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

Updated: Jul 15, 2021
  • Author: Winston W Tan, MD, FACP; Chief Editor: Nagla Abdel Karim, MD, PhD  more...
  • Print

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.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!