Is Surgery Better Than Radiation In Early Lung Cancer

Stereotactic Body Radiation Therapy (SBRT) has recently been hailed as a better alternative to surgery for early lung cancer. Radiation Oncologists have been effectively pushing it and patients are falling for it. The truth may be different. Despite the fact that surgical resection has been the standard of care for early-stage non–small cell lung cancer (NSCLC), an increasing number of patients with potentially operable early-stage NSCLC are now being treated with SBRT. Patients identified as having cT1N0 NSCLC with a tumor less than 2 cm underwent SBRT (1,514 patients) or wedge resection (6,923). Compared with the wedge resection cohort, the SBRT patients were significantly older (74 vs.

69 years) and significantly more likely to be treated at an academic comprehensive cancer program (47% vs. 37%). The median Charlson/Deyo score was lower in the SBRT patients (0 vs. 1). In unmatched…