The Role of Conventionally Fractionated Radiotherapy and Stereotactic Radiotherapy in the Treatment of Carcinoid Tumors and Large-Cell Neuroendocrine Cancer of the Lung

Abstract

The occurrence of neuroendocrine tumors among the diagnosed neoplasms is extremely rare and is associated with difficulties in undertaking effective therapy due to the histopathological differentiation of individual subtypes and the scarce clinical data and recommendations found in the literature. The choice of treatment largely depends not only on its type, but also on the location and production of excess hormones by the tumor itself. Common therapeutic approaches include surgical removal of the tumor, the use of chemotherapy, targeted drug therapy, peptide receptor radionuclide therapy, and the use of radiation therapy. This article reviews the current knowledge on the classification and application of radiotherapy in the treatment of lung NETs. Case reports were presented in which treatment with conventional radiotherapy, radical and palliative radiochemotherapy, as well as stereotactic fractionated radiotherapy in the treatment of typical (TC) and atypical (AT) lung carcinoids and large cell neuroendocrine carcinoma (LCNC) were used. We hope that the solutions presented in the literature will allow many radiation oncologists to make the best, often personalized decisions about the therapeutic qualifications of patients.

Risk factors, survival analysis, and nomograms for distant metastasis in patients with primary pulmonary large cell neuroendocrine carcinoma: A population-based study

“…( 39 ) However, radiotherapy may shorten the survival time of individuals undergoing surgery. ( 40 – 42 ) On the other hand, it is interesting to note that the metastatic pattern of LCNEC is similar to NSCLC, but the prognosis is similar to that of SCLC. ( 43 )The brain was the most common metastatic site, so prophylactic cranial irradiation is an effective treatment and might be improve survival time.…”

Neuroendocrine Tumors: Treatment and Management

“…This poses a serious problem when a patient needs to be directed to external radiotherapy. Bilski et al [ 11 ] present the current knowledge on the use of radiotherapy in the treatment of lung NETs, providing a description of several clinical cases that could potentially help radiation oncologists to make the best and most personalized therapeutic decisions.…”