VITS is primarily indicated for patients with stage I lung cancer” to “Television-assisted thoracoscopic surgery (VATS) is a minimally invasive thoracic surgical technique that has matured in recent years, and VATS and other minimally invasive means are recommended in the absence of contraindications to surgery.” 2014 NCCN guidelines: VATS or other minimally invasive pneumonectomy is highly recommended for early-stage NSCLC as long as the patient has no anatomical variants and no contraindications to surgery and as long as it does not violate oncologic treatment criteria and principles of thoracic surgical resection. The multicenter study RTOG0236, conducted in North America, was designed to test the outcomes of SBRT in the treatment of inoperable tie-up non-small cell lung cancer. The study population included 55 patients (44 T1, 11 T2) with a median follow-up time of 34.4 months. The resulting 3-year tumor control rate was 97.6%, local control rate was 87.2%, DFS was 48.3%, and OS was 55.8%. SEER-Medcare 2001 to 2007, enrolled 10,923 cases, aged ≥66 years, with stage IA-IIA NSCLC, who received five conditions for comparison: lobectomy (58.9%), sublobar resection (11.7%), conventional radiotherapy (14.8%), SABR (1.1%) and observation group (12.6%) Outcome: 2-year mortality — 18.3% for lobectomy, 25.1% for sublobar resection, 41.1% for SABR, 56.7% for conventional radiotherapy, and 73.4% for supportive care. CONCLUSION: In this bulk case-review study, lobectomy remains the best treatment for obtaining long-term outcomes in physically fit older adults with early-stage NSCLC. The results of this exploratory analysis suggest that SABR is not a less effective treatment in some selective cases. Randomized studies are urgently needed. National medical website survey: For T1-2 NSCLC, 68% of physicians chose surgery, 32% chose SBRT. 58% of radiologists chose SBRT, and 81% of physicians other than radiologists chose surgery. The new regulations recommend that “patients with stage I and II NSCLC whose organic conditions, such as cardiopulmonary function, are assessed to be inaccessible for surgery should first choose radical radiation therapy, followed by radiofrequency ablation therapy and pharmacological treatment.” 2014 ESMO guidelines: SABR is recommended for patients who are not suitable for surgery or refuse surgical treatment. 2014 NCCN guidelines: the preferred treatment for stage IA NSCLC in the operating room, where radical radiotherapy is feasible if surgery is inoperable or refused for medical reasons. This includes stereotactic radiotherapy (SBRT) at a recommended dose of 100 Gy.