Stereotactic body radiation therapy versus surgery for patients with stage I non-small cell lung cancer

Stereotactic body radiotherapy (SBRT) has been shown to be effective and safe for patients with inoperable stage I non-small cell lung cancer (NSCLC). In contrast, lobectomy is the standard treatment for patients with operable tumors, with sublobar resection (SLR) as an alternative for patients who cannot tolerate lobectomy. To investigate whether SBRT is an alternative to surgery, several randomized phase III trials were designed to compare lobectomy or SLR with SBRT, but those were closed because of slow accrual. Studies using propensity score-matching analyses to compare SBRT and lobectomy or SLR have reported that SBRT can be an alternative to both SLR and lobectomy in high-risk patients. Randomized phase III trials comparing lobectomy or SLR with SBRT are warranted in the near future