title: Definitive and Adjuvant Radiotherapy in Locally Advanced Non-Small-Cell Lung Cancer: American Society of Clinical Oncology Clinical Practice Guideline Endorsement of the American Society for Radiation Oncology Evidence-Based Clinical Practice Guideline.
abstract: OBJECTIVE
  The American Society for Radiation Oncology (ASTRO) produced an evidence-based guideline on external-beam radiotherapy for patients with locally advanced non-small-cell lung cancer (NSCLC). Because of its relevance to the American Society of Clinical Oncology (ASCO) membership, ASCO endorsed the guideline after applying a set of procedures and a policy that are used to critically examine and endorse guidelines developed by other guideline development organizations.
  
  
  METHODS
  The ASTRO guideline was reviewed by ASCO content experts for clinical accuracy and by ASCO methodologists for developmental rigor. On favorable review, an ASCO expert panel was convened and endorsed the guideline. The ASCO guideline approval body, the Clinical Practice Guideline Committee, approved the final endorsement.
  
  
  RESULTS
  The recommendations from the ASTRO guideline, published in Practical Radiation Oncology, are clear, thorough, and based on the most relevant scientific evidence. The ASCO Endorsement Panel endorsed the guideline and added qualifying statements.
  
  
  CONCLUSIONS
  For curative-intent treatment of locally advanced NSCLC, concurrent chemoradiotherapy improves local control and overall survival compared with sequential chemotherapy followed by radiation. The standard dose-fractionation of radiation is 60 Gy given in 2-Gy once-daily fractions over 6 weeks. There is no role for the routine use of induction therapy before chemoradiotherapy. Current data fail to support a clear role for consolidation therapy after chemoradiotherapy; however, consolidation therapy remains an option for patients who did not receive full systemic chemotherapy doses during radiotherapy. Important questions remain about the ideal concurrent chemotherapy regimen and optimal management of patients with resectable stage III disease.
authors.affiliation: Andrea Bezjak, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Sarah Temin, American Society of Clinical Oncology, Alexandria, VA; Gregg Franklin, New Mexico Cancer Center, Albuquerque, NM; Giuseppe Giaccone, Lombardi Cancer Center, Washington, DC; Ramaswamy Govindan, Washington University, St Louis, MO; Melissa L. Johnson, Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Andreas Rimner, Memorial Sloan Kettering Cancer Center; Bryan J. Schneider, Weill Cornell Medical College, New York, NY; John Strawn, Patient Representative, Houston, TX; and Christopher G. Azzoli, Massachusetts General, Boston, MA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bezjak
authors.affiliation: Andrea Bezjak, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Sarah Temin, American Society of Clinical Oncology, Alexandria, VA; Gregg Franklin, New Mexico Cancer Center, Albuquerque, NM; Giuseppe Giaccone, Lombardi Cancer Center, Washington, DC; Ramaswamy Govindan, Washington University, St Louis, MO; Melissa L. Johnson, Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Andreas Rimner, Memorial Sloan Kettering Cancer Center; Bryan J. Schneider, Weill Cornell Medical College, New York, NY; John Strawn, Patient Representative, Houston, TX; and Christopher G. Azzoli, Massachusetts General, Boston, MA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Temin
authors.affiliation: Andrea Bezjak, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Sarah Temin, American Society of Clinical Oncology, Alexandria, VA; Gregg Franklin, New Mexico Cancer Center, Albuquerque, NM; Giuseppe Giaccone, Lombardi Cancer Center, Washington, DC; Ramaswamy Govindan, Washington University, St Louis, MO; Melissa L. Johnson, Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Andreas Rimner, Memorial Sloan Kettering Cancer Center; Bryan J. Schneider, Weill Cornell Medical College, New York, NY; John Strawn, Patient Representative, Houston, TX; and Christopher G. Azzoli, Massachusetts General, Boston, MA.
authors.forename: Gregg
authors.initials: G
authors.lastname: Franklin
authors.affiliation: Andrea Bezjak, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Sarah Temin, American Society of Clinical Oncology, Alexandria, VA; Gregg Franklin, New Mexico Cancer Center, Albuquerque, NM; Giuseppe Giaccone, Lombardi Cancer Center, Washington, DC; Ramaswamy Govindan, Washington University, St Louis, MO; Melissa L. Johnson, Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Andreas Rimner, Memorial Sloan Kettering Cancer Center; Bryan J. Schneider, Weill Cornell Medical College, New York, NY; John Strawn, Patient Representative, Houston, TX; and Christopher G. Azzoli, Massachusetts General, Boston, MA.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Giaccone
authors.affiliation: Andrea Bezjak, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Sarah Temin, American Society of Clinical Oncology, Alexandria, VA; Gregg Franklin, New Mexico Cancer Center, Albuquerque, NM; Giuseppe Giaccone, Lombardi Cancer Center, Washington, DC; Ramaswamy Govindan, Washington University, St Louis, MO; Melissa L. Johnson, Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Andreas Rimner, Memorial Sloan Kettering Cancer Center; Bryan J. Schneider, Weill Cornell Medical College, New York, NY; John Strawn, Patient Representative, Houston, TX; and Christopher G. Azzoli, Massachusetts General, Boston, MA.
authors.forename: Ramaswamy
authors.initials: R
authors.lastname: Govindan
authors.affiliation: Andrea Bezjak, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Sarah Temin, American Society of Clinical Oncology, Alexandria, VA; Gregg Franklin, New Mexico Cancer Center, Albuquerque, NM; Giuseppe Giaccone, Lombardi Cancer Center, Washington, DC; Ramaswamy Govindan, Washington University, St Louis, MO; Melissa L. Johnson, Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Andreas Rimner, Memorial Sloan Kettering Cancer Center; Bryan J. Schneider, Weill Cornell Medical College, New York, NY; John Strawn, Patient Representative, Houston, TX; and Christopher G. Azzoli, Massachusetts General, Boston, MA.
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Johnson
authors.affiliation: Andrea Bezjak, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Sarah Temin, American Society of Clinical Oncology, Alexandria, VA; Gregg Franklin, New Mexico Cancer Center, Albuquerque, NM; Giuseppe Giaccone, Lombardi Cancer Center, Washington, DC; Ramaswamy Govindan, Washington University, St Louis, MO; Melissa L. Johnson, Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Andreas Rimner, Memorial Sloan Kettering Cancer Center; Bryan J. Schneider, Weill Cornell Medical College, New York, NY; John Strawn, Patient Representative, Houston, TX; and Christopher G. Azzoli, Massachusetts General, Boston, MA.
authors.forename: Andreas
authors.initials: A
authors.lastname: Rimner
authors.affiliation: Andrea Bezjak, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Sarah Temin, American Society of Clinical Oncology, Alexandria, VA; Gregg Franklin, New Mexico Cancer Center, Albuquerque, NM; Giuseppe Giaccone, Lombardi Cancer Center, Washington, DC; Ramaswamy Govindan, Washington University, St Louis, MO; Melissa L. Johnson, Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Andreas Rimner, Memorial Sloan Kettering Cancer Center; Bryan J. Schneider, Weill Cornell Medical College, New York, NY; John Strawn, Patient Representative, Houston, TX; and Christopher G. Azzoli, Massachusetts General, Boston, MA.
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Schneider
authors.affiliation: Andrea Bezjak, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Sarah Temin, American Society of Clinical Oncology, Alexandria, VA; Gregg Franklin, New Mexico Cancer Center, Albuquerque, NM; Giuseppe Giaccone, Lombardi Cancer Center, Washington, DC; Ramaswamy Govindan, Washington University, St Louis, MO; Melissa L. Johnson, Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Andreas Rimner, Memorial Sloan Kettering Cancer Center; Bryan J. Schneider, Weill Cornell Medical College, New York, NY; John Strawn, Patient Representative, Houston, TX; and Christopher G. Azzoli, Massachusetts General, Boston, MA.
authors.forename: John
authors.initials: J
authors.lastname: Strawn
authors.affiliation: Andrea Bezjak, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Sarah Temin, American Society of Clinical Oncology, Alexandria, VA; Gregg Franklin, New Mexico Cancer Center, Albuquerque, NM; Giuseppe Giaccone, Lombardi Cancer Center, Washington, DC; Ramaswamy Govindan, Washington University, St Louis, MO; Melissa L. Johnson, Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Andreas Rimner, Memorial Sloan Kettering Cancer Center; Bryan J. Schneider, Weill Cornell Medical College, New York, NY; John Strawn, Patient Representative, Houston, TX; and Christopher G. Azzoli, Massachusetts General, Boston, MA.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Azzoli
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy*; D008297:Male; D008495:Medical Oncology / Q000592:standards; D017410:Practice Guidelines as Topic; D018787:Radiation Oncology / Q000592:standards; D011878:Radiotherapy / Q000592:standards*; D018714:Radiotherapy, Adjuvant / Q000592:standards*; D012955:Societies, Medical; D014481:United States