Role of particle beam therapy in a trimodality approach to locally advanced non‐small cell lung cancer

Thoracic Cancer

Aparna H. Kesarwala¹  Surbhi Grover² 

[1] Radiation Oncology Branch, National Institutes of Health, National Cancer Institute, Bethesda, MD, USA;Department of Radiation Oncology, Perelman Center for Advanced Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

关键词: NSCLC;    particle beam radiotherapy;    trimodality therapy;   

DOI  :  10.1111/j.1759-7714.2012.00174.x

来源: Wiley

【 摘 要 】

Abstract

Lung cancer accounts for nearly one-fifth of all cancer deaths worldwide and is the most common cause of cancer-related death in the United States. Outcomes for locally advanced non-small cell lung cancer remain extremely poor with regards to both local control and overall survival. Modest gains in local control were obtained with the incorporation of multimodality treatment, including preoperative chemotherapy followed by surgical resection; combination chemoradiotherapy also improved survival, secondary to improved local control. While the natural progression to trimodality therapy resulted in superior local control, it did not translate to improved overall survival, secondary to increased toxicity. The additional morbidity is likely from radiation toxicity, the minimization of which will be crucial to the future success of trimodality therapy. One strategy to decrease toxicity is to utilize charged particles, such as protons, which deposit a high dose at the Bragg peak with a minimal dose beyond the peak, thereby reducing the dose to distal normal tissues. Trimodality therapy incorporating preoperative proton radiation therapy and chemotherapy, followed by surgery, is currently being evaluated as a potential strategy to achieve improved local control and overall survival in locally advanced non-small cell lung cancer.

【 授权许可】

Unknown   
© 2012 Tianjin Lung Cancer Institute and Wiley Publishing Asia Pty Ltd