What are ASTRO recommendations for curative-intent radiation therapy for locally advanced non–small cell lung cancer (NSCLC)?

Updated: Jun 05, 2020
  • Author: Winston W Tan, MD, FACP; Chief Editor: Nagla Abdel Karim, MD, PhD  more...
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Answer

Curative-intent Treatment

  • Concurrent chemoradiation improves local control and overall survival and is recommended over sequential chemotherapy followed by radiation or radiation therapy alone

  • The standard dose-fractionation of radiation with concurrent chemotherapy is 60 Gy given in fractions of 2 Gy once per day over 6 weeks

  • Dose escalation beyond 60 Gy has no demonstrated benefit.

  • There is no role for the routine use of induction chemotherapy beforechemoradiation

  • Current data fail to support routine use of consolidation chemotherapy after chemoradiotherapy, but this remains an option for patients who did not receive full systemic chemotherapy doses during radiotherapy.

  • The ideal concurrent chemotherapy regimen has not been determined. The two most common regimens are cisplatin/etoposide and carboplatin/paclitaxel.

  • For patients who cannot tolerate chemoradiation, sequential chemotherapy followed by radical radiation improves overall survival when compared to radiotherapy alone.


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