Can Radiotherapy Replace Surgery in Early Lung Cancer?

Surgery remains the standard treatment for early-stage non-small cell lung cancer ( NSCLC ). However, more than half of patients experience moderate to severe postoperative complications, underscoring the need for less invasive options. To address this, a phase II clinical trial compared the efficacy of stereotactic ablative radiotherapy (SABR) with video-assisted thoracoscopic lobectomy with mediastinal lymph node dissection (VATS L-MLND) in 160 patients. Over a median follow-up of 8.3 years, SABR demonstrated a 10-year overall survival rate of 69%, comparable to 66% in the surgical group.

Lung cancer –specific survival (92% vs. 89%) and recurrence-free survival (57% vs. 65%) were also similar between the two treatment arms. Importantly, SABR was associated with minimal adverse effects, with no treatment-related hospitalizations or deaths, aside from three isolated cases of grade 2–3…