SBRT: Is Surgery the Only Option in Early Lung Cancer?

Lung cancerperspectives have changed since the 1930s, when surgery was seen as the only chance of survival, through technology and personalized treatments. Options should be safe, effective and low in adverse effects. Surgery remains standard for early non-small cell lung cancer (NSCLC). Recent studies of targeted stereotactic ablative radiation treatment, radiotherapy (SBRT) have shown in studies of SBRT that this is an effective and reliable method for this group of patients.

Especially in older, frail patients, its apparent equivalence to surgery and reported %0 procedural mortality raise the question of changing conventional practice.

The respected journal Cancerpublished a study assessing 92 NSCLC patients. Operable early-stage tumors measuring 5 - 7.5 cm without nodal involvement received SBRT.

SBRT was standard for inoperable early NSCLC under 5 cm. Experience above 5 cm was limited; this multicenter study reports the largest results to date for tumors over 5 cm.

Local control at 1 year was %72 and at 2 years %54. Disease-specific survival at 1 year was %96 and at 2 years %76.

Pretreatment PET/CTuptake correlated with overall survival. Radiation-related pneumonia developed in 4 patients.

Although this study showed SBRT as effective and safe as surgery in early NSCLC, results need maturation. Four well-designed direct comparisons continue. Awaiting them and individualizing treatment appears most appropriate.