• Checkpoint inhibitor
• Early-stage
• Immunotherapy
• Non–small cell lung cancer
• Resectability
• Review

• Humans
• Carcinoma, Non-Small-Cell Lung/therapy
• Carcinoma, Non-Small-Cell Lung/pathology
• Carcinoma, Non-Small-Cell Lung/immunology
• Lung Neoplasms/therapy
• Lung Neoplasms/pathology
• Lung Neoplasms/immunology
• Immunotherapy/methods
• Neoplasm Staging

• non-small cell lung cancer
• stereotactic body radiotherapy

• Fiducial markers
• Four-dimensional computed tomography
• Lung
• Stereotactic body radiotherapy
• Target localization error

• local response
• non-small cell lung cancer
• predictive
• radiomics
• stereotactic body radiation therapy

• biomarkers
• management
• non-small cell lung cancer
• radiomics
• stereotactic body radiation therapy

• dose prescription
• isodose line
• lung
• static multi-beam stereotactic body radiotherapy
• treatment planning

• Humans
• Radiosurgery/methods
• Lung Neoplasms/radiotherapy
• Lung Neoplasms/surgery
• Lung Neoplasms/pathology
• Radiotherapy Dosage
• Radiotherapy Planning, Computer-Assisted
• Organs at Risk/radiation effects
• Male

• BED
• EUD
• LQ model
• RBE
• eye plaque brachytherapy

• Humans
• Brachytherapy
• Relative Biological Effectiveness
• Melanoma/radiotherapy
• Radiotherapy Dosage
• Eye Neoplasms/radiotherapy
• Iodine Radioisotopes

• Distant metastasis
• Non-small cell lung cancer
• PET/CT
• Radiomics
• Stereotactic body radiotherapy

• Humans
• Radiosurgery
• Carcinoma, Non-Small-Cell Lung/diagnostic imaging
• Carcinoma, Non-Small-Cell Lung/radiotherapy
• Carcinoma, Non-Small-Cell Lung/surgery
• Lung Neoplasms/diagnostic imaging
• Lung Neoplasms/radiotherapy
• Lung Neoplasms/surgery
• Positron Emission Tomography Computed Tomography
• Radiomics
• China
• Risk Factors
• Small Cell Lung Carcinoma

• 82172674 National Natural Science Foundation of China
• 20JCYBJC00090 Natural Science Foundation of Tianjin Municipal Science and Technology Bureau
• 2019-N-11-26 Cancer Precision Radiotherapy Spark Program of China International Medical Foundation
• ZLJZZDYYWZL08 Construction Project of Cancer Precision Diagnosis and Drug Treatment Technology, TMUCIH
• 320.6750.2020-10-96 Wu Jieping Medical Foundation

• PI3K
• gene expression
• non-small cell lung cancer
• stereotactic body radiation therapy

• Humans
• Carcinoma, Non-Small-Cell Lung/genetics
• Carcinoma, Non-Small-Cell Lung/radiotherapy
• Lung Neoplasms/genetics
• Lung Neoplasms/radiotherapy
• Neoplasm Staging
• Phosphatidylinositol 3-Kinases/genetics
• Radiosurgery
• Retrospective Studies
• Small Cell Lung Carcinoma/pathology
• Transcriptome
• Treatment Outcome

• P30CA033572 NIH HHS
• P30CA033572 NIH HHS

• cancer immunotherapy
• tumour immunology
• translational research
• radiotherapy
• non-small-cell lung cancer

• Humans
• Carcinoma, Non-Small-Cell Lung/drug therapy
• Carcinoma, Non-Small-Cell Lung/radiotherapy
• Lung Neoplasms/drug therapy
• Lung Neoplasms/radiotherapy
• Small Cell Lung Carcinoma
• Radiosurgery

• P30 CA093373 NCI NIH HHS
• R00 CA256526 NCI NIH HHS
• R01 CA240751 NCI NIH HHS
• S10 OD032406 NIH HHS
• K24 AR077313 NIAMS NIH HHS
• UL1 TR001863 NCATS NIH HHS
• U.S. Department of Defense (United States Department of Defense)
• U.S. Department of Health & Human Services | NIH | National Cancer Institute (NCI)

• Anti-tumor immune response
• Cancer bronchique non à petites cellules
• Chirurgie
• Ganglions de drainage tumoral
• Non-small cell lung cancer
• Radiothérapie stéréotaxique
• Réponse immunitaire anti-tumorale
• Stereotactic body radiotherapy
• Surgery
• Tumor draining lymph node

• Humans
• Carcinoma, Non-Small-Cell Lung/radiotherapy
• Carcinoma, Non-Small-Cell Lung/pathology
• Lung Neoplasms/radiotherapy
• Lung Neoplasms/pathology
• Radiation Oncologists
• Immunotherapy
• Radiosurgery
• Neoplasm Staging

• Competing risk analysis
• Early-stage non-small cell lung cancer
• SABR
• Stereotactic ablative radiation therapy

• Humans
• Carcinoma, Non-Small-Cell Lung/pathology
• Lung Neoplasms/pathology
• Retrospective Studies
• Neoplasm Staging
• Small Cell Lung Carcinoma/pathology
• Radiosurgery
• Risk Factors
• Risk Assessment
• Treatment Outcome

• evolution
• hypo fractionation
• management
• optimization
• radiotherapy
• technology
• throughput

• BED, biological effective dose
• CCI, Charlson comorbidity index
• CSS, cancer-specific survival
• CT, computed tomography
• DM, distant metastasis
• FEV1, forced expiratory volume in the first second
• FVC, forced vital capacity
• ITV, internal target volume
• KPS, Karnofsky performance status
• LRR, locoregional recurrence
• Locoregional recurrence
• MPLC, multiple primary lung cancer
• Multiple primary lung cancers
• NSCLC, non-small cell lung cancer
• OS, overall survival
• PET/CT, positron emission tomography/computed tomography
• PTV, planning target volume
• Radical resection
• SBRT, stereotactic body radiation therapy
• Stereotactic body radiation therapy
• TTP, time to progression
• Toxicity
• VATS, video-assisted thoracoscopic surgery

• And end results database
• Epidemiology
• Lung cancer
• Propensity score matching
• Radiotherapy
• Segmentectomy
• Surveillance

Lung cancer remains the leading cause of cancer-related mortality worldwide. Although early-stage non-small cell lung cancer (NSCLC) is likely to be controlled with stereotactic body radiation therapy (SBRT), approximately 18% of patients lead to recurrence. The aim of this study was to identify prognostic factors and establish a predictive model for survival outcomes of patients with non-metastatic NSCLC treated with SBRT. Several radiomic features were selected as predictive factors and two prediction models were established from the pre-treatment computed tomography images of 250 patients in the training cohort. One radiomic factor remained a significant prognostic factor of overall survival (OS) (p = 0.044), and one predicting model could estimate OS time (mean: 37.8 months) similar to the real OS time (33.7 months). In this study, we identified one radiomic factor and one prediction model that can be widely used.

Stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer (NSCLC) leads to recurrence in approximately 18% of patients. We aimed to extract the radiomic features, with which we predicted clinical outcomes and to establish predictive models. Patients with primary non-metastatic NSCLC who were treated with SBRT between 2002 and 2022 were retrospectively reviewed. The 358 primary tumors were randomly divided into a training cohort of 250 tumors and a validation cohort of 108 tumors. Clinical features and 744 radiomic features derived from primary tumor delineation on pre-treatment computed tomography were examined as prognostic factors of survival outcomes by univariate and multivariate analyses in the training cohort. Predictive models of survival outcomes were established from the results of the multivariate analysis in the training cohort. The selected radiomic features and prediction models were tested in a validation cohort. We found that one radiomic feature showed a significant difference in overall survival (OS) in the validation cohort (p = 0.044) and one predicting model could estimate OS time (mean: 37.8 months) similar to the real OS time (33.7 months). In this study, we identified one radiomic factor and one prediction model that can be widely used.

The rate of recurrence remains high for lymph node negative early-stage non-small cell lung cancer that are over 2–3 cm in size following stereotactic body radiation therapy (SBRT). This is due to the increased incidence of out-of-field failures, which warrants the addition of systemic therapy. Immune checkpoint inhibitors (ICIs), a class of immunotherapy, may induce a strong distant therapeutic effect known as the “abscopal” effect. This makes them a very suitable class of drugs to be combined with SBRT when treating early lung cancer with high-risk features, such as larger tumor size. In this review, we discuss the rationale and evidence for doing so.

Stereotactic body radiation therapy (SBRT) has been widely adopted as an alternative to lobar resection in medically inoperable patients with lymph-node negative (N0) early-stage (ES) non-small cell lung cancer (NSCLC). Excellent in-field local control has been consistently achieved with SBRT in ES NSCLC ≤ 3 cm in size. However, the out-of-field control following SBRT remains suboptimal. The rate of recurrence, especially distant recurrence remains high for larger tumors. Additional systemic therapy is warranted in N0 ES NSCLC that is larger in size. Radiation has been shown to have immunomodulatory effects on cancer, which is most prominent with higher fractional doses. Strong synergistic effects are observed when immune checkpoint inhibitors (ICIs) are combined with radiation doses in SBRT’s dose range. Unlike chemotherapy, ICIs can potentiate a strong systemic response outside of the irradiated field when combined with SBRT. Together with their less toxic nature, ICIs represent a very suitable class of systemic agents to be combined with SBRT when treating ES NSCLC with high-risk features, such as larger tumor size. In this review, we describe the rationale and emerging evidence, as well as ongoing investigations in this area.

Hypofractionated image-guided radiotherapy (HIGRT) is a common method in which high doses of radiation are delivered to treat oligometastatic disease. We have previously reported on the clinical outcomes of treating oligometastases with radiation using an elective simultaneous integrated boost technique (SIB), delivering higher doses to known metastases and reduced doses to adjacent bone or nodal basins. Here we compare outcomes of oligometastases receiving radiation targeting metastases alone (MA) versus those treated via an SIB. Both SIB and MA irradiation of oligometastases achieved high rates of tumor metastases control and similar pain control. Further investigation of this technique with prospective trials is warranted.

Purpose: We previously reported on the clinical outcomes of treating oligometastases with radiation using an elective simultaneous integrated boost technique (SIB), delivering higher doses to known metastases and reduced doses to adjacent bone or nodal basins. Here we compare outcomes of oligometastases receiving radiation targeting metastases alone (MA) versus those treated via an SIB. Methods: Oligometastatic patients with ≤5 active metastases treated with either SIB or MA radiation at two institutions from 2013 to 2019 were analyzed retrospectively for treatment-related toxicity, pain control, and recurrence patterns. Tumor metastasis control (TMC) was defined as an absence of progression in the high dose planning target volume (PTV). Marginal recurrence (MR) was defined as recurrence outside the elective PTV but within the adjacent bone or nodal basin. Distant recurrence (DR) was defined as any recurrence that is not within the PTV or surrounding bone or nodal basin. The outcome rates were estimated using the Kaplan–Meier method and compared between the two techniques using the log-rank test. Results: 101 patients were treated via an SIB to 90 sites (58% nodal and 42% osseous) and via MA radiation to 46 sites (22% nodal and 78% osseous). The median follow-up among surviving patients was 24.6 months (range 1.4–71.0). Of the patients treated to MA, the doses ranged from 18 Gy in one fraction (22%) to 50 Gy in 10 fractions (50%). Most patients treated with an SIB received 50 Gy to the treated metastases and 30 Gy to the elective PTV in 10 fractions (88%). No acute grade ≥3 toxicities occurred in either cohort. Late grade ≥3 toxicity occurred in 3 SIB patients (vocal cord paralysis and two vertebral body compression), all related to the high dose PTV and not the elective volume. There was similar crude pain relief between cohorts. The MR-free survival rate at 2 years was 87% (95% CI: 70%, 95%) in the MA group and 98% (95% CI: 87%, 99%) in the SIB group (p = 0.07). The crude TMC was 89% (41/46) in the MA group and 94% (85/90) in the SIB group. There were no significant differences in DR-free survival (65% (95% CI: 55–74%; p = 0.24)), disease-free survival (60% (95% CI: 40–75%; p = 0.40)), or overall survival (88% (95% CI: 73–95%; p = 0.26)), between the MA and SIB cohorts. Conclusion: Both SIB and MA irradiation of oligometastases achieved high rates of TMC and similar pain control, with a trend towards improved MR-free survival for oligometastases treated with an SIB. Further investigation of this technique with prospective trials is warranted.

• adenocarcinoma
• non-small-cell lung carcinoma
• squamous cell carcinoma
• stereotactic body radiation therapy

• Early Stage
• Guidelines
• Management
• Non-small cell lung cancer

Stereotactic body radiation therapy (SBRT) is a frequently used modality for the treatment of early stage non-small cell lung cancer and oligometastatic disease of the lung. The radiological changes observed in the lung after SBRT are likely to differ from those observed after conventional thoracic radiation therapy, primarily due to the small size of the target volume and highly conformal dose distributions with steep dose gradients from the target to surrounding normal lung tissues used in SBRT. Knowledge of the radiological changes that can occur after SBRT is required to correctly diagnose local failure. Herein, I report several radiological changes specific to SBRT that have been observed.

To characterise the motion of pulmonary tumours during stereotactic body radiation therapy (SBRT) and to evaluate different margins when creating the planning target volume (PTV) on a single 4D CT scan (4DCT).

We conducted a retrospective single-site analysis on 30 patients undergoing lung SBRT. Two 4DCTs (4DCT1 and 4DCT2) were performed on all patients. First, motion was recorded for each 4DCT in anterior–posterior (AP), superior-inferior (SI) and rightleft (RL) directions. Then, we used 3 different margins (3,4 and 5 mm) to create the PTV, from the internal target volume (ITV) of 4DCT1 only (PTV D1 + 3, PTV D1 + 4, PTV D1 + 5). We compared, using the Dice coefficient, the volumes of these 3 PTVs, to the PTV actually used for the treatment (PTV_ttt). Finally, new treatment plans were calculated using only these 3 PTVs. We studied the ratio of the D2%, D50% and D98% between each new plan and the plan actually used for the treatment (D2% PTV_ttt, D50% PTV_ttt, D50% ITVttt D98% PTV_ttt).

30 lesions were studied. The greatest motion was observed in the SI axis (8.8 ± 6.6 [0.4–25.8] mm). The Dice index was higher when comparing PTVttt to PTV D1 + 4 mm (0.89 ± 0.04 [0.82–0.98]). Large differences were observed when comparing plans relative to PTVttt and PTV D1 + 3 for D98% PTV_ttt (0.85 ± 0.24 [0.19–1.00]).

and also for D98% ITV_ttt (0.93 ± 0.12 [0.4–1.0]).D98% PTV_ttt (0.85 ± 0.24 [0.19–1.00], p value = 0.003) was statistically different when comparing plans relative to PTV_ttt and PTV D1 + 3. No stastistically differences were observed when comparing plans relative to PTV_ttt and PTV D1 + 4. A difference greater than 10% relative to D98% PTV_ttt was found for only in one UL lesion, located under the carina.

A single 4DCT appears feasible for upper lobe lesions located above the carina, using a 4-mm margin to generate the PTV.

Propostion of a personalized SBRT treatment (number of 4DCT, margins) according to tumor location (above or under the carina).

• Four dimensional computed tomography
• Lung tumors
• Motion study
• PTV margin
• Stereotactic body radiation therapy

• DSOCs
• diagnostic standards of care
• diagnostics
• lung cancer

• DIR
• DVH
• IMRT
• NSCLC
• RILI
• stage I

• Immunotherapy
• Lung cancer
• Main trials
• Radiotherapy

• carbon ion therapy
• conformal delivery
• motion-synchronized
• multi-phase 4D dose delivery
• projected therapeutic outcomes
• proton therapy

Computed tomography (CT) appearance pattern after lung tumor stereotactic body radiation therapy(SBRT) might predicts survival. This study aimed to investigate the correlation between CT appearance pattern after SBRT and outcomes in patients with early-stage non-small-cell lung cancer (NSCLC).

Clinical data of inoperable patients with early-stage NSCLC undergoing SBRT were retrospectively analyzed from 2012 to 2015 at the Zhejiang Cancer Hospital. The relationship between CT appearance pattern after SBRT and patient’s survival was analyzed.

The data from 173 patients with early-stage lung cancer treated with SBRT were analyzed. One month after SBRT, diffuse consolidation was seen in 17 patients, patchy consolidation in 28 patients, diffuse ground-glass opacity (GGO) in 10 patients, and patchy GGO in 22 patients. The survival time was significantly longer in the “no evidence of increased density” group compared with the “consolidation or GGO” group [2-year overall survival (OS) rate, 96.1% vs 89.3%; hazard ratio (HR), 0.36; 95% confidence interval (CI), 0.16–0.85; P = 0.015]. A similar trend was found in the progression-free survival (PFS) analysis (2-year PFS rate, 91.3% vs 85.0%; HR, 0.35; 95% CI, 0.13–0.95; P = 0.015) and distant metastasis free survival(DMFS) (2-year DMFS rate, 93.3% vs 87.1%; HR, 0.41; 95% CI, 0.20–0.86; P = 0.031). However, no significant difference was found in recurrence-free survival between the two groups (P = 0.212).

One month after SBRT, the radiological change “no evidence of increased density” was prevalent. The OS, PFS, and DMFS were significantly longer in the “no evidence of increased density” group compared with the “consolidation or GGO” group. Further studies are needed to validate these findings.

• CT appearance pattern
• SBRT
• follow-up
• lung cancer
• prognostic prediction

To investigate the safety and efficacy of hypofractionated radiation therapy (HFRT) in patients with non-small cell lung cancer who are unfit for surgery or stereotactic body radiation therapy (SBRT) at our institution.

From May 2007 to December 2018, HFRT was used to treat 68 lesions in 64 patients who were unsuitable for SBRT because of central tumor location, large tumor size, or contiguity with the chest wall. The HFRT schedule included a dose of 50–70 Gy delivered in 10 fractions over 2 weeks. The primary outcome was freedom from local progression (FFLP), and the secondary endpoints included overall survival (OS), disease-free survival, and toxicities.

The median follow-up period was 25.5 months (range, 5.3 to 119.9 months). The FFLP rates were 79.8% and 67.8% at 1 and 2 years, respectively. The OS rates were 82.8% and 64.1% at 1 and 2 years, respectively. A larger planning target volume was associated with lower FFLP (p = 0.023). Dose escalation was not associated with FFLP (p = 0.964). Four patients (6.3%) experienced grade 3–5 pulmonary toxicities. Tumor location, central or peripheral, was not associated with either grade 3 or higher toxicity.

HFRT with 50–70 Gy in 10 fractions demonstrated acceptable toxicity; however, the local control rate can be improved compared with the results of SBRT. More studies are required in patients who are unfit for SBRT to investigate the optimal fractionation scheme.

• Non-small cell lung carcinomas
• Radiation dose fractionation
• Radiation dose hypofractionation
• Toxicity
• Treatment outcome

• AAA
• acuros
• airways
• dose calculation
• functional avoidance radiotherapy planning

• Cross validation
• Machine learning
• Non-small cell lung cancer
• Radiomics

• lobectomy
• lung cancer
• particle beam therapy (PBT)

• Aged
• Aged, 80 and over
• Carcinoma, Non-Small-Cell Lung/radiotherapy
• Disease Progression
• Female
• Heavy Ion Radiotherapy
• Humans
• Lung Neoplasms/radiotherapy
• Male
• Markov Chains
• Middle Aged
• Prognosis
• Proton Therapy
• Randomized Controlled Trials as Topic/methods
• User-Computer Interface

• National Research Foundation of Korea

Stereotactic body radiotherapy (SBRT) has been increasingly regarded as a reasonable option for early-stage lung cancer patients without pretreatment pathologic results, but the efficacy and safety in a Chinese population remains unclear. The aim of this study was to compare survival outcomes and toxicities between patients with clinically diagnosed early-stage lung cancer or biopsy-proven early-stage non-small cell lung cancer and to demonstrate the rationality of this treatment.

From May 2012 to December 2018, 56 patients with clinically diagnosed early-stage lung cancer and 60 patients with early-stage biopsy-proven were selected into non-pathological group and pathological group, respectively. Propensity score matching (PSM) was performed to reduce patient selection bias. Survival analysis with log-rank test was used to assess the differences of treatment outcomes, which included local control (LC), progression-free survival (PFS), and overall survival (OS).

The median age was 76 (range 47–93) years, and the median follow-up time was 58.3 (range 4.3–95.1) months in the cohort without pathologic results. The median age was 74 (range 57–88) years, and the median follow-up time was 56.3 (range 2.6–94) months in the cohort with pathologic results. 45 matched-pair were analyzed. The 5-year LC, PFS, and OS rates in matched-pair patients with or without pathologic biopsy were 85.5% and 89.8%, 40.6% and 70.9%, and 63.2% and 76.1%, respectively. On Kaplan-Meier survival analysis after PSM analysis, there was no significant difference between patients with pathologic results versus patients with no pathologic results in terms of LC (P= 0.498) and OS (P=0.141). Of the matched-pair patients treated with SBRT, only 1 patient experienced grade 3 or above radiation pneumonitis.

For early-stage lung cancer patients with medically inoperable or not suitable for invasive diagnosis, SBRT may be a good local treatment.

• clinical diagnosis
• early stage
• lung cancer
• propensity-matched analysis
• stereotactic body radiotherapy

• Dose accumulation
• Lung cancer
• NTCP
• Rib fracture
• SBRT

• TCP
• hypofractionation
• hypoxia
• linear-quadratic model
• tumor volume

• biological markers
• modified Glasgow prognostic score (mGPS)
• non-small cell lung cancer (NSCLC)
• prognosis
• stereotactic body radiation therapy (SBRT)

• Aged
• Aged, 80 and over
• Carcinoma, Non-Small-Cell Lung/pathology
• Carcinoma, Non-Small-Cell Lung/radiotherapy
• Female
• Humans
• Kaplan-Meier Estimate
• Lung Neoplasms/pathology
• Lung Neoplasms/radiotherapy
• Male
• Middle Aged
• Multivariate Analysis
• Prognosis
• Progression-Free Survival
• Proportional Hazards Models
• Radiosurgery
• Retrospective Studies

Stereotactic radiosurgery, or SRS, uses focused beams of gamma radiation targeted to specific areas of the body and has been used for multiple forms of non-small cell lung cancer. In this article, the authors describe two incidental cases of osteonecrosis in patients who had previously undergone stereotactic radiosurgery with recurrence of tumor. While this is a known side effect of traditional radiation therapy, it has not been described in the context of stereotactic radiosurgery. Further, these lesions were immediately deep to a rib, which may have shielded the lesion, and led to SRS failure. Osteonecrosis of the rib is a rare clinical entity but has been found to occur with glucocorticoid use, bisphosphonates, radiation therapy, and radiofrequency ablation. In the authors' review of the literature on SRS for lung cancer and intrathoracic pathology, rib osteonecrosis was not described and has not been mentioned as a possible side effect. Patients who have undergone thoracic stereotactic radiotherapy may develop side effects of traditional radiotherapy. We identified two patients who developed rib osteonecrosis though that has not been previously described as an adverse effect of stereotactic radiotherapy. The patients described in this case did not have any radiographic evidence of disease on imaging, suggesting that further research is warranted on the diagnosis and management of this rare disease entity.

• gamma radiation
• radiation side effects
• rib osteonecrosis
• stereotatic radiosurgery

• Non-small cell lung cancer (NSCLC)
• radiotherapy (RT)
• radiotherapy fractionation
• total dose

• Dosimetry
• Lung cancer
• Radiation pneumonitis
• Stereotactic ablative radiotherapy

• Aged
• Female
• Humans
• Lung
• Lung Neoplasms/radiotherapy
• Lung Neoplasms/surgery
• Radiation Pneumonitis/epidemiology
• Radiation Pneumonitis/etiology
• Radiosurgery/adverse effects
• Radiotherapy Dosage
• Retrospective Studies
• United Kingdom

• 21993 Cancer Research UK

Stereotactic body radiation therapy (SBRT) is an established therapy for medically inoperable early-stage non-small cell lung cancer (NSCLC). Many elderly patients are medically inoperable owing to comorbidities. Therefore, SBRT may be a useful therapy for elderly patients. However, the application of SBRT for patients aged ≥ 80 years has not been completely elucidated. Therefore, this study aimed to assess the clinical utility of SBRT for elderly patients aged ≥ 80 years with pathologically proven early-stage NSCLC.

We retrospectively evaluated the data of patients aged ≥ 80 years with pathologically proven primary NSCLC who underwent SBRT at our institution between January 2009 and March 2020. Treatment outcomes and toxicities were analyzed. We used the Kaplan–Meier method to estimate survival curves and the log-rank test to compare the survival curves. We performed univariate and multivariate Cox regression analyses. p-values < 0.05 were regarded significant.

Sixty-four patients (65 lesions) were included, and the median follow-up period was 38.7 (range 3.5–95.7) months. The median age was 82.9 (range 80.0–94.8) years. Sixteen patients were medically operable, and 48 patients were medically inoperable. The prescribed dose of SBRT was either 48 Gy in four fractions or 60 Gy in 10 fractions. The median survival time was 60.0 months (95% confidence interval, 43.5–71.1). The 1-, 3-, and 5-year local control, cancer-specific survival, progression-free survival, and overall survival rates were 98.4%, 98.4%, 81.0%, and 88.9%; 90.1%, 93.7%, 58.9%, and 68.3%; and 87.4%, 83.5%, 38.2%, and 47.5%, respectively. Multivariate analysis revealed that inoperability and solid nodules were the predictors of poor overall survival after SBRT in elderly patients. Two patients (3.1%) had grade 3 radiation pneumonitis, and one patient (1.6%) had grade 5 radiation pneumonitis.

SBRT was feasible in patients aged ≥ 80 years with NSCLC. It achieved good local control with minimal toxicity. SBRT may be beneficial in elderly patients with early-stage NSCLC.

• Clinical pathology
• Elderly
• Non-small cell lung carcinoma
• Radiosurgery
• Stereotactic body radiation therapy

• diseases
• hollow inorganic nanomedicine
• photothermal therapy