Dr. Jeffrey Bradley, Radiation Oncologist at Washington University in St. Louis, defines oligometastatic lung cancer and describes the recent trend toward the use of stereotactic body radiation therapy to treat it.

Dr. Jeffrey Bradley, Radiation Oncologist at Washington University in St. Louis, provides evidence for the use of stereotactic body radiation therapy as an alternative to surgery for operable early stage lung cancer.

Dr. Chris Loiselle, radiation oncologist, describes stereotactic body radiation therapy (SBRT) as a helpful and increasingly favored treatment option for sicker, “medically inoperable” patients with early stage lung cancer.

Surgery, specifically a lobectomy or possibly pneumonectomy, has been the longtime historical standard of care for fit patients with early-stage, operable non-small cell lung cancer (NSCLC).

There is a principle in management of lung cancer that some patients who have a very limited degree of metastatic disease or progression after a good response may do unusually well with local treatment, such as radiation or surgery, for the isolated area(s) of disease that are metastatic or growing.

For early stage NSCLC, the historic standard of care is a lobectomy.  But the reality is that with the median age of patients with new lung cancer a little over 70 and many patients quite sick from their lung cancer, COPD, and/or other medical problems, not every patient is a great candidate for surgery.

The subject of stereotactic lung radiotherapy (SBRT) for cure of stage I disease has been extensively covered on GRACE with good cause: we may be witnessing a major change in how we treat early stage cancer. Multiple strategies for improved surveillance are being developed, and hopefully one or more will be successful, resulting in more frequent detection of early stage disease. If so, we will have what my mentor calls a “delicious dilemma” – what is the best way to cure these early-stage patients?

Dr. Quynh Le, radiation oncologist and Professor at Stanford University, was kind enough to participate in our NSCLC Patient Education Forum. She spoke on the topic of emerging treatment options using radiation for early stage NSCLC. The new work she's describing on stereotactic body radiation therapy (SBRT) is looking promising enough that it's being considered increasingly as a very strong choice for people with localized lung cancer but who aren't good candidates for surgery or are disinclined to pursue it.