Background Fractionated stereotactic body radiotherapy (SBRT) can achieve excellent tumor control with good toxicity profiles and maintained quality of life through non-invasive application of ablative radiation dose in patients with early stage non-small-cell lung cancer (ES-NSCLC). Materials and methods The current standard and challenges of SBRT for patients with ES-NSCLC are presented. Recommendations from guidelines and literature are also discussed. Results For inoperable patients, SBRT is considered the standard of care and is superior to conventionally fractionated RT and radiofrequency ablation (RFA) in survival data. For operable patients, resection remains the standard, even if studies show good local control rates, toxicity profiles, and quality of life for SBRT. Only risk-adapted fractionation schemes should be used in patients with central ES-NSCLC; in patients with interstitial lung disease (ILD), increased risk of toxicity must be weighed against the indication. Another challenge is to improve systemic control and survival, which is addressed by combining SBRT with checkpoint inhibitors. Conclusions The innovative technique of extracranial SBRT has undergone exorbitant developments in recent years and represents an established treatment alternative to surgery and RFA that is already recommended for inoperable patients with ES-NSCLC and is to be considered for operable patients. Challenges in the use of SBRT are treatment of centrally localized tumors, patients suffering from pulmonary diseases and the combination of SBRT with systemic therapy, which is the subject of current studies.     «

Background Fractionated stereotactic body radiotherapy (SBRT) can achieve excellent tumor control with good toxicity profiles and maintained quality of life through non-invasive application of ablative radiation dose in patients with early stage non-small-cell lung cancer (ES-NSCLC). Materials and methods The current standard and challenges of SBRT for patients with ES-NSCLC are presented. Recommendations from guidelines and literature are also discussed. Results For inoperable patients, SBRT is...     »