Stereotactic Body Radiation Therapy for Stage I Non-Small Cell Lung Cancer

Conventional fractionated radiotherapy has resulted in 5-year local control rates of 30% to 50% and overall survival rates of 10% to 30% in stage I inoperable non-small cell lung cancer (NSCLC). Early stage NSCLC is not inherently a systemic disease at the time of diagnosis; research directed toward improving survival should put more emphasis on improving local tumor obliteration. Image-guided hypofractionated stereotactic body radiation therapy can deliver a high biologic effective dose to the target while minimizing the normal tissue toxicities, which may translate into improved local control and survival rates. This article discusses the rationale, indications, and optimal techniques for stereotactic body radiation therapy and comparison with surgical resection in patients with stage I NSCLC.