Radiotherapy Research Today is a free monthly online journal that collates and summarizes the latest research about Radiotherapy, including details on cancer treatment, side effects.

Localized non-small cell lung cancer: adjuvant radiotherapy in the era of effective systemic therapy.

Bogart JA, Aronowitz JN

Department of Radiation Oncology, State University of New York Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA. bogartj@upstate.edu

Investigators in Europe, Canada, and the United States recently established a definitive role for adjuvant systemic chemotherapy following resection of early-stage non-small cell lung cancer (NSCLC). This was no small accomplishment, as upward of 20 randomized trials had previously been conducted. The role of postoperative radiotherapy (PORT) has been studied with far less vigor in the modern era. A 1998 meta-analysis of randomized trials suggesting that PORT was detrimental to survival included studies of doubtful quality. The value of PORT should be considered in the same context as recent chemotherapy trials. Advances in imaging have improved the accuracy of staging, patient selection, and target definition. Modern dosimetry and accelerator technologies have advanced the capacity to deliver radiation to the target with less tissue toxicity. Evolving philosophies in dosing and fractionation should improve the therapeutic ratio. Finally, it is reasonable to assume that the importance of local control will be enhanced in the setting of better systemic therapies. We will review the data on PORT and address critical issues in the design of trials to assess the role of modern radiotherapy in the integrated approach to management of early-stage NSCLC.

Published 7 July 2005 in Clin Cancer Res, 11(13): 5004s-5010s.
Full-text of this article is available online (may require subscription).

© 2004-2008 Radiotherapy Research Today. All Rights Reserved.