The evolving role of radiotherapy in non-small cell lung cancer

Abstract

Lung cancer is the most commonly diagnosed cancer and biggest cause of cancer mortality worldwide with non-small cell lung cancer (NSCLC) accounting for most cases. Radiotherapy (RT) plays a key role in its management and is used at least once in over half of patients in both curative and palliative treatments. This narrative review will demonstrate how the evolution of RT for NSCLC has been underpinned by improvements in RT technology. These improvements have facilitated geometric individualization, increasingly accurate treatment and now offer the ability to deliver truly individualized RT. In this review, we summarize and discuss recent developments in the field of advanced RT in early stage, locally advanced and metastatic NSCLC. We highlight limitations in current approaches and discuss future potential treatment strategies for patients with NSCLC.

Early High-Grade Thoracic Toxicity After Palliative Radiotherapy for Non-Small Cell Lung Cancer

“…Despite the well-proven and highly relevant clinical benefits of palliative radiotherapy for non-small cell lung cancer (NSCLC), this treatment frequently induces acute and sub-acute side effects, e.g., esophagitis, weight loss, and fatigue [1][2][3]. Especially with total doses equivalent to at least 30 Gy in 10 fractions and combination with chemotherapy, pneumonitis, and cardiac adverse events might also be observed, though not to the same degree as in the radical treatment setting [4][5][6][7]. Intermediate radiation doses between 30 and 60 Gy, such as the Norwegian CONRAD regime (42 Gy in 15 fractions), are also endorsed in current guidelines, preferably in combination with platinum-based chemotherapy [8,9].…”

Palliative Thoracic Radiotherapy for Non-Small Cell Lung Cancer in Outpatients: Reasons for Unplanned Hospitalization and Its Impact on Survival

“…Palliative radiotherapy, increasingly in combination with platinum-based chemotherapy, continues to play an important role in the management of non-small cell lung cancer (NSCLC) [1][2][3]. Such treatment often provides symptom relief, objective imaging responses and improved survival [4].…”

Up-regulation of VANGL1 by IGF2BPs and miR-29b-3p attenuates the detrimental effect of irradiation on lung adenocarcinoma

“…Radiotherapy is often used for the treatment of solid tumors. Compared with other treatment methods, radiotherapy has evident economic advantages [ 7 – 9 ]. Moreover, the combination of radiotherapy and other treatments usually has a better clinical outcome than individual modalities [ 7 – 9 ].…”

“…Compared with other treatment methods, radiotherapy has evident economic advantages [7][8][9]. Moreover, the combination of radiotherapy and other treatments usually has a better clinical outcome than individual modalities [7][8][9]. However, radiation treatment also causes an adaptive response of LUAD, which facilitates the development of acquired radioresistance of LUAD.…”