ACR appropriateness criteria® postoperative adjuvant therapy in non-small cell lung cancer

Roy H. Decker, Corey J. Langer, Kenneth E. Rosenzweig, Joe Yujiao Chang, Richard M. Gewanter, Mark E. Ginsburg, Feng Ming Kong, Brian E. Lally, Gregory M. Videtic, Benjamin Movsas

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

Therapeutic options for postoperative adjuvant treatment for patients with non-small cell lung cancer (NSCLC) continue to evolve, and may include postoperative radiotherapy (PORT) and chemotherapy, alone or in combination. The use of platinum-based adjuvant chemotherapy has been demonstrated to confer an improvement in overall survival in patients with completely resected, stage N1 or N2 NSCLC, in several randomized trials and 2 meta-analyses. Consideration may also be given to adjuvant chemotherapy in patients with node-negative NSCLC, when the primary tumor is >4 cm, based on subset analyses of recent prospective studies. The precise role of PORT is less well defined. Older randomized studies indicated that the toxicity of PORT outweighed the potential improvement in local control, but studies using more modern radiation techniques show significantly reduced toxicity, inferring that select patients may benefit. Relative indications for PORT include the presence of mediastinal lymph nodes, positive surgical margins, and considerations with regard to the extent and type of resection. This study by the lung cancer expert panel of the American College of Radiology summarizes the recent evidence-based literature that addresses the use of postoperative adjuvant radiotherapy and chemotherapy in patients with NSCLC, illustrated with clinical scenarios. The sequencing of radiotherapy and chemotherapy is discussed, along with issues regarding radiotherapy dose and fractionation, and the appropriate use of intensity modulated radiation therapy and particle therapy.

Original languageEnglish (US)
Pages (from-to)537-544
Number of pages8
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume34
Issue number5
DOIs
StatePublished - Oct 1 2011

Fingerprint

Non-Small Cell Lung Carcinoma
Radiotherapy
Adjuvant Chemotherapy
Therapeutics
Dose Fractionation
Drug Therapy
Adjuvant Radiotherapy
Platinum
Radiology
Meta-Analysis
Lung Neoplasms
Lymph Nodes
Prospective Studies
Radiation
Survival
Neoplasms

Keywords

  • Appropriateness Criteria
  • chemotherapy
  • non-small cell lung cancer
  • radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Decker, R. H., Langer, C. J., Rosenzweig, K. E., Chang, J. Y., Gewanter, R. M., Ginsburg, M. E., ... Movsas, B. (2011). ACR appropriateness criteria® postoperative adjuvant therapy in non-small cell lung cancer. American Journal of Clinical Oncology: Cancer Clinical Trials, 34(5), 537-544. https://doi.org/10.1097/COC.0b013e318216e5a2

ACR appropriateness criteria® postoperative adjuvant therapy in non-small cell lung cancer. / Decker, Roy H.; Langer, Corey J.; Rosenzweig, Kenneth E.; Chang, Joe Yujiao; Gewanter, Richard M.; Ginsburg, Mark E.; Kong, Feng Ming; Lally, Brian E.; Videtic, Gregory M.; Movsas, Benjamin.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 34, No. 5, 01.10.2011, p. 537-544.

Research output: Contribution to journalReview article

Decker, RH, Langer, CJ, Rosenzweig, KE, Chang, JY, Gewanter, RM, Ginsburg, ME, Kong, FM, Lally, BE, Videtic, GM & Movsas, B 2011, 'ACR appropriateness criteria® postoperative adjuvant therapy in non-small cell lung cancer', American Journal of Clinical Oncology: Cancer Clinical Trials, vol. 34, no. 5, pp. 537-544. https://doi.org/10.1097/COC.0b013e318216e5a2
Decker, Roy H. ; Langer, Corey J. ; Rosenzweig, Kenneth E. ; Chang, Joe Yujiao ; Gewanter, Richard M. ; Ginsburg, Mark E. ; Kong, Feng Ming ; Lally, Brian E. ; Videtic, Gregory M. ; Movsas, Benjamin. / ACR appropriateness criteria® postoperative adjuvant therapy in non-small cell lung cancer. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 2011 ; Vol. 34, No. 5. pp. 537-544.
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