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Target Volume Delineation in Non-small Cell 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 (RT) is an established treatment for all stages of non-small cell lung cancer (NSCLC), from definitive RT for early-stage disease to palliative RT for advanced and metastatic disease. Identifying the appropriate RT target for each patient starts at the time of consultation, where the radiation oncologist synthesizes the patient’s history, physical exam, imaging, and pathology with evidence-based treatment paradigms. When RT is recommended, the treatment planning workflow starts with a three-dimensional (and now often a four-dimensional) computed tomography (CT) simulation, which has largely supplanted two-dimensional treatment planning. Following CT simulation, the radiation oncologist delineates target volumes and organs at risk, defines planning objectives, and then engages in an iterative process of plan optimization and plan evaluation, culminating in image-guided radiation therapy (IGRT). These steps are intertwined; for instance, the reproducibility of patient setup and the type of image guidance used are reflected in the target volume margins. The steps may also vary based on the treatment intent and technique, with different workflows for stereotactic body radiation therapy (SBRT) for early-stage (or oligometastatic) disease, three-dimensional conformal radiation therapy (3D CRT) or intensity-modulated radiation therapy (IMRT) for locoregionally advanced disease, and palliative RT for symptomatic metastatic disease.

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Authors and Affiliations

  1. Department of Radiation Oncology, Durham, NC, USA

    Jessica W. Lee, Haijun Song, Matthew J. Boyer & Joseph K. Salama

  2. Radiation Oncology Clinical Service, Durham VA Health System, Durham, NC, USA

    Jessica W. Lee, Haijun Song, Matthew J. Boyer & Joseph K. Salama

Authors
  1. Jessica W. Lee
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  2. Haijun Song
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  3. Matthew J. Boyer
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  4. Joseph K. Salama
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Corresponding author

Correspondence to Joseph K. Salama .

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Editors and Affiliations

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

    Branislav Jeremić

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Lee, J.W., Song, H., Boyer, M.J., Salama, J.K. (2022). Target Volume Delineation in Non-small Cell Lung Cancer. In: Jeremić, B. (eds) Advances in Radiation Oncology in Lung Cancer. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2022_309

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  • DOI: https://doi.org/10.1007/174_2022_309

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