对于早期非小细胞肺癌（NSCLC），手术是可手术患者的首选方法，而立体定向消融放射治疗（SABR）是因医学原因无法手术的患者的首选方法。 MISSILE II 期试验对新辅助 SABR 和手术的组合进行了测试。我们报告了超过 5 年随访的长期结果。被诊断为 T1-2N0M0 NSCLC、体力状态良好且肺功能充足的患者被纳入研究。患者接受新辅助 SABR 治疗，然后进行肺叶切除术/楔形切除术。 40 名入组患者接受了 SABR，其中 36 名患者进行了手术。病理和主要完全缓解率分别为 60% 和 63%。术后中位随访时间为 6.6 年。五年总体无病生存率和癌症特异性生存率分别为 66.7% (95% CI: 48.8-79.5)、58.3% (95% CI: 40.7-72.4) 和 76.4% (95% CI: 58.2-87.4)。五年局部、区域和远程控制分别为 93.5% (95% CI: 76.3-98.4)、80.1% (95% CI: 62.7-90.0) 和 82.4% (95% CI: 64.9-91.7)。 SABR 和手术后，16.7% (n=6) 的患者经历了相关 ≥ 3 级不良事件，并且没有 5 级事件。SABR 和手术的联合方法是安全的，并显示出合理的长期临床结果，但与单独手术。版权所有 © 2024。由 Elsevier Inc. 出版。

For early-stage non-small cell lung cancer (NSCLC), surgery is the preferred approach in operable patients, whereas stereotactic ablative radiotherapy (SABR) is preferred for medically inoperable patients. The combination of neoadjuvant SABR followed by surgery was tested in the MISSILE phase II trial. We report long-term outcomes, beyond 5 years of follow-up.Patients diagnosed with T1-2N0M0 NSCLC with good performance status and adequate lung function were enrolled. Patients underwent neoadjuvant SABR followed by lobectomy/wedge resection. Forty enrolled patients received SABR, of which 36 patients proceeded to surgery.The pathologic and major complete response rates were 60% and 63%, respectively. Median follow-up was 6.6 years following surgery. Five-year overall, disease-free and cancer-specific survival were 66.7% (95% CI: 48.8-79.5), 58.3% (95% CI: 40.7-72.4) and 76.4% (95% CI: 58.2-87.4). Five-year local, regional and distant control were 93.5% (95% CI: 76.3-98.4), 80.1% (95% CI: 62.7-90.0) and 82.4% (95% CI: 64.9-91.7). After SABR and surgery, 16.7% (n=6) of patients experienced related grade ≥ 3 adverse events and there were no grade 5 events.The combined approach of SABR and surgery was safe and demonstrated reasonable long-term clinical outcomes, but similar to surgery alone.Copyright © 2024. Published by Elsevier Inc.