Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Feb;8(1):32-47.
doi: 10.21037/tlcr.2018.06.11.

Medically inoperable stage I non-small cell lung cancer: best practices and long-term outcomes

J Isabelle Choi  1
Affiliations
Review

Medically inoperable stage I non-small cell lung cancer: best practices and long-term outcomes

J Isabelle Choi. Transl Lung Cancer Res. 2019 Feb.

Abstract

Early-stage non-small cell lung cancer (ES-NSCLC) currently represents a minority of all NSCLC diagnoses but, with ongoing refinement and improvement of treatment approaches, is a group with increasing likelihood of long-term disease control and survival. A significant proportion of this population will not be optimal candidates for definitive surgical resection due to tumor characteristics, patient frailty, or comorbid status. The clinical evidence to support the use of stereotactic body radiation therapy (SBRT) in patients with medically inoperable stage I NSCLC is growing as long-term data are obtained. In this review, initial workup, SBRT delivery considerations, recent trial data, and post-treatment surveillance of this population are discussed.

Keywords: Stereotactic body radiation therapy (SBRT); early stage; inoperable; lung cancer; stereotactic ablative radiotherapy.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The author has no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Decision-tree algorithm for workup and treatment of a patient with a new, <5 cm, isolated lung mass. NSCLC, non-small cell lung cancer; SBRT, stereotactic body radiation therapy; PFTs, pulmonary function tests; Y, yes; N, no.
Figure 2
Figure 2
Proximal bronchial zone, or “no-fly zone,” of a centrally-located lung tumor. Definition of central tumor location as per RTOG 0236: tumors within 2 cm in all directions of the proximal bronchial tree, including the carina, right and left main bronchi, and bronchial tree to the second bifurcation. Updates to this definition include: (I) tumors within 2 cm of the proximal bronchial tree and abutting the mediastinum, pericardium, and spine; and (II) tumors within 2 cm in all directions of any mediastinal critical structure, including the esophagus, heart, spinal cord, great vessels, phrenic nerve, and recurrent laryngeal nerve. Adapted with permission from Timmerman et al. (45).
See this image and copyright information in PMC

References

    1. American Cancer Society. Global Cancer Facts & Figures 3rd Edition. Atlanta: American Cancer Society, 2015.
    1. Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. Lyon, France: International Agency for Research on Cancer, 2013.
    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin 2018;68:7-30. 10.3322/caac.21442 - DOI - PubMed
    1. Cancer of the Lung and Bronchus (Invasive). In: Howlader N, Noone AM, Krapcho M, et al. editors. SEER Cancer Statistics Review, 1975-2014. Bethesda, MD: National Cancer Institute, 2017.
    1. Amin MB, Edge S, Greene F, et al. AJCC Staging Manual. 8th Ed. New York, NY: Springer International Publishing, 2017.