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Median age was 70\u00a0years (range 44\u201390). Diagnosis was based on biopsy for 37.4% of patients, while pathological confirmation was unavailable due to high risk for 62.6%.\n                      <jats:sup>18<\/jats:sup>\n                      F\u2011fluorodeoxyglucose positron-emission tomography (18-FDG-PET) was part of the pretreatment diagnostic workup in 96% (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u2009386) of the total cohort. Tumor stage distribution was T1a in 32 (8%), T1b in 179 (44.6%), T1c in 112 (27.9%), T2a in 67 (16.7%), and T2b in 11 (2.7%) patients. Applied dose schemes were identical for both LINAC and CyberKnife treatments, using risk-adapted doses of 45\u201360\u202fGy in 3\u00a0to 8\u00a0fractions, (biologically effective dose ranging from 86\u00a0to 151.2\u202fGy BED\n                      <jats:sub>10<\/jats:sub>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At a\u00a0median follow-up of 32\u00a0months (range 2\u2013104), the crude survival rate was 58%. Median overall survival (OS) was 63\u00a0months (95% CI: 51.1\u201374.8) the 2\u2011, 3\u2011, and 4\u2011year OS rates were 79, 68,\u00a0and 56%, respectively. Actuarial local control (LC) rates were 94% at 2\u00a0years, 90% at 3\u00a0years, and 87% at 4\u00a0years. Median LC was not reached. Median local progression-free survival (LPFS) and progression-free survival (PFS) rates were 49.5 months (95% CI: 42.8\u201356.3) and 37\u00a0months (95% CI: 31.2.\u201342.8), respectively. Actuarial 2\u2011, 3\u2011, and 4\u2011year LPFS and PFS rates were 75, 60, and 51% and 66, 51, and 42%, respectively. On multivariate analysis, BED\n                      <jats:sub>10<\/jats:sub>\n                      \u202f\u2265\u2009132\u202fGy predicted improved LPFS, while earlier tumor stage and better ECOG performance status were associated with improved OS. No grade\u00a03 or higher acute side effects were observed. Grade\u00a03 late side effects occurred in 4\u00a0patients (1%), including grade\u00a03 late pulmonary fibrosis in 3\u00a0cases and potentially treatment-related grade\u00a03 pneumothorax in 1\u00a0patient. Rib fracture was observed in 14\u00a0cases (3%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Clinical results after SBRT at a\u00a0national comprehensive cancer center demonstrate high LC and LPFS rates and favorable PFS and OS, comparable to published studies. Application of a\u00a0BED\n                      <jats:sub>10<\/jats:sub>\n                      of 132\u202fGy or higher shows a\u00a0potential benefit in terms of LPFS and may thus be recommended in the absence of conflict with organ at risk constraints. SBRT with either LINAC or CK is proven to be a\u00a0well-tolerated but still highly effective treatment for the elderly, medically inoperable early-stage lung cancer population.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00066-025-02455-3","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T07:37:55Z","timestamp":1756107475000},"page":"1208-1218","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Long-term clinical results of early-stage lung cancer patients treated with risk-adapted stereotactic body radiotherapy using LINAC or CyberKnife"],"prefix":"10.1007","volume":"201","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4583-4901","authenticated-orcid":false,"given":"Zsolt Levente","family":"J\u00e1nv\u00e1ry","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e1s","family":"Bajcsay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e1bor","family":"Stelczer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e1bor","family":"Kontra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tam\u00e1s","family":"P\u00f3cza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merc\u00e9desz","family":"Gerd\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f3zsef","family":"L\u00f6vey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsuzsa S.","family":"Kocsis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katalin","family":"Lad\u00e1nyi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c9va","family":"Pap","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tibor","family":"Major","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Csaba","family":"Polg\u00e1r","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"2455_CR1","unstructured":"Cancer-World Health Organisation https:\/\/www.who.int\/news-room\/fact-sheetsdetail\/cancer. 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Approval was obtained from the ethics committee of the Hungarian Medical Research Council (ETT-TUKEB), no. BM\/1754-2\/2024. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}