The development of stereotactic body radiotherapy (SBRT) for medically inoperable early stage non-small cell lung cancer: an international phenomenon

Introduction Lung cancer is the most common malignancy worldwide. The standard of care for early stage lung cancer is surgical resection. Patients with this diagnosis frequently have co-morbidities making surgery not feasible. Limited resections result in inadequate disease control. Historic alternatives to surgery such as conventional radiotherapy provide poor outcomes and undue toxicity. Over the past decade, stereotactic body radiotherapy (SBRT) has emerged as a novel radiation modality with significant applications in the medically inoperable, early stage lung cancer population. A range of international retrospective and prospective reports has established SBRT's feasibility, safety and efficacy in these patients using a variety of dose regimens and technologies. Results SBRT results consistently show excellent local control, little acute toxicity, and improved overall survival compared with historical controls of fractionated radiotherapy. Ongoing prospective trials are defining the optimal SBRT regimen in the inoperable population and starting to explore its role for the operable patient.