Stereotactic body radiation therapy in the treatment of early stage non-small cell Lung cancer

Lung cancer is a significant cause of morbidity and mortality in the United States, with an estimated 173,000 new lung cancer cases and 156,300 deaths due to lung cancer in 2003 [1]. Eighty-five percent of these patients are diagnosed with non-small cell lung cancer (NSCLC), of which 15-20% will have early stage disease [2]. Treatment options for early stage NSCLC depend on patient factors, such as pulmonary reserve, to determine if a patient is a surgical candidate or not. Typically, standard cut-off medical guidelines for surgical resection of NSCLC include the following: baseline forced expiratory volume in 1 s (FEV ₁) < 40% of predicted, post-operative predicted FEV₁ < 30%, severely reduced diffusion capacity, baseline hypoxemia and/or hypercapnia, and exercise oxygen consumption < 50% predicted. For the relatively healthy patient, the traditional treatment of choice for Stage I (T1-2, N0, M0) NSCLC usually consists of radical surgery (lobectomy, pneumonectomy) resulting in an approximate 60% to 80% 5-year overall survival [3]-[5].