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Purpose: Three-dimensional non-coplanar conforrnal radiotherapy (3-DNCCRT) has recently been considered promising for the treatment of stage Ⅰ non-small cell lung cancer (NSCLC).Usually, it is performed in the form of SBRT using 10-20Gy fraction dose.However, this method is considered to be contraindicated for so-called central tumors because of the toxicity of serial organs, such as bronchus, large vessels, etc.We have been treating these tumors with relatively small fraction dose (usually 3Gy) keeping BED10 at the similar level to that of SBRT.In this study, we analyzed our 10-year results.Methods:Eligibility criteria were as follows: maximum tumor diameter not greater than 5cm, PS between 0 and 2,and no limitation regarding age and pulmonary function.Radiotherapy was given with 6MV photon beam by fixed 10 non-coplanar conformal beams to a total dose of 75Gy in 25 fractions in 5 weeks.Irradiation was aiming at the ITV withproper margins.Between Jan.2002 and Dec.2010, 111 eligible cases were treated.Age ranged from 53 to 93 (median 78).The male/female ratio was80/31.There were 64 T1 tumors and 47 T2.Twenty-four tumors were sqcca, 71adenoca, and 16 others.There were 92 inoperable cases and 19 operable cases, who refused operation.Among the entire cases, 46 cases were central tumors and the other 65 were peripheral tumors.Median follow-up period was 46 months.Results:Three-and 5-year local control rate (LC), overall survival rate (OS), cause-specific survival rate, and relapse-free survival rate for overall cases were, 85% and 85%, 67%and 50%, 79% and 65%, and 56% and 41%,respectively.Three-year LC and OS for T1 and T2 cases were 87%, 66%, and 87%, 69%, respectively (n.s.).Three-year LC and OS for central and peripheral tumors were 85%, 70%, and 86%, 66%, respectively (n.s.).Three-and 5-year OS for operable and inoperable cases were 89%, 89%, and 65%, 43%, respectively (p=0.055).There were 7 Grade 3 pulmonary toxicities (6%), but there were no severe adverse effects concerning serial organs.Conclusions: Three-DNCCRT for stage I non-small cell lung cancer has been safe and effectivefor not only inoperable but also operable cases, and equally effective for peripheral and central tumors, and T1 and T2 tumors.Our treatment might be an alternative to SBRT especially central tumors and T2 tumors, which the results of SBRT have not been satisfactory.In this presentation, I will talk about our technique in comparison with the ordinal SBRT.