What are ASTRO recommendations for adjunctive radiation therapy for 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
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.


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