title: Definitive radiation therapy in locally advanced non-small cell lung cancer: Executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based clinical practice guideline.
abstract: OBJECTIVE
  To provide guidance to physicians and patients with regard to the use of definitive external beam radiation therapy (RT) in locally advanced non-small cell lung cancer (LA NSCLC) based on available medical evidence complemented by consensus-based expert opinion.
  
  
  METHODS
  A panel authorized by the American Society for Radiation Oncology (ASTRO) Board of Directors and Guidelines Subcommittee conducted 3 systematic reviews on the following topics: (1) ideal radical RT dose fractionation for RT alone; (2) ideal radical RT dose fractionation for chemoradiation; and (3) ideal timing of radical radiation therapy with systemic chemotherapy. Practice guideline recommendations were approved using an a priori-defined consensus-building methodology supported by ASTRO and approved tools for the grading of evidence quality and the strength of guideline recommendations.
  
  
  RESULTS
  For patients managed by RT alone, a minimum dose of 60 Gy of RT is recommended. Dose escalation beyond 60 Gy in the context of combined modality concurrent chemoradiation has not been found to be associated with any clinical benefits. In the context of combined modality therapy, chemotherapy and radiation should ideally be given concurrently to maximize survival, local control, and disease response rate.
  
  
  CONCLUSIONS
  A consensus and evidence-based clinical practice guideline for the definitive radiotherapeutic management of LA NSCLC has been created that addresses 3 important questions.
authors.affiliation: Department of Radiation Oncology, London Health Sciences Centre, London, Ontario, Canada. Electronic address: george.rodrigues@lhsc.on.ca.
authors.forename: George
authors.initials: G
authors.lastname: Rodrigues
authors.affiliation: Department of Radiation Oncology, University of Texas Southwestern, Dallas, Texas.
authors.forename: Hak
authors.initials: H
authors.lastname: Choy
authors.affiliation: Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Bradley
authors.affiliation: Department of Radiation Oncology, The Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Rosenzweig
authors.affiliation: Department of Radiation Oncology, State University of New York Upstate Medical University, Syracuse, New York.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Bogart
authors.affiliation: Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia.
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Curran
authors.affiliation: Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gore
authors.affiliation: Department of Medical Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Corey
authors.initials: C
authors.lastname: Langer
authors.affiliation: Department of Radiation Oncology, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Alexander V
authors.initials: AV
authors.lastname: Louie
authors.affiliation: Department of Radiation Oncology, Blanchard Valley Health System, Findlay, Ohio.
authors.forename: Stephen
authors.initials: S
authors.lastname: Lutz
authors.affiliation: Department of Radiation Oncology, UH Case Medical Center, Cleveland, Ohio.
authors.forename: Mitchell
authors.initials: M
authors.lastname: Machtay
authors.affiliation: Department of Surgery, Washington University School of Medicine, St Louis, Missouri.
authors.forename: Varun
authors.initials: V
authors.lastname: Puri
authors.affiliation: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: Maria
authors.initials: M
authors.lastname: Werner-Wasik
authors.affiliation: Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Gregory M M
authors.initials: GMM
authors.lastname: Videtic
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000532:radiotherapy*; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D032921:Consensus; D019583:Dose Fractionation, Radiation; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D018787:Radiation Oncology / Q000592:standards; D012958:Societies, Scientific; D014481:United States