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Non-small Cell Lung Cancer

  • Michael Wahl
  • Matthew A. Gubens
  • Sue S. Yom
Chapter

Abstract

This chapter will discuss diagnosis, workup, management, and radiation therapy techniques for patients with non-small cell lung cancer.

Keywords

Non-small cell lung cancer Radiotherapy Stereotactic body radiotherapy 

Notes

Acknowledgment

We thank Siavash Jabbari MD, Eric K. Hansen MD, and Daphne A. Haas-Kogan MD for their work on the prior edition of this chapter.

References

  1. Albain KS, Swann RS, Rusch VW, Turrisi AT, Shepherd FA, Smith C, et al. Radiotherapy plus chemotherapy with or without surgical resection for stage III non-small-cell lung cancer: a phase III randomised controlled trial. Lancet. 2009;374(9687):379–86.CrossRefGoogle Scholar
  2. Andre F, Grunenwald D, Pignon JP, Dujon A, Pujol JL, Brichon PY, et al. Survival of patients with resected N2 non-small-cell lung cancer: evidence for a subclassification and implications. J Clin Oncol. 2000;18(16):2981–9.CrossRefGoogle Scholar
  3. Aupérin A, Le Péchoux C, Rolland E, Curran WJ, Furuse K, Fournel P, et al. Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer. J Clin Oncol. 2010;28(13):2181–90.CrossRefGoogle Scholar
  4. Benedict SH, Yenice KM, Followill D, Galvin JM, Hinson W, Kavanagh B, et al. Stereotactic body radiation therapy: the report of AAPM task group 101. Med Phys. 2010;37(8):4078–101.CrossRefGoogle Scholar
  5. Bezjak A, Paulus R, Gaspar LE, Timmerman RD, Straube WL, Ryan WF, et al. Primary study endpoint analysis for NRG Oncology/RTOG 0813 trial of stereotactic body radiation therapy (SBRT) for centrally located non-small cell lung cancer (NSCLC). Int J Radiat Oncol Biol Phys. 2016;94(1):5–6.CrossRefGoogle Scholar
  6. Bradley JD, Paulus R, Komaki R, Masters G, Blumenschein G, Schild S, et al. Standard-dose versus high-dose conformal radiotherapy with concurrent and consolidation carboplatin plus paclitaxel with or without cetuximab for patients with stage IIIA or IIIB non-small-cell lung cancer (RTOG 0617): a randomised, two-by-two factorial phase 3 study. Lancet Oncol. 2015;16(2):187–99.CrossRefGoogle Scholar
  7. Chang JY, Senan S, Paul MA, Mehran RJ, Louie AV, Balter P, et al. Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomised trials. Lancet Oncol. 2015;16:630–7.CrossRefGoogle Scholar
  8. Chun SG, Hu C, Choy H, et al. Impact of Intensity-Modulated Radiation Therapy Technique for Locally Advanced Non-Small-Cell Lung Cancer: A Secondary Analysis of the NRG Oncology RTOG 0617 Randomized Clinical Trial. Journal of Clinical Oncology. 2017;35(1):56–62.CrossRefGoogle Scholar
  9. Curran WJ, Paulus R, Langer CJ, Komaki R, Lee JS, Hauser S, et al. Sequential vs concurrent chemoradiation for stage III non-small cell lung cancer: randomized phase III trial RTOG 9410. J Natl Cancer Inst. 2011;103(19):1452–7.CrossRefGoogle Scholar
  10. Dillman RO, Seagren SL, Propert KJ, Guerra J, Eaton WL, Perry MC, et al. A randomized trial of induction chemotherapy plus high-dose radiation versus radiation alone in stage III non-small-cell lung cancer. N Engl J Med. 1990;323(14):940–5.CrossRefGoogle Scholar
  11. Douillard J-Y, Rosell R, De Lena M, Riggi M, Hurteloup P, Mahe M-A, Adjuvant Navelbine International Trialist Association. Impact of postoperative radiation therapy on survival in patients with complete resection and stage I, II, or IIIA non-small-cell lung cancer treated with adjuvant chemotherapy: the adjuvant Navelbine International Trialist Association (ANITA) randomized trial. Int J Radiat Oncol Biol Phys. 2008;72(3):695–701.CrossRefGoogle Scholar
  12. Eaton BR, Pugh SL, Bradley JD, et al. Institutional Enrollment and Survival Among NSCLC Patients Receiving Chemoradiation: NRG Oncology Radiation Therapy Oncology Group (RTOG) 0617. J Natl Cancer Inst. 2016;108(9).Google Scholar
  13. Eberhardt WEE, Pöttgen C, Gauler TC, Friedel G, Veit S, Heinrich V, et al. Phase III study of surgery versus definitive concurrent chemoradiotherapy boost in patients with resectable stage IIIA(N2) and selected IIIB non-small-cell lung cancer after induction chemotherapy and concurrent chemoradiotherapy (ESPATUE). J Clin Oncol. 2015;33(35):4194–201.CrossRefGoogle Scholar
  14. Fakiris AJ, McGarry RC, Yiannoutsos CT, Papiez L, Williams M, Henderson MA, Timmerman R. Stereotactic body radiation therapy for early-stage non-small-cell lung carcinoma: four-year results of a prospective phase II study. Int J Radiat Oncol Biol Phys. 2009;75(3):677–82.CrossRefGoogle Scholar
  15. Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Ann Thorac Surg. 1995;60(3):615–23.CrossRefGoogle Scholar
  16. Giraud P, Antoine M, Larrouy A, Milleron B, Callard P, De Rycke Y, et al. Evaluation of microscopic tumor extension in non-small-cell lung cancer for three-dimensional conformal radiotherapy planning. Int J Radiat Oncol Biol Phys. 2000;48(4):1015–24.CrossRefGoogle Scholar
  17. Gore EM, Bae K, Wong SJ, Sun A, Bonner JA, Schild SE, et al. Phase III comparison of prophylactic cranial irradiation versus observation in patients with locally advanced non-small-cell lung cancer: primary analysis of radiation therapy oncology group study RTOG 0214. J Clin Oncol. 2011;29(3):272–8.CrossRefGoogle Scholar
  18. Gould MK, Kuschner WG, Rydzak CE, Maclean CC, Demas AN, Shigemitsu H, et al. Test performance of positron emission tomography and computed tomography for mediastinal staging in patients with non-small-cell lung cancer: a meta-analysis. Ann Intern Med. 2003;139(11):879–92.CrossRefGoogle Scholar
  19. Grant JD, Jensen GL, Tang C, et al. Radiotherapy-Induced Malfunction in Contemporary Cardiovascular Implantable Electronic Devices: Clinical Incidence and Predictors. JAMA Oncol. 2015;1(5):624–32.CrossRefGoogle Scholar
  20. Hurkmans CW, Knegjens JL, Oei BS, Maas AJJ, Uiterwaal GJ, van der Borden AJ, et al. Management of radiation oncology patients with a pacemaker or ICD: a new comprehensive practical guideline in The Netherlands. Dutch Society of Radiotherapy and Oncology (NVRO). Radiat Oncol. 2012;7:198.CrossRefGoogle Scholar
  21. Lally BE. Postoperative radiotherapy for stage II or III non-small-cell lung cancer using the surveillance, epidemiology, and end results database. J Clin Oncol. 2006;24(19):2998–3006.CrossRefGoogle Scholar
  22. Lynch R, Pitson G, Ball D, Claude L, Sarrut D. Computed tomographic atlas for the new international lymph node map for lung cancer: a radiation oncologist perspective. Pract Radiat Oncol. 2013;3(1):54–66.CrossRefGoogle Scholar
  23. National Lung Screening Trial Research Team, Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395–409.CrossRefGoogle Scholar
  24. Onishi H, Araki T, Shirato H, Nagata Y, Hiraoka M, Gomi K, et al. Stereotactic hypofractionated high-dose irradiation for stage I nonsmall cell lung carcinoma: clinical outcomes in 245 subjects in a Japanese multiinstitutional study. Cancer. 2004;101(7):1623–31.CrossRefGoogle Scholar
  25. Patel SH, Ma Y, Wernicke AG, Nori D, Chao KSC, Parashar B. Evidence supporting contemporary post-operative radiation therapy (PORT) using linear accelerators in N2 lung cancer. Lung Cancer. 2014;84(2):156–60.CrossRefGoogle Scholar
  26. Pignon J-P, Tribodet H, Scagliotti GV, Douillard J-Y, Shepherd FA, Stephens RJ, et al. Lung adjuvant cisplatin evaluation: a pooled analysis by the LACE collaborative group. J Clin Oncol. 2008;26(21):3552–9.CrossRefGoogle Scholar
  27. PORT Meta-analysis Trialists Group. Postoperative radiotherapy in non-small-cell lung cancer: systematic review and meta-analysis of individual patient data from nine randomised controlled trials. PORT Meta-analysis Trialists Group. Lancet. 1998;352(9124):257–63.CrossRefGoogle Scholar
  28. PORT Meta-analysis Trialists Group. Postoperative radiotherapy for non-small cell lung cancer. Cochrane Database Syst Rev. 2005;2:CD002142.Google Scholar
  29. Robinson CG, Patel AP, Bradley JD, DeWees T, Waqar SN, Morgensztern D, et al. Postoperative radiotherapy for pathologic N2 non-small-cell lung cancer treated with adjuvant chemotherapy: a review of the National Cancer Data Base. J Clin Oncol. 2015;33(8):870–6.CrossRefGoogle Scholar
  30. Rodrigues G, Videtic GMM, Sur R, Bezjak A, Bradley J, Hahn CA, et al. Palliative thoracic radiotherapy in lung cancer: an American Society for Radiation Oncology evidence-based clinical practice guideline. Pract Radiat Oncol. 2011;1(2):60–71.CrossRefGoogle Scholar
  31. Rodrigues G, Choy H, Bradley J, Rosenzweig KE, Bogart J, Curran WJ Jr, et al. Definitive radiation therapy in locally advanced non-small cell lung cancer: executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based clinical practice guideline. Pract Radiat Oncol. 2015;5(3):141–8.CrossRefGoogle Scholar
  32. Rosenzweig KE, Sura S, Jackson A, Yorke E. Involved-field radiation therapy for inoperable non small-cell lung cancer. J Clin Oncol. 2007;25(35):5557–61.CrossRefGoogle Scholar
  33. Rusch VW, Giroux DJ, Kraut MJ, Crowley J, Hazuka M, Johnson D, et al. Induction chemoradiation and surgical resection for non-small cell lung carcinomas of the superior sulcus: initial results of Southwest Oncology Group Trial 9416 (Intergroup Trial 0160). J Thorac Cardiovasc Surg. 2001;121(3):472–83.CrossRefGoogle Scholar
  34. Rusch VW, Asamura H, Watanabe H, Giroux DJ, Rami-Porta R, Goldstraw P, Members of IASLC Staging Committee. The IASLC lung cancer staging project: a proposal for a new international lymph node map in the forthcoming seventh edition of the TNM classification for lung cancer. J Thorac Oncol. 2009;4(5):568–77.CrossRefGoogle Scholar
  35. Sause W, Kolesar P, Taylor SIV, Johnson D, Livingston R, Komaki R, et al. Final results of phase III trial in regionally advanced unresectable non-small cell lung cancer: radiation therapy oncology group, eastern cooperative oncology group, and southwest oncology group. Chest. 2000;117(2):358–64.CrossRefGoogle Scholar
  36. Schmidt-Hansen M, Baldwin DR, Hasler E, Zamora J, Abraira V, Roqué I, Figuls M. PET-CT for assessing mediastinal lymph node involvement in patients with suspected resectable non-small cell lung cancer. Cochrane Database Syst Rev. 2014;11:CD009519.Google Scholar
  37. Senthi S, Lagerwaard FJ, Haasbeek CJA, Slotman BJ, Senan S. Patterns of disease recurrence after stereotactic ablative radiotherapy for early stage non-small-cell lung cancer: a retrospective analysis. Lancet Oncol. 2012;13(8):802–9.CrossRefGoogle Scholar
  38. Song W-A, Zhou N-K, Wang W, Chu X-Y, Liang C-Y, Tian X-D, et al. Survival benefit of neoadjuvant chemotherapy in non-small cell lung cancer: an updated meta-analysis of 13 randomized control trials. J Thorac Oncol. 2010;5(4):510–6.CrossRefGoogle Scholar
  39. Thomas M, Rübe C, Hoffknecht P, Macha HN, Freitag L, Linder A, et al. Effect of preoperative chemoradiation in addition to preoperative chemotherapy: a randomised trial in stage III non-small-cell lung cancer. Lancet Oncol. 2008;9(7):636–48.CrossRefGoogle Scholar
  40. Timmerman R, McGarry R, Yiannoutsos C, Papiez L, Tudor K, DeLuca J, et al. Excessive toxicity when treating central tumors in a phase II study of stereotactic body radiation therapy for medically inoperable early-stage lung cancer. J Clin Oncol. 2006;24(30):4833–9.CrossRefGoogle Scholar
  41. Timmerman R, Paulus R, Galvin J, Michalski J, Straube W, Bradley J, et al. Stereotactic body radiation therapy for inoperable early stage lung cancer. JAMA. 2010;303(11):1070–6.CrossRefGoogle Scholar
  42. Timmerman R, Paulus R, Pass H, Gore E, Edelman M, Galvin J, et al. Stereotactic body radiation therapy (SBRT) to treat operable early-stage lung cancer patients. J Clin Oncol. 2013;31:(suppl; abstr 7523).Google Scholar
  43. van Meerbeeck JP, Kramer GWPM, Van Schil PEY, Legrand C, Smit EF, Schramel F, et al. Randomized controlled trial of resection versus radiotherapy after induction chemotherapy in stage IIIA-N2 non-small-cell lung cancer. J Natl Cancer Inst. 2007;99(6):442–50.CrossRefGoogle Scholar
  44. Verstegen NE, Lagerwaard FJ, Haasbeek CJA, Slotman BJ, Senan S. Outcomes of stereotactic ablative radiotherapy following a clinical diagnosis of stage I NSCLC: comparison with a contemporaneous cohort with pathologically proven disease. Radiother Oncol. 2011;101(2):250–4.CrossRefGoogle Scholar
  45. Videtic GMM, Hu C, Singh AK, Chang JY, Parker W, Olivier KR, et al. A randomized phase 2 study comparing 2 stereotactic body radiation therapy schedules for medically inoperable patients with stage I peripheral non-small cell lung cancer: NRG oncology RTOG 0915 (NCCTG N0927). Int J Radiat Oncol Biol Phys. 2015;93(4):757–64.CrossRefGoogle Scholar
  46. Vokes EE, Herndon JE, Kelley MJ, Cicchetti MG, Ramnath N, Neill H, et al. Induction chemotherapy followed by chemoradiotherapy compared with chemoradiotherapy alone for regionally advanced unresectable stage III non-small-cell lung cancer: cancer and leukemia group B. J Clin Oncol. 2007;25(13):1698–704.CrossRefGoogle Scholar
  47. Wang EH, Corso CD, Rutter CE, Park HS, Chen AB, Kim AW, et al. Postoperative radiation therapy is associated with improved overall survival in incompletely resected stage II and III non-small-cell lung cancer. J Clin Oncol. 2015;33:2727–34.CrossRefGoogle Scholar
  48. Werner-Wasik M, Scott C, Cox JD, Sause WT, Byhardt RW, Asbell S, et al. Recursive partitioning analysis of 1999 radiation therapy oncology group (RTOG) patients with locally-advanced non-small-cell lung cancer (LA-NSCLC): identification of five groups with different survival. Int J Radiat Oncol Biol Phys. 2000;48(5):1475–82.CrossRefGoogle Scholar
  49. Westeel V, Quoix E, Puyraveau M, Lavolé A, Braun D, Laporte S, et al. A randomised trial comparing preoperative to perioperative chemotherapy in early-stage non-small-cell lung cancer (IFCT 0002 trial). Eur J Cancer. 2013;49(12):2654–64.CrossRefGoogle Scholar
  50. Yom SS, Liao Z, Liu HH, Tucker SL, Hu C-S, Wei X, et al. Initial evaluation of treatment-related pneumonitis in advanced-stage non-small-cell lung cancer patients treated with concurrent chemotherapy and intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys. 2007;68(1):94–102.  https://doi.org/10.1016/j.ijrobp.2006.12.031.CrossRefPubMedGoogle Scholar
  51. Yuan S, Sun X, Li M, Yu J, Ren R, Yu Y, et al. A randomized study of involved-field irradiation versus elective nodal irradiation in combination with concurrent chemotherapy for inoperable stage III nonsmall cell lung cancer. Am J Clin Oncol. 2007;30(3):239–44.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Radiation OncologyUniversity of California San FranciscoSan FranciscoUSA
  2. 2.Department of MedicineUniversity of California San FranciscoSan FranciscoUSA

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