Stereotactic Body Radiation Therapy For Early-Stage Non-Small Cell Lung Cancer

Publication Date: October 1, 2017
Last Updated: March 14, 2022

Recommendations

When is SBRT appropriate for patients with T1-2, N0 NSCLC who are medically operable?

Any patient with operable stage I NSCLC being considered for SBRT should be evaluated by a thoracic surgeon, preferably in a multidisciplinary setting, to reduce specialty bias. (Strong, Moderate)
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For patients with “standard operative risk” (ie, with anticipated operative mortality of <1.5%) and stage I NSCLC, SBRT is not recommended as an alternative to surgery outside of a clinical trial. Discussions about SBRT are appropriate, with the disclosure that long-term outcomes with SBRT >3 years are not wellestablished. For this population, lobectomy with systematic mediastinal lymph node evaluation remains the recommended treatment, though a sublobar resection may be considered in select clinical scenarios. (Strong, High)
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For patients with “high operative risk” (ie, those who cannot tolerate lobectomy, but are candidates for sublobar resection) stage I NSCLC, discussions about SBRT as a potential alternative to surgery are encouraged. Patients should be informed that while SBRT may have decreased risks from treatment in the short term, the longer term outcomes >3 years are not well-established. (Conditional, Moderate)
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Overview

Title

Stereotactic Body Radiation Therapy For Early-Stage Non-Small Cell Lung Cancer

Authoring Organization

American Society for Radiation Oncology