Abstract
Lung cancer remains the leading cause of cancer related death in the United States with mortality rates surpassing breast, prostate, brain, and colorectal cancers combined [1,2]. Recent data shows that susceptibility for both men and women for developing invasive lung and bronchogenic carcinoma peak after the age of 70 years [2]. As the generation of baby boomers age, those older than 65 years will nearly double and the number of elderly population older than 85 years will triple from 2020 to 2050
Highlights
Lung cancer remains the leading cause of cancer related death in the United States with mortality rates surpassing breast, prostate, brain, and colorectal cancers combined [1,2]
The standard of care for early-stage non-small cell lung cancer (NSCLC) includes an anatomic pulmonary resection with sampling or dissection of mediastinal and hilar lymph nodes amongst appropriate surgical candidates [6]
The use of Stereotactic Body Radiotherapy (SBRT), or Stereotactic Ablative Radiotherapy (SAbR), has been increasing over time and has surpassed lobectomy for treatment of Stage I NSCLC in octogenarians [7]
Summary
Surgery Versus Radiation Therapy for Early-Stage Lung Cancer: Patient Selection is Crucial. It remains imperative that lung cancer treatment and selection criteria evolves in elderly and high-risk population. SBRT greatly impacted the capability of offering definitive ablative treatment for early-stage NSCLC in high-risk patients [9]. Patients who refused surgery or were medically inoperable with early-stage NSCLC were given a definitive alternate treatment therapy that had a low toxicity profile and could be conducted in a relatively short amount of time [10]. In a meta-analysis by Cao et al, when compared to SBRT in patients with early-stage NSCLC, both lobectomy and sublobar resection were associated with better overall survival (OR 1.71 95% CI: 1.52-1.93 p
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