Purpose The American Society for Radiation Oncology (ASTRO) produced an evidence-based guideline on treatment with stereotactic body radiotherapy (SBRT) for patients with early-stage non-small-cell lung cancer. ASCO has a policy and set of procedures for endorsing and/or adapting clinical practice guidelines that have been developed by other professional organizations. Methods The ASTRO Evidence-Based Guideline for Stereotactic Body Radiotherapy for Early-Stage Non-Small-Cell Lung Cancer was reviewed for developmental rigor by methodologists. An ASCO Expert Panel updated the literature search and reviewed the guideline content and recommendations. Results The ASCO Expert Panel determined that the recommendations from the ASTRO guideline, published in 2017, are clear, thorough, and based on the most relevant scientific evidence. ASCO statements and minor modifications were added to enhance the applicability of the ASTRO guideline for the broader ASCO audience. Recommendations For standard operative risk patients with stage I NSCLC, SBRT is not recommended outside of a clinical trial. Lobectomy with systematic lymph node evaluation remains the recommended treatment, although a sublobar resection may be considered in select clinical scenarios. Recommendations are provided regarding the use of SBRT in high operative risk patients and for inoperative patients, including in challenging scenarios where tumors are: centrally located, > 5 cm in diameter, lacking tissue diagnosis, synchronous primary or multifocal, second primary after pneumonectomy, proximal to or involved with mediastinal structures, abutting the chest wall, or recurring after previous treatment. Qualifying statements are included to provide further guidance for implementation, and the importance of a discussion of treatment options among members of the multidisciplinary cancer care team is emphasized. Additional information is available at: www.asco.org/thoracic-cancer-guidelines and www.asco.org/guidelineswiki .

中文翻译：

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早期非小细胞肺癌立体定向放射治疗：美国临床肿瘤学会认可美国放射肿瘤学会循证指南

目的 美国放射肿瘤学会 (ASTRO) 制定了关于立体定向放疗 (SBRT) 治疗早期非小细胞肺癌患者的循证指南。ASCO 有一套政策和一套程序来认可和/或调整其他专业组织制定的临床实践指南。方法 方法学家审查了 ASTRO 早期非小细胞肺癌立体定向放射治疗循证指南的发展严谨性。ASCO 专家小组更新了文献检索并审查了指南内容和建议。结果 ASCO 专家小组确定，2017 年发布的 ASTRO 指南中的建议清晰、彻底，并且基于最相关的科学证据。添加了 ASCO 声明和细微修改，以增强 ASTRO 指南对更广泛 ASCO 受众的适用性。建议 对于具有标准手术风险的 I 期 NSCLC 患者，不建议在临床试验之外进行 SBRT。尽管在某些临床情况下可能会考虑进行亚肺叶切除术，但仍推荐进行系统淋巴结评估的肺叶切除术。提供了关于在手术风险高的患者和非手术患者中使用 SBRT 的建议，包括在具有挑战性的情况下：肿瘤位于中心，直径 > 5 cm，缺乏组织诊断，同步原发灶或多灶性，全肺切除术后第二原发灶，近端纵隔结构或累及胸壁，或在先前治疗后复发。包括合格声明以提供进一步的实施指导，并强调了多学科癌症护理团队成员之间讨论治疗方案的重要性。如需更多信息，请访问：www.asco.org/thoracic-cancer-guidelines 和 www.asco.org/guidelineswiki。