Definitive radiation therapy in locally advanced non-small cell lung cancer: Executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based clinical practice guideline

George Rodrigues, Hak Choy, Jeffrey Bradley, Kenneth E. Rosenzweig, Jeffrey Bogart, Walter J. Curran, Elizabeth Gore, Corey Langer, Alexander V. Louie, Stephen Lutz, Mitchell Machtay, Varun Puri, Maria Werner-Wasik, Gregory M M Videtic

Research output: Contribution to journalArticle

44 Scopus citations

Abstract

Purpose: To provide guidance to physicians and patients with regard to the use of definitive external beam radiation therapy (RT) in locally advanced non-small cell lung cancer (LA NSCLC) based on available medical evidence complemented by consensus-based expert opinion. Methods and materials: A panel authorized by the American Society for Radiation Oncology (ASTRO) Board of Directors and Guidelines Subcommittee conducted 3 systematic reviews on the following topics: (1) ideal radical RT dose fractionation for RT alone; (2) ideal radical RT dose fractionation for chemoradiation; and (3) ideal timing of radical radiation therapy with systemic chemotherapy. Practice guideline recommendations were approved using an a priori-defined consensus-building methodology supported by ASTRO and approved tools for the grading of evidence quality and the strength of guideline recommendations. Results: For patients managed by RT alone, a minimum dose of 60 Gy of RT is recommended. Dose escalation beyond 60 Gy in the context of combined modality concurrent chemoradiation has not been found to be associated with any clinical benefits. In the context of combined modality therapy, chemotherapy and radiation should ideally be given concurrently to maximize survival, local control, and disease response rate. Conclusions: A consensus and evidence-based clinical practice guideline for the definitive radiotherapeutic management of LA NSCLC has been created that addresses 3 important questions.

Original languageEnglish (US)
Pages (from-to)141-148
Number of pages8
JournalPractical Radiation Oncology
Volume5
Issue number3
DOIs
StatePublished - May 2015

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

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    Rodrigues, G., Choy, H., Bradley, J., Rosenzweig, K. E., Bogart, J., Curran, W. J., Gore, E., Langer, C., Louie, A. V., Lutz, S., Machtay, M., Puri, V., Werner-Wasik, M., & Videtic, G. M. M. (2015). Definitive radiation therapy in locally advanced non-small cell lung cancer: Executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based clinical practice guideline. Practical Radiation Oncology, 5(3), 141-148. https://doi.org/10.1016/j.prro.2015.02.012