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Radiation Time, Dose, and Fractionation in the Treatment of Lung Cancer

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Advances in Radiation Oncology in Lung Cancer

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

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Abstract

Radiation therapy plays a vital role in the definitive management of early stage and locally advanced lung cancer. Local treatment failure is a primary cause of disease progression in lung cancer and improved local control has been associated with improved overall survival in both non-small cell (NSCLC) and small cell lung cancers (SCLC) (Arriagada et al. 1991; Machtay et al. 2012; Pignon et al. 1992). Delivery of radiation to the intrathoracic sites of disease is limited by the sensitivity of the surrounding non-neoplastic tissues, in particular the normal lung, esophagus, and heart. As such, substantial effort has been made to optimize radiation treatments to maximize tumor control while minimizing toxicity. Technological advancements have led to better imaging of tumors and organs at risk at the time of treatment planning and more precise delivery of therapeutic radiation. Other ways to improve the therapeutic ratio for lung radiotherapy include altering variables such as radiation dose, fractionation schedule, and time interval between treatments. This chapter will focus on the seminal trials that have established the standards for these factors in modern lung radiotherapy, specifically in the nonoperative management of early stage NSCLC (defined as stage I-IIB according to the American Joint Committee on Cancer staging system), locally advanced NSCLC (defined as stages IIIA-B according to the American Joint Committee on Cancer staging system), and limited stage SCLC (LS-SCLC, defined as disease limited to the ipsilateral hemithorax and regional lymph nodes).

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Authors and Affiliations

  1. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    David L. Billing & Andreas Rimner

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  1. David L. Billing
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  2. Andreas Rimner
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Correspondence to Andreas Rimner .

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  1. School of Medicine, University of Kragujevac, Kragujevac, Serbia

    Branislav Jeremić

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Billing, D.L., Rimner, A. (2021). Radiation Time, Dose, and Fractionation in the Treatment of Lung Cancer. In: Jeremić, B. (eds) Advances in Radiation Oncology in Lung Cancer. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2021_272

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