The treatment of unresectable, locally advanced non-small-cell lung cancer: a radiation therapy perspective with an emphasis on the trials of the Radiation Therapy Oncology Group.
Radiation therapy used as a single modality in the treatment of locally advanced non-small-cell lung cancer is potentially curative, but long-term survival rates are disappointing due to both locoregional and distant failures. The trials of the Radiation Therapy Oncology Group (RTOG) have been instrumental in defining the optimal management of this disease. The conclusions and questions posed by the RTOG are discussed in this review. The conclusions of this review include the following: chemotherapy combined with radiation therapy improves survival in patients with good performance, with increased toxicity; concurrent chemoradiation is superior to sequential chemoradiation. Questions remain regarding the value of the addition of induction or consolidation chemotherapy to concurrent chemoradiation, the value of three-dimensional conformal radiation therapy, the role of altered fractionation regimens in combination with chemotherapy, the optimal chemotherapeutic regimen, and the role of novel biologic agents.
Hazard
Lisa J
LJ
Radiation Oncology Department, University of Utah Medical Center, Salt Lake City 84132, USA. lisa.hazard@hsc.utah.edu
Sause
William T
WT