Is surgery preferable over SBRT for peripheral NSCLC invading into ribs?

There is not much data about SBRT in tumor invading the rib. Technically, this is T3 disease. There are three uncertainties: 1. Chest wall toxicity. 2. Tumor contour and margin. 3. Optimal dose. Since surgical resection remains the standard care for operable disease, without further data, I would vo...

Agree with @Dr. First Last that the data for T3N0 and SBRT is really murky. In an operable patient I too would favor surgery.

If the tumor is very inflitrative into the chest wall I'd do induction chemo/xrt (50-60Gy with weekly carboplatin/taxol) to try to limit the extent of chest wall resection th...

I agree with @Dr. First Last's answer - if operable then resection offers the least compromised approach in terms of oncological outcome.

If high risk for resection or medically inoperable the decision becomes more complicated. ChemoRT, conventional RT, hyporfactionated RT, and SBRT are all reasonabl...

There should be an option for concurrent chemo-radiation IMO. I'd take it to 70 with carbo/taxol, assuming the patient is not a surgical candidate.