title: Primary Treatment Options for High-Risk/Medically Inoperable Early Stage NSCLC Patients.
abstract: Lung cancer is among the most common cancers worldwide and is the leading cause of cancer death in both men and women. For patients with early stage (American Joint Committee on Cancer T1-2, N0) non-small-cell lung cancer, the current standard of care is lobectomy with systematic lymph node evaluation. Unfortunately, patients with lung cancer often have medical comorbities, which may preclude the option of surgical resection. In such cases, a number of minimally invasive to noninvasive treatment options have gained popularity in the treatment of these high-risk patients. These modalities provide significant advantages, including patient convenience, treatment in an outpatient setting, and acceptable toxicities, including reduced impact on lung function and a modest risk of postprocedure chest wall pain. We provide a comprehensive review of the literature, including reported outcomes, complications, and limitations of sublobar resection with or without intraoperative brachytherapy, radiofrequency ablation, microwave ablation, percutaneous cryoablation, photodynamic therapy, and stereotactic body radiotherapy.
authors.affiliation: National Cancer Institute, Bethesda, MD. Electronic address: guy.jones@nih.gov.
authors.forename: Guy C
authors.initials: GC
authors.lastname: Jones
authors.affiliation: National Cancer Institute, Bethesda, MD.
authors.forename: Jason D
authors.initials: JD
authors.lastname: Kehrer
authors.affiliation: National Cancer Institute, Bethesda, MD.
authors.forename: Jenna
authors.initials: J
authors.lastname: Kahn
authors.affiliation: National Cancer Institute, Bethesda, MD.
authors.forename: Bobby N
authors.initials: BN
authors.lastname: Koneru
authors.affiliation: National Cancer Institute, Bethesda, MD.
authors.forename: Ram
authors.initials: R
authors.lastname: Narayan
authors.affiliation: National Cancer Institute, Bethesda, MD.
authors.forename: Tarita O
authors.initials: TO
authors.lastname: Thomas
authors.affiliation: National Cancer Institute, Bethesda, MD.
authors.forename: Kevin
authors.initials: K
authors.lastname: Camphausen
authors.affiliation: National Cancer Institute, Bethesda, MD.
authors.forename: Minesh P
authors.initials: MP
authors.lastname: Mehta
authors.affiliation: National Cancer Institute, Bethesda, MD.
authors.forename: Aradhana
authors.initials: A
authors.lastname: Kaushal
mesh_terms: D000553:Ambulatory Care; D001918:Brachytherapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy* / Q000601:surgery; D017115:Catheter Ablation; D000075202:Contraindications; D003452:Cryosurgery; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D010778:Photochemotherapy; D011013:Pneumonectomy; D016634:Radiosurgery; D012306:Risk; D016896:Treatment Outcome
keywords: Intraoperative brachytherapy; Microwave ablation; Percutaneous cryotherapy; Photodynamic therapy; Radiofrequency ablation; SBRT; Stereotactic body radiotherapy