Stereotactic Radiosurgery Followed by Wedge Resection in Treating Patients With Early Stage Peripheral Non-small Cell Lung Cancer

Inclusion Criteria

• •Eastern Cooperative Oncology Group (ECOG) performance status 0, 1, or 2
• •Biopsy proven non-small cell lung cancer
• •Maximum tumor dimension =\< 5 cm
• •No clinical evidence of N1, N2 or N3 lymph nodes as assessed by CT and/or PET-CT
• •No evidence of distant metastatic disease
• •Tumor verified by a thoracic surgeon to be in a location that will permit a sublobar resection
• •Tumor located peripherally within the lung (peripheral defined as not touching any surface within 2 cm of the proximal bronchial tree in all directions) and not touching the mediastinal pleura
• •Pulmonary function tests (PFTs) with diffusing capacity of the lung for carbon monoxide (DLCO) within 90 days prior to registration
• •Patient at high-risk of complications from lobectomy meeting a minimum of one major criteria or two minor criteria as described below:
• •* Major criteria
• •* Predicted postoperative forced expiratory volume in one second (FEV1) =\< 40%
• •* Predicted postoperative DLCO =\< 40%
• •* Age \>= 72
• •* Minor criteria
• •* Predicted postoperative FEV1 41-60%
• •* Predicted postoperative DLCO 41-60%
• •* Pulmonary hypertension (defined by a pulmonary artery systolic pressure greater than 40 mm Hg) as estimated by echocardiography or right heart catheterization
• •* Poor left ventricular function (defined as an ejection fraction 40% or less)
• •* Resting or exercising arterial partial pressure of oxygen (pO2) =\< 55 mmHg or oxygen saturation (SpO2) =\< 88%
• •* Partial pressure of carbon monoxide (pCO2) \> 45 mm Hg
• •* Modified Medical Research Council Dyspnea Scale \>= 3
• •Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 90 days following completion of therapy; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
• •* A female of child-bearing potential is any woman (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria:
• •* Has not undergone a hysterectomy or bilateral oophorectomy; or
• •* Has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding 12 consecutive months)
• •Ability to understand and the willingness to sign a written informed consent