A critical review of recent developments in radiotherapy for non-small cell lung cancer

Abstract

Lung cancer is the leading cause of cancer mortality, and radiotherapy plays a key role in both curative and palliative treatments for this disease. Recent advances include stereotactic ablative radiotherapy (SABR), which is now established as a curative-intent treatment option for patients with peripheral early-stage NSCLC who are medically inoperable, or at high risk for surgical complications. Improved delivery techniques have facilitated studies evaluating the role of SABR in oligometastatic NSCLC, and encouraged the use of high-technology radiotherapy in some palliative settings. Although outcomes in locally advanced NSCLC remain disappointing for many patients, future progress may come about from an improved understanding of disease biology and the development of radiotherapy approaches that further reduce normal tissue irradiation. At the moment, the benefits, if any, of radiotherapy technologies such as proton beam therapy remain unproven. This paper provides a critical review of selected aspects of modern radiotherapy for lung cancer, highlights the current limitations in our understanding and treatment approaches, and discuss future treatment strategies for NSCLC.

Lung cancer requires multidisciplinary treatment to improve patient survival: A case report

“…Radiotherapy could be either palliative or curative, depending on the stage at the time of treatment (18). Radiotherapy in elderly people has been demonstrated to provide some benefit to patients with stage I as a curative treatment and in patients with metastatic stage as palliative treatments to improve the quality of life (17).…”

“…Radical radiotherapy for patients with NSCLC can be curative for the minority of patients with early stage disease (17). In addition, when treatment is not curative palliative radiotherapy can be used to aid in pain relief (17,18).…”

AJRCCM: 100-Year Anniversary.The Shifting Landscape for Lung Cancer: Past, Present, and Future

“…Perhaps the most impactful recent advance is the emergence of stereotactic ablative body radiotherapy (SABR) for treatment of early-stage lung cancer in medically inoperable or high surgical risk patients. SABR, initially described in the mid-1990s (71), is a method for delivering external beam radiotherapy with a high degree of accuracy to a target using high doses of radiation in one to eight treatment fractions (72,73).…”

Long-Term Safety and Stability of Gold Coil Fiducial Markers in Non-Small-Cell Lung Cancer Image-Guided Radiotherapy

“…While significant improvements in imaging technology lead to improved tumor delineation, other challenges such as respiratory and cardiac-induced motion, setup inconsistencies, and volume changes and deformation result in significant uncertainties when it comes to targeting the tumor and minimizing normal tissue toxicity [1][2][3]. Both conventional fractionation and SBRT necessitate accurate delivery of radiotherapy [4].…”