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relative survival rates were 96%, 90%, 84% and 71% for sub-lobar resection compared to 93%, 78%, 65% and
[41]
46% respectively for SBRT . Moreover, a comparative analysis among patients Stage IA treated with SBRT
or wedge resection found the SBRT cohort experienced lower survival compared to wedge resection: 5-year
OS rate was 30% vs. 55.2% (P < 0.001) in unmatched analysis and still remained significantly in favor of
[42]
surgery after adjustment for covariates (31% vs. 49.9%, P < 0.001) .

CONCLUSION
Early stage non-small cell lung cancer patients have excellent 5-year survival rates of 60-80% if treated. The
standard of care is lobectomy, but surgery is not always an option. SBRT delivers a high conformal ablative
dose to the target, resulting in local control with an acceptable toxicity profile. Randomized clinical trials
have tried to investigate SBRT for patients who are not candidates for surgical resection, and have showed
encouraging results not inferior to surgery. Unfortunately, the trials designed for testing SBRT in patients
who are potentially operable have been terminated for scarce accrual of results. Many systematic reviews
and meta-analysis have tried to answer the question whether SBRT can be equal to surgery in fit patients,
but results are not definitive. Therefore, SBRT is an effective and safe alternative for patients with Stage I-II
NSCLC who are not candidates for surgery or who refuse surgical treatment.

DECLARATIONS
Authors’ contributions
Conception and design, acquisition of data, analysis and interpretation of data: Reverberi C, Trovò M

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
Both authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2020.

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