caa a22 4500 445298820 CHVBK 20180317142550.0 cr unu---uuuuu 170323e20100601xx s 000 0 eng 10.1007/s11864-010-0119-z doi (NATIONALLICENCE)springer-10.1007/s11864-010-0119-z Alternatives to Surgery for Early Stage Non-Small Cell Lung Cancer-Ready for Prime Time? [Elektronische Daten] [Millie Das, Mohamed Abdelmaksoud, Billy Loo Jr., Nishita Kothary] Opinion statement: Surgery is the standard of care for early stage non-small cell lung cancer (NSCLC), with lobectomy being the most oncologically sound resection. Medically inoperable patients and high-risk surgical candidates require effective alternatives to surgery; even operable patients may opt for less invasive options if they are proven to achieve similar outcomes to surgery. Minimally invasive local treatment modalities including dose-intensified conformal radiation therapy, most notably stereotactic ablative radiotherapy (SABR; also known as stereotactic body radiation therapy), and thermal ablation methods such as radiofrequency ablation (RFA) and microwave ablation (MWA) are emerging as promising treatment options whose roles in the treatment of early stage lung cancer are being defined. Early clinical experience and a rapidly growing body of prospective clinical trials, primarily in medically inoperable patients, are demonstrating encouraging effectiveness and safety outcomes in some cases approaching historical results with surgery. Given the very poor prognosis of the medically inoperable patient population, these alternatives to surgery, particularly SABR, are starting to be considered appropriate first-line therapy in properly selected patients, and prospective cooperative group trials to evaluate and optimize RFA and SABR in specific patient subsets are being conducted. For operable patients, prospective multi-center and cooperative groups trials of SABR are ongoing or completed, and international randomized trials of SABR vs. surgery have been initiated. Thus, promising alternatives to surgery for early stage NSCLC are ready for prime time evaluation in the setting of clinical trials, and participation in ongoing trials for both operable and medically inoperable patients is strongly encouraged. Springer Science+Business Media, LLC, 2010 Das Millie Department of Medicine, Division of Medical Oncology, Stanford Cancer Center, 875 Blake Wilbur Drive, 94305, Stanford, CA, USA aut Abdelmaksoud Mohamed Department of Radiology, Division of Interventional Radiology, Stanford University, 300 Pasteur Drive, H3652, 94305-5642, Stanford, CA, USA aut Loo Jr. Billy Department of Radiation Oncology, Stanford University and Cancer Center, 875 Blake Wilbur Drive, 94305-5847, Stanford, CA, USA aut Kothary Nishita Department of Radiology, Division of Interventional Radiology, Stanford University, 300 Pasteur Drive, H3652, 94305-5642, Stanford, CA, USA aut Current Treatment Options in Oncology Springer US; http://www.springer-ny.com 11/1-2(2010-06-01), 24-35 1527-2729 11:1-2<24 2010 11 11864 https://doi.org/10.1007/s11864-010-0119-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11864-010-0119-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Das Millie Department of Medicine, Division of Medical Oncology, Stanford Cancer Center, 875 Blake Wilbur Drive, 94305, Stanford, CA, USA aut NATIONALLICENCE 700 1- Abdelmaksoud Mohamed Department of Radiology, Division of Interventional Radiology, Stanford University, 300 Pasteur Drive, H3652, 94305-5642, Stanford, CA, USA aut NATIONALLICENCE 700 1- Loo Jr Billy Department of Radiation Oncology, Stanford University and Cancer Center, 875 Blake Wilbur Drive, 94305-5847, Stanford, CA, USA aut NATIONALLICENCE 700 1- Kothary Nishita Department of Radiology, Division of Interventional Radiology, Stanford University, 300 Pasteur Drive, H3652, 94305-5642, Stanford, CA, USA aut NATIONALLICENCE 773 0- Current Treatment Options in Oncology Springer US; http://www.springer-ny.com 11/1-2(2010-06-01), 24-35 1527-2729 11:1-2<24 2010 11 11864 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer