Subscribe to RSS
DOI: 10.1055/s-2008-1076748
Advances in Radiotherapy for Lung Cancer
Publication History
Publication Date:
02 June 2008 (online)
![](https://www.thieme-connect.de/media/srccm/200803/lookinside/thumbnails/10.1055-s-2008-1076748-1.jpg)
ABSTRACT
The past decade has seen steady advances in the field of radiation therapy, impacting definitive treatment options for early and advanced tumors, as well as identifying further roles for adjuvant and palliative therapy. The widespread availability of 18F-fluoro-2-deoxy-D-glucose positron emission tomographic (FDG PET) imaging has improved staging, and better defines a population that will benefit from aggressive local therapy. Technological advances in radiation treatment planning allow for less normal lung irradiation, allowing increasing dose and decreasing normal tissue toxicity. Ongoing clinical investigations in the role of radiosurgery for early lung tumors, postoperative radiation of locally advanced non-small-cell lung cancer (NSCLC), and prophylactic cranial irradiation in small-cell lung cancer (SCLC) help to identify patients who may benefit from treatment.
KEYWORDS
Lung cancer - stereotactic radiotherapy - postoperative radiation therapy - cranial irradiation
REFERENCES
- 1 Wisnivesky J P, Bonomi M, Henschke C, Iannuzzi M, McGinn T. Radiation therapy for the treatment of unresected stage I–II non-small cell lung cancer. Chest. 2005; 128 1461-1467
- 2 McGarry R C, Song G, des Rosiers P, Timmerman R. Observation-only management of early stage, medically inoperable lung cancer: poor outcome. Chest. 2002; 121 1155-1158
- 3 Decker R H, Tanoue L T, Colasanto J M, Detterbeck F C, Wilson L D. Evaluation and definitive management of medically inoperable early stage non-small-cell lung cancer, II: Newer treatment modalities. Oncology (Williston Park). 2006; 20 899-905
- 4 Rosenzweig K E, Fox J L, Yorke E et al.. Results of a phase I dose-escalation study using three-dimensional conformal radiotherapy in the treatment of inoperable nonsmall cell lung carcinoma. Cancer. 2005; 103 2118-2127
- 5 Kong F M, Ten Haken R K, Schipper M J et al.. High-dose radiation improved local tumor control and overall survival in patients with inoperable/unresectable non-small-cell lung cancer: long-term results of a radiation dose escalation study. Int J Radiat Oncol Biol Phys. 2005; 63 324-333
- 6 Bradley J, Graham M V, Winter K et al.. Toxicity and outcome results of RTOG 9311: a phase I–II dose-escalation study using three-dimensional conformal radiotherapy in patients with inoperable non-small-cell lung carcinoma. Int J Radiat Oncol Biol Phys. 2005; 61 318-328
- 7 Onishi H, Shirato H, Nagata Y et al.. Hypofractionated stereotactic radiotherapy (HypoFXSRT) for stage I non-small cell lung cancer: updated results of 257 patients in a Japanese multi-institutional study. J Thorac Oncol. 2007; 2(7, Suppl 3) S94-S100
- 8 Mountain C F. The international system for staging lung cancer. Semin Surg Oncol. 2000; 18 106-115
- 9 McGarry R C, Papiez L, Williams M, Whitford T, Timmerman R D. Stereotactic body radiation therapy of early-stage non-small-cell lung carcinoma: phase I study. Int J Radiat Oncol Biol Phys. 2005; 63 1010-1015
- 10 Timmerman R, Papiez L, McGarry R et al.. Extracranial stereotactic radioablation: results of a phase I study in medically inoperable stage I non-small cell lung cancer. Chest. 2003; 124 1946-1955
- 11 Timmerman R, McGarry R, Yiannoutsos C et al.. Excessive toxicity when treating central tumors in a phase II study of stereotactic body radiation therapy for medically inoperable early-stage lung cancer. J Clin Oncol. 2006; 24 4833-4839
- 12 Shiu A S, Chang E L, Ye J S et al.. Near simultaneous computed tomography image-guided stereotactic spinal radiotherapy: an emerging paradigm for achieving true stereotaxy. Int J Radiat Oncol Biol Phys. 2003; 57 605-613
- 13 Onishi H, Kuriyama K, Komiyama T et al.. A new irradiation system for lung cancer combining linear accelerator, computed tomography, patient self-breath-holding, and patient-directed beam-control without respiratory monitoring devices. Int J Radiat Oncol Biol Phys. 2003; 56 14-20
- 14 Postoperative radiotherapy in non-small-cell lung cancer: systematic review and meta-analysis of individual patient data from nine randomised controlled trials. PORT Meta-analysis Trialists Group. Lancet. 1998; 352 257-263
- 15 Burdett S, Stewart L. Postoperative radiotherapy in non-small-cell lung cancer: update of an individual patient data meta-analysis. Lung Cancer. 2005; 47 81-83
- 16 Lally B E, Zelterman D, Colasanto J M, Haffty B G, Detterbeck F C, Wilson L D. Postoperative radiotherapy for stage II or III non-small-cell lung cancer using the surveillance, epidemiology, and end results database. J Clin Oncol. 2006; 24 2998-3006
- 17 Douillard J Y, Rosell R, De L M et al.. Adjuvant vinorelbine plus cisplatin versus observation in patients with completely resected stage IB-IIIA non-small-cell lung cancer (Adjuvant Navelbine International Trialist Association [ANITA]): a randomised controlled trial. Lancet Oncol. 2006; 7 719-727
- 18 Bekelman J E, Rosenzweig K E, Bach P B, Schrag D. Trends in the use of postoperative radiotherapy for resected non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2006; 66 492-499
- 19 Auperin A, Arriagada R, Pignon J P et al.. Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic Cranial Irradiation Overview Collaborative Group. N Engl J Med. 1999; 341 476-484
- 20 Meert A P, Paesmans M, Berghmans T et al.. Prophylactic cranial irradiation in small cell lung cancer: a systematic review of the literature with meta-analysis. BMC Cancer. 2001; 1 5
- 21 Slotman B, Faivre-Finn C, Kramer G et al.. Prophylactic cranial irradiation in extensive small-cell lung cancer. N Engl J Med. 2007; 357 664-672
- 22 Fonseca R, O'Neill B P, Foote R L, Grill J P, Sloan J A, Frytak S. Cerebral toxicity in patients treated for small cell carcinoma of the lung. Mayo Clin Proc. 1999; 74 461-465
- 23 Gregor A, Cull A, Stephens R J et al.. Prophylactic cranial irradiation is indicated following complete response to induction therapy in small cell lung cancer: results of a multicentre randomised trial. United Kingdom Coordinating Committee for Cancer Research (UKCCCR) and the European Organization for Research and Treatment of Cancer (EORTC). Eur J Cancer. 1997; 33 1752-1758
- 24 Arriagada R, Le C T, Borie F et al.. Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. J Natl Cancer Inst. 1995; 87 183-190
- 25 Le Chevalier T, Arriagada R, Quoix E et al.. Radiotherapy alone versus combined chemotherapy and radiotherapy in unresectable non-small cell lung carcinoma. Lung Cancer. 1994; 10(Suppl 1) S239-S244
- 26 Mehta M, Scrimger R, Mackie R, Paliwal B, Chappell R, Fowler J. A new approach to dose escalation in non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2001; 49 23-33
- 27 Marks L B, Sibley G. The rationale and use of three-dimensional radiation treatment planning for lung cancer. Chest. 1999; 116(6, Suppl) 539S-545S
- 28 Chao K S, Deasy J O, Markman J et al.. A prospective study of salivary function sparing in patients with head-and-neck cancers receiving intensity-modulated or three-dimensional radiation therapy: initial results. Int J Radiat Oncol Biol Phys. 2001; 49 907-916
- 29 Zelefsky M J, Fuks Z, Hunt M et al.. High dose radiation delivered by intensity modulated conformal radiotherapy improves the outcome of localized prostate cancer. J Urol. 2001; 166 876-881
- 30 Zelefsky M J, Fuks Z, Hunt M et al.. High dose radiation delivered by intensity modulated conformal radiotherapy improves the outcome of localized prostate cancer. J Urol. 2001; 166 876-881
- 31 Yom S S, Liao Z, Liu H H et al.. Initial evaluation of treatment-related pneumonitis in advanced-stage non-small-cell lung cancer patients treated with concurrent chemotherapy and intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys. 2007; 68 94-102
- 32 MacManus M P, Hicks R J, Matthews J P et al.. High rate of detection of unsuspected distant metastases by pet in apparent stage III non-small-cell lung cancer: implications for radical radiation therapy. Int J Radiat Oncol Biol Phys. 2001; 50 287-293
- 33 Bradley J D, Perez C A, Dehdashti F, Siegel B A. Implementing biologic target volumes in radiation treatment planning for non-small cell lung cancer. J Nucl Med. 2004; 45(Suppl 1) 96S-101S
- 34 Kong F M, Frey K A, Quint L E et al.. A pilot study of [18F]fluorodeoxyglucose positron emission tomography scans during and after radiation-based therapy in patients with non small-cell lung cancer. J Clin Oncol. 2007; 25 3116-3123
- 35 Giraud P, De R Y, Dubray B et al.. Conformal radiotherapy (CRT) planning for lung cancer: analysis of intrathoracic organ motion during extreme phases of breathing. Int J Radiat Oncol Biol Phys. 2001; 51 1081-1092
- 36 Seppenwoolde Y, Shirato H, Kitamura K et al.. Precise and real-time measurement of 3D tumor motion in lung due to breathing and heartbeat, measured during radiotherapy. Int J Radiat Oncol Biol Phys. 2002; 53 822-834
- 37 Stevens C W, Munden R F, Forster K M et al.. Respiratory-driven lung tumor motion is independent of tumor size, tumor location, and pulmonary function. Int J Radiat Oncol Biol Phys. 2001; 51 62-68
- 38 Giraud P, Yorke E, Ford E C et al.. Reduction of organ motion in lung tumors with respiratory gating. Lung Cancer. 2005; 51 41-51
Roy H DeckerM.D. Ph.D.
Department of Therapeutic Radiology, Yale University School of Medicine
132 HRT, 333 Cedar St., New Haven, CT 06520-8040
Email: Roy.Decker@Yale.edu