Radiation time, dose, and fractionation in the treatment of lung cancer Journal Article
| Authors: | Billing, D. L.; Rimner, A. |
| Article Title: | Radiation time, dose, and fractionation in the treatment of lung cancer |
| Abstract: | Radiation therapy plays a vital role in the definitive management of early stage and locally advanced lung cancer. Local treatment failure is a primary cause of disease progression in lung cancer and improved local control has been associated with improved overall survival in both non-small cell (NSCLC) and small cell lung cancers (SCLC) (Arriagada et al. 1991; Machtay et al. 2012; Pignon et al. 1992). Delivery of radiation to the intrathoracic sites of disease is limited by the sensitivity of the surrounding non-neoplastic tissues, in particular the normal lung, esophagus, and heart. As such, substantial effort has been made to optimize radiation treatments to maximize tumor control while minimizing toxicity. Technological advancements have led to better imaging of tumors and organs at risk at the time of treatment planning and more precise delivery of therapeutic radiation. Other ways to improve the therapeutic ratio for lung radiotherapy include altering variables such as radiation dose, fractionation schedule, and time interval between treatments. This chapter will focus on the seminal trials that have established the standards for these factors in modern lung radiotherapy, specifically in the nonoperative management of early stage NSCLC (defined as stage I-IIB according to the American Joint Committee on Cancer staging system), locally advanced NSCLC (defined as stages IIIA-B according to the American Joint Committee on Cancer staging system), and limited stage SCLC (LS-SCLC, defined as disease limited to the ipsilateral hemithorax and regional lymph nodes). © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG. |
| Keywords: | cancer survival; treatment failure; overall survival; cancer recurrence; intensity modulated radiation therapy; cisplatin; doxorubicin; paclitaxel; positron emission tomography; follow up; carboplatin; progression free survival; lung toxicity; tumor volume; etoposide; esophagitis; lung cancer; risk factor; skull irradiation; dyspnea; pneumonia; dysphagia; lung metastasis; thorax pain; gene rearrangement; radiation dose fractionation; cancer specific survival; lymph node; radiosensitivity; stereotactic radiosurgery; maximum tolerated dose; toxicity; acute toxicity; stereotactic body radiation therapy; hydrolysis; radiation sickness; volumetric modulated arc therapy; recurrence free survival; gross tumor volume; non small cell lung cancer; clinical target volume; proton therapy; organs at risk; therapeutic index; planning target volume; hypofractionated radiotherapy; human; male |
| Journal Title: | Medical Radiology |
| ISSN: | 0942-5373 |
| Publisher: | Springer Nature |
| Date Published: | 2023-01-01 |
| Start Page: | 171 |
| End Page: | 187 |
| Language: | English |
| DOI: | 10.1007/174_2021_272 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Book Chapter in "Advances in Radiation Oncology in Lung Cancer" (ISBN: 978-3-031-34846-4), which is part of a subseries of Medical Radiology called "Radiation Oncology" (ISSN: 2731-4715) -- Found in "Part III Basic Treatment Considerations" -- Source: Scopus |
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