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Lung cancer radiation therapy: Defining optimal evidence-based treatment approaches

C. Shah,T. Smile,Naveen Karthik,S. Parsai,K. Stephans,G. Videtic

Published 2016 in Applied radiation oncology

ABSTRACT

As the second most common cancer in the United States with an estimated incidence of more than 220,000 cases per year, lung cancer remains the leading cause of cancer mortality with 158,000 deaths annually.1 However, lung cancer is not a homogeneous disease process, but rather a complex entity that goes far beyond traditional dichotomies of small cell (SCLC) and non-small cell lung cancer (NSCLC). Recent studies have highlighted this fact, demonstrating that even within histologic subsets of NSCLC, different treatment paradigms may be required based on tumor biology and tumor genetics.2,3 Further, treatment techniques for surgery, radiation therapy, and systemic therapy have evolved as well, providing physicians with new modalities and treatment options for patients regardless of stage. As such, clinicians treating lung cancer are tasked with constantly re-evaluating emerging data and techniques to offer their patients evidence-based treatment options. Such innovations and paradigm shifts have been particularly evident in radiation oncology, where significant changes to treatment indications, techniques, and principles have occurred over the past decade. Therefore, the purpose of this review is to provide clinicians with a framework to make decisions regarding radiation therapy in lung cancer based on recent data as well as recent guidelines and treatment pathways.

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