United States. Only a small percentage of patients with non–small cell lung cancer present with early-stage disease. The standard curative treatment is lobectomy but patients with lung cancer frequently have comorbidities, rendering them unsuitable for surgical resection. Conventional radiotherapy has been used as a nonsurgical alternative for patients with early-stage non–small cell lung cancer but the outcomes are inferior to surgical resection. Stereotactic body radiation therapy (SBRT) has emerged as a promising treatment for medically inoperable early-stage non–small cell lung cancer with local control rates exceeding 90%, rivaling surgical resection. Multiple retrospective studies and prospective trials across the world have consistently demonstrated high local control rates and low rates of severe toxicities. Currently, multiple phase II and randomized phase III trials are ongoing, attempting to determine optimal SBRT regimen for different clinical scenarios and to compare SBRT with surgery.