TY - JOUR
T1 - Definitive radiation therapy in locally advanced non-small cell lung cancer
T2 - Executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based clinical practice guideline
AU - Rodrigues, George
AU - Choy, Hak
AU - Bradley, Jeffrey
AU - Rosenzweig, Kenneth E.
AU - Bogart, Jeffrey
AU - Curran, Walter J.
AU - Gore, Elizabeth
AU - Langer, Corey
AU - Louie, Alexander V.
AU - Lutz, Stephen
AU - Machtay, Mitchell
AU - Puri, Varun
AU - Werner-Wasik, Maria
AU - Videtic, Gregory M.M.
N1 - Funding Information:
Conflicts of interest: Before initiation of this guideline, all members of the Task Force were required to complete disclosure statements. These statements are maintained at the American Society for Radiation Oncology (ASTRO) Headquarters in Fairfax, VA, and pertinent disclosures are published within this report. The ASTRO Conflict of Interest Disclosure Statement seeks to provide a broad disclosure of outside interests. Where a potential conflict is detected, remedial measures to address any potential conflict are taken and will be noted in the disclosure statement. The guideline chairs (G.R. and G.V.) in concert with the ASTRO guidelines subcommittee reviewed these disclosures and determined that they have no substantive impact upon the content of the manuscript. George Rodrigues, MD, PhD, has received research funding from the Ontario Institute of Cancer Research. Jeffrey Bradley, MD, has received research funding from Calypso Medical Inc. Jeffrey Bogart, MD, has received travel expense funding from Alliance Clinical Trials Cooperative Group. Hak Choy, MD, is on the advisory board for EMD Serono and Bayer; in addition, he has received research funding from Celgene and has been a consultant for Eli Lilly. Walter J. Curran Jr, MD, has been a consultant for Bristol Meyers Squibb. Corey Langer, MD, has received honoraria, been a consultant to, or served on the advisory board of Bristol Meyers Squibb, Eli Lilly, Genentech, Synta, and Abbott. Mitchell Machtay, MD, served as a consultant to Bristol Meyers Squibb, Eli Lilly, and Imclone. Maria Werner-Wasik, MD, received travel expense funding from Elekta Oncology.
Publisher Copyright:
© 2015 American Society for Radiation Oncology.
PY - 2015/5
Y1 - 2015/5
N2 - Purpose: 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 and materials: 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.
AB - Purpose: 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 and materials: 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.
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U2 - 10.1016/j.prro.2015.02.012
DO - 10.1016/j.prro.2015.02.012
M3 - Article
C2 - 25957184
AN - SCOPUS:84947343697
VL - 5
SP - 141
EP - 148
JO - Practical Radiation Oncology
JF - Practical Radiation Oncology
SN - 1879-8500
IS - 3
ER -
