Stereotactic body radiation therapy (SBRT) is imparting profound changes in non small cell lung cancer management, proving an alternative to surgical therapy in early tumors, and decreasing treatment duration and toxicity over conventional fractionation. In view of the positive findings of the national Lung Cancer Screening Trial and recent NCCN guidelines for lung cancer screening, the number of early-stage tumors in high-risk patients, that are amenable to SBRT, will likely increase. There is wide variability of techniques, dose schedules, fractionation schemes and post-therapy follow-up care. Normal tissue constraints and delivery techniques continue to evolve. This panel will discuss innovations in targeting, imaging and delivery techniques, new SBRT indications, e.g. medial/central tumors, predictors of therapy outcome, and follow-up. The panel will discuss controversies, e.g. treatment without tissue diagnosis in selected poor-risk patients. The panel will provide an international transatlantic perspective of the use of SBRT for lung cancer in the U.S. and Europe (and/or Asia). At the conclusion of this activity, the learner will be able to do the following: 1. Explain innovative approaches for management of early-stage lung cancer with SBRT. 2. Describe established and new indications for SBRT in lung cancer . 3. Identify innovations in treatment delivery, technical implementation, challenges and potential toxicities innovative use of SBRT for lung cancer.