Stereotactic Body Radiotherapy and Radiofrequency Ablation for Lung Tumors Near Central Airways

Inclusion Criteria:

* Histologically confirmed primary lung cancer, lung metastasis from another primary, or recurrent tumors in the setting of prior RFA or cryotherapy
* Tumors \< 2 cm from trachea or zone of proximal bronchial tree (central tumors)
* Each tumor \< 5 cm in size prior to treatment
* Medically inoperable patients as determined at the multidisciplinary thoracic tumor board, or medically operable patients who refuse surgery
* Criterion for medical inoperability include:

  * Overall clinical assessment at the UCLA thoracic tumor board
  * Reduced Pulmonary Function (FEV1, DLCO, etc) based on one major or two minor criterion as described below:
* Modified ACOSOG Criteria for medical inoperability:

  * Major Criteria: FEV1% \< 50% or \< 1L and DLCO \< 50%
  * Minor Criteria: Age \> 75, FEV1 51-60% predicted, or FEV1 1-1.2L, DLCO 51%-60% predicted, pulmonary hypertension, poor left ventricular function (EF \< 40% or less), resting or exercise arterial pO2 \< 55 mmHg, and pCO2 \> 45 mmHg
* Age \> 18 years old
* KPS \> 70
* If a woman is of childbearing potential, a negative urine or serum pregnancy test must be documented.
* Ability to understand and the willingness to sign a written informed consent

Exclusion Criteria:

* Prior thoracic radiation near the targets of interest
* More than 2 central tumor targets per patient
* Active infections requiring systemic antibiotics