Surgery Versus Stereotactic Body Radiotherapy for Resectable Lung Cancer
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Purpose of Review
Radiotherapy has been considered in the past an option for local control of resectable lung cancer only in cases of patients considered unfit or declining surgical treatment.
Recent technological improvements allow radiation oncologists to deliver precisely targeted radiation at much higher doses compared to traditional radiation therapy, in one single or few sessions, minimizing damage to the surrounding healthy tissue. In this review, we discuss the advantages and inconveniences of surgery and stereotactic body radiotherapy (SBRT) for the treatment of resectable non-small cell lung cancer.
Although the use of modern surgical techniques has decreased the overall rate of adverse effects and mortality of lung resection, surgery-related morbidity is not comparable to that recorded after SBRT. This advantage has to be balanced against, in some cases, lack of definite cyto-histological diagnosis and non-accurate definitive pathological staging. In the absence of high-quality randomized trials comparing surgery and SBRT, the published 1- and 3-year survival rates after SBRT seem to be comparable to lung resection. Nevertheless, we have to be cautious in recommending non-surgical therapy for operable patients having resectable tumours due to the aforementioned limitations biasing the results.
KeywordsNon-small cell lung cancer Lung surgery Pulmonary lobectomy Radiotherapy Stereotactic body radiation therapy High-dose radiotherapy
Compliance with Ethics Guidelines
Conflict of Interest
Drs. Jimenez, Novoa, and Varela declare no conflict of interest relevant to this manuscript.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as:• Of importance •• Of major importance
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