Radiation and Combined Therapies for Lung Cancer
|Editors:||Shenglin Ma, George Rodrigues, James W. Welsh|
Publisher: AME Publishing Company; 1st edition (2018)
Hardcover: 249 pages
With regard to systemic treatment in NSCLC, significant progress has been made in recent years, including angiogenesis inhibitors, molecular targeting therapies specific for oncogenic drivers and immunotherapies. The applications of these treatments were increased in clinic practice, which produced relatively high response rate and long duration with acceptable toxicity profile. Furthermore, the life expectancy in these patients was significantly prolonged than those in the past with treatment of chemotherapy alone. In this context, radiotherapy, as a local treatment modality, has more space for development and imagination in the area of combination therapies. For example, in local advanced NSCLC with EGFR mutation, the combination of thoracic radiotherapy and oral small-molecule tyrosine kinase inhibitors produced a progression free survival of 27.9 months (RECEL study). Maintain treatment with the PD-L1 inhibitor (durvalumab) in patients with locally advanced NSCLC who have not progressed following concurrent chemoradiotherapy, showed encouraging results; the median progression free survival from randomization was 16.8 months in the randomized phase III trial (PACIFIC). Of interest, in a post hoc analysis of KEYNOTE-001 phase 1 trial, patients with a history of previous radiotherapy showed better clinical activity and got more survival benefits from the treatment of pembrolizumab, albeit most patients in this study (64%) received radiotherapy with a palliative intent. All of those indicated that combination of modern radiotherapy with novel systemic treatment deserves intensive investigation, and further work will be necessary to determine the optimal dose/fractionation, timing of radiation in order to harmonize the synergy effects. In this book, many challenging clinical scenarios in lung cancer radiotherapy will be discussed, and recommendations based on available data or directions deserved further research will be given, including SBRT in early stage NSCLC, radiotherapy in local advanced NSCLC, cranial irradiation in specific lung cancer, and the combination of radiotherapy with chemotherapy, immunotherapy, targeted therapy and surgery.
|René-Olivier Mirimanoff||Professor Emeritus in Radiation Oncology, Faculty of Biology and Medicine, University of Lausanne, Switzerland|
|Abraham J. Wu||Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA|
|Shenglin Ma||Nanjing Medical University, Af liated Hangzhou First People’s Hospital, Hangzhou, Zhejiang, China|
|George Rodrigues||London Health Sciences Centre and Western University, London, Ontario, Canada|
|James W. Welsh||Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA|
|Bing Xia||Nanjing Medical University, Af liated Hangzhou First People’s Hospital, Hangzhou, Zhejiang, China|
|Ugur Selek||Department of Radiation Oncology, Ko University, School of Medicine, Istanbul, Turkey; Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA|
Table of Contents
Radiotherapy for Lung Cancer
1 Radiation therapy for locally advanced lung cancer
17 Stereotactic body radiation therapy in lung
31 Brachytherapy in lung cancer: a review
47 Advances in radiotherapy techniques and delivery for non-small cell lung cancer: bene ts of intensity- modulated radiation therapy, proton therapy, and stereotactic body radiation therapy
64 Stereotactic ablative radiotherapy for early stage non-small cell lung cancer: a word of caution
68 Cranial irradiation in patients with EGFR-mutant non-small cell lung cancer brain metastases
72 Advances in palliative radiotherapy of metastatic non-small cell lung cancer
78 Can proton beam therapy be clinically relevant for the management of lung cancer?
Chemoradiotherapy for Lung Cancer
91 Chemoradiotherapy for stage III non-small cell lung cancer: have we reached the limit?
101 Overcoming toxicity-challenges in chemoradiation for non-small cell lung cancer
Radiotherapy and Immunotherapy for Lung Cancer
106 Novel radiotherapy approaches for lung cancer: combining radiation therapy with targeted and immunotherapies
114 Integrating immunotherapy into chemoradiation regimens for medically inoperable locally advanced non- small cell lung cancer
120 Uncovering the immune tumor microenvironment in non-small cell lung cancer to understand response rates to checkpoint blockade and radiation
131 Clinical experiences of combining immunotherapy and radiation therapy in non-small cell lung cancer: lessons from melanoma
140 Immunotherapy and radiation therapy for operable early stage and locally advanced non-small cell lung cancer
148 Mini-review of conventional and hypofractionated radiation therapy combined with immunotherapy for non-small cell lung cancer
Radiotherapy and Targeted Therapy for Lung Cancer
158 Non-small cell lung cancer (NSCLC) and central nervous system (CNS) metastases: role of tyrosine kinase inhibitors (TKIs) and evidence in favor or against their use with concurrent cranial radiotherapy
169 Management of non-small cell lung cancer with EGFR mutation: the role of radiotherapy in the era of tyrosine kinase inhibitor therapy—opportunities and challenges
Radiotherapy and Surgical Treatment of Lung Cancer
178 Is post-operative radiotherapy of any bene t after R0 resection for N2 disease?
180 Response to “Is post-operative radiotherapy of any bene t after R0 resection for N2 disease?”
181 Salvage surgery after high-dose radiotherapy
189 Surgery versus stereotactic ablative radiotherapy (SABR) for early-stage non-small cell lung cancer: less is not more
196 Stereotactic ablative body radiotherapy (SABR): an alternative to surgery in stage I-II non-small-cell cancer of the lung?
206 Stereotactic ablative body radiation therapy or surgery for operable early non-small cell lung cancer patients: bound hand and foot to evidence
Sequence of Radiotherapy and Chemotherapy After Lung Cancer Operation
209 Optimal sequencing of adjuvant chemotherapy and radiation therapy in resected non-small cell lung cancer with pathological N2 disease
212 Optimal sequencing of postoperative radiotherapy and chemotherapy in IIIA-N2 non-small cell lung cancer
216 Neoadjuvant chemoradiotherapy followed by surgery for stage IIIa and IIIb non-small-cell lung cancer (NSCLC): is it still justified?