Carcinoma Lung

  • Sandeep Muzumder
  • M. G. John Sebastian


Lung cancer is among the most common cancers and is the leading cause of cancer related deaths. Lung cancer includes two different histological subtypes, non-small cell lung cancer and small cell lung cancer, which behaves differently and is managed differently. The chapter aims in understanding how to clinically evaluate and work up a patient with carcinoma lung. The practical radiation planning aspects and dose fractionations are also discussed. Two clinical scenarios: one patient with non-small cell lung cancer and another with small cell lung cancer are also discussed.


Non-small cell lung cancer Small cell lung cancer Radiotherapy Stereotactic radiotherapy 


  1. 1.
    Rengan R, Chetty IJ, Decker R, Langer CJ, O’Meara WP, Perez MB. Brady’s principles and practice of radiation oncology. In: Halperin EC, Wazer DE, Perez CA, Brady LW, editors. Lung cancer. 6th ed. Philadelphia: Wolters Kluwer/LWW; 2013. p. 938–73.Google Scholar
  2. 2.
    Beyzadeoglu M, Ozyigit G, Ebruli C. Basic radiation oncology. New York: Springer; 2010. p. 303–28.CrossRefGoogle Scholar
  3. 3.
    Porta RR, Asamura H, Travis WD, Rusch VW. AJCC cancer staging manual. 8th ed. Berlin: Springer/Lung; 2017. p. 431–56.CrossRefGoogle Scholar
  4. 4.
    Saunders M, Dische S, Barrett A, Harvey A, Griffiths G, Palmar M. Continuous, hyperfractionated, accelerated radiotherapy (CHART) versus conventional radiotherapy in non-small cell lung cancer: mature data from the randomised multicentre trial. CHART Steering committee. Radiother Oncol. 1999;52(2):137–48.CrossRefGoogle Scholar
  5. 5.
    Baumann M, Herrmann T, Koch R, et al. Final results of the randomized phase III CHARTWEL-trial (ARO 97-1) comparing hyperfractionated-accelerated versus conventionally fractionated radiotherapy in non-small cell lung cancer (NSCLC). Radiother Oncol. 2011;100:76–85. Scholar
  6. 6.
    Curran WJ, Paulus R, Langer CJ, 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;103:1452–60.CrossRefGoogle Scholar
  7. 7.
    Rodrigues G, Choy H, Bradley J, 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;5:141–8. Scholar
  8. 8.
    Miller AB, Fox W, Tell R. Five-year follow-up of the Medical Research Council’s comparative trial of surgery and radiotherapy for the primary treatment of small-celled and oat-celled carcinoma of the bronchus. Lancet. 1969;1:501–5.CrossRefGoogle Scholar
  9. 9.
    Pignon JP, Arriagada R, Ihde DC, Johnson DH, Perry MC, Souhami RL, Brodin O, Joss RA, Kies MS, Lebeau B, et al. A meta-analysis of thoracic radiotherapy for small-cell lung cancer. N Engl J Med. 1992;327(23):1618–24.CrossRefGoogle Scholar
  10. 10.
    Pijls-Johannesma M. Timing of chest radiotherapy in patients with limited stage small cell lung cancer: a systematic review and meta-analysis of randomised controlled trials. Cancer Treat Rev. 2007;33(5):461–73.CrossRefGoogle Scholar
  11. 11.
    Turrisi AT, Kim K, Blum R, et al. Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide. Intergroup INT-0096 trial. N Engl J Med. 1999;340:265–71.CrossRefGoogle Scholar
  12. 12.
    Faivre-Finn C, Snee M, Ashcroft L, et al. CONVERT study team. Concurrent once-daily versus twice-daily chemoradiotherapy in patients with limited-stage small-cell lung cancer (CONVERT): an open-label, phase 3, randomised, superiority trial. Lancet Oncol. 2017;18(8):1116–25. Scholar
  13. 13.
    Meta-analysis Trialist Group PORT. 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;352:257–63.CrossRefGoogle Scholar
  14. 14.
    Aupérin A, Arriagada R, Pignon JP, et al. Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. N Engl J Med. 1999;341:476–84.CrossRefGoogle Scholar
  15. 15.
    Slotman B, Faivre-Finn C, Kramer G, et al. Prophylactic cranial irradiation in extensive small-cell lung cancer. N Engl J Med. 2007;357:664–72.CrossRefGoogle Scholar
  16. 16.
    Takahashi T, Yamanaka T, Seto T, et al. Prophylactic cranial irradiation versus observation in patients with extensive-disease small-cell lung cancer: a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2017;18:663–71.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Sandeep Muzumder
    • 1
  • M. G. John Sebastian
    • 1
  1. 1.Radiation OncologySt. John’s Medical College and HospitalBengaluruIndia

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