Which is the Best in Early Lung Cancer; Surgery or Stereotactic Body Radiation Therapy?

Abstract

Despite all improvements in surgical treatment of lung cancer, 25% of early-stage lung cancer patients can either still not undergosafe resection due to medical comorbidities, or they reject surgical treatment. Even though sublober resections were approachedwith suspicion and even garnered strong reactions in the beginning, it was shown in many studies that results like lobectomywere obtained, and today it has now become a common and safe practice. Based upon the successful results achieved with stereotacticradiosurgery in primary and metastatic brain tumors, due to the technologic advancements, stereotactic body radiationtherapy–stereotactic ablative body radiotherapy (SBRT-SABR) practices started to be used at the beginning of the 2000s, whichare based on delivering a few fractions of an extremely high radiation dose to a single target. The aim of this study is to evaluateand to discuss the results of clinical interventions in literature about early lung cancer resections and SBRT. The medical literaturein the thoracic and cardiovascular surgery and oncology network was reviewed, and studies, cases, and meta-analysis articles thatprovided early lung cancer treatment even surgical or SBRT outcomes were examined. A discussion was made by also analyzingthe survival data in the light of the available guidelines. Surgery is the standard treatment for early-stage lung cancer. SABR is thesuitable treatment option in patients that cannot or refuse to undergo surgery. There is no evidence that SABR can be an alternativeto surgical treatment in early-stage lung cancer cases with a medically fit condition that do not refuse surgery.