ASTRO Radiation Therapy Summary of the ASCO Guideline on Management of Stage III Non-Small Cell Lung Cancer.

Autor:	Simone CB 2nd; Department of Radiation Oncology, New York Proton Center, New York, New York., Bradley J; Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia., Chen AB; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas., Daly ME; Department of Radiation Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, California., Louie AV; Department of Radiation Oncology, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada., Robinson CG; Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri., Videtic GMM; Department of Radiation Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio., Rodrigues G; Department of Radiation Oncology, London Health Sciences Cancer, London, Ontario, Canada. Electronic address: George.Rodrigues@lhsc.on.ca.
Jazyk:	angličtina
Zdroj:	Practical radiation oncology [Pract Radiat Oncol] 2023 May-Jun; Vol. 13 (3), pp. 195-202.
DOI:	10.1016/j.prro.2023.01.005
Abstrakt:	Purpose: To develop a radiation therapy summary of recommendations on the management of locally advanced non-small cell lung cancer (NSCLC) based on the Management of Stage III Non-Small Cell Lung Cancer: American Society of Clinical Oncology Guideline, which was endorsed by the American Society for Radiation Oncology (ASTRO). Methods: The American Society of Clinical Oncology, ASTRO, and the American College of Chest Physicians convened a multidisciplinary panel to develop a guideline based on a systematic review of the literature and a formal consensus process, that has been separately published. A new panel consisting of radiation oncologists from the original guideline as well as additional ASTRO members was formed to provide further guidance to the radiation oncology community. A total of 127 articles met the eligibility criteria to answer 5 clinical questions. This summary focuses on the 3 radiation therapy questions (neoadjuvant, adjuvant, and unresectable settings). Results: Radiation-specific recommendations are summarized with additional relevant commentary on specific questions regarding the management of preoperative radiation, postoperative radiation, and combined chemoradiation. Conclusions: Patients with stage III NSCLC who are planned for surgical resection, should receive either neoadjuvant chemotherapy or chemoradiation. The addition of neoadjuvant treatment is particularly important in patients planned for surgery in the N2 or superior sulcus settings. Postoperatively, patients who did not receive neoadjuvant chemotherapy should be offered adjuvant chemotherapy. The use of postoperative radiation for completely resected N2 disease is not routinely recommended. Unresectable patients with stage III NSCLC should ideally be managed with combined concurrent chemoradiation using a platinum-based doublet with a standard radiation dose of 60 Gy followed by consolidation durvalumab in patients without progression after initial therapy. Patients who cannot tolerate a concurrent chemoradiation approach can be managed either by sequential chemotherapy followed by radiation or by dose-escalated or hypofractionated radiation alone. (Copyright © 2023 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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