Prognosis and Treatment Decision Making in Early Stage Non-Small Cell Lung Cancer

Lung cancer is one of the leading causes of death worldwide, and it is the largest contributor to new cancer diagnoses (12% of total new cancer cases) and to death from cancer (18% of total cancer deaths). There are two major groups of lung cancer that arise from the cells of the respiratory epithelium: non-small-cell lung cancer (NSCLC) and small-cell lung cancer, accounting for approximately 85% and 15% of lung cancer cases, respectively. The 5 year survival rate is 70-85% for localized NSCLC, and approximately 10% for metastasized NSCLC. Although surgery is still the standard treatment for early stage lung cancer for operable patients, stereotactic body radiotherapy (SBRT) has emerged as an alternative treatment option, especially for patients in whom surgery is less desirable. Good oncological outcome in these patients have resulted in an increased interest for the use of SBRT. Several studies have been performed about the use of SBRT in potentially operable patients suggesting that SBRT may be as effective as surgery. Given the value sensitive nature of the decision between surgery and SBRT or no treatment, effort should be made to involve the patient in treatment decision making so that they can make a choice consistent with their preferences