What are ASTRO recommendations for adjunctive radiation therapy for 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

Adjunctive Therapy

Radiotherapy alone may be used for patients ineligible for combined modality treatment; it may offer better tolerability, but poorer survival.

Postoperative radiotherapy may be recommended for patients with complete resection of N2 disease to improve local control, but should be delivered sequentially after adjuvant chemotherapy.

For patients receiving postoperative radiotherapy for R0 disease, conventionally fractionated doses in the range of 50 Gy to 54 Gy (in 1.8-2.0 Gy/day) should be used.

Postoperative radiotherapy with conventionally fractionated doses in the range of 54 Gy to 60 Gy (in 1.8-2.0 Gy/day) to improve local control for patients with R1 disease (incomplete resection), to be given either concurrently or sequentially with chemotherapy. 

 Patients with R2 disease may be candidates for postoperative radiotherapy with conventionally fractionated doses of at least 60 Gy (in 1.8-2.0 Gy/day fraction size) to improve local control, to be given either concurrently or sequentially with chemotherapy.


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