ASTRO Updates Guideline for Palliative Radiation Therapy for Lung Cancer
Posted: Monday, June 25, 2018
The American Society for Radiation Oncology (ASTRO) has issued an update to its clinical guideline for the use of palliative thoracic radiation therapy for patients with incurable non–small cell lung cancer (NSCLC). Published in Practical Radiation Oncology, the guideline now reflects new evidence from randomized clinical trials; it recommends the addition of concurrent chemotherapy with palliative thoracic external-beam radiation therapy for some patients with incurable stage III NSCLC, including those who are unable to tolerate chemotherapy and have a life expectancy of longer than 3 months. Data remain insufficient, however, to support this approach in all other patients with incurable NSCLC.
“The primary question we faced with this revision was whether providers can enhance the impact of moderate, palliative doses of radiation by introducing additional therapy,” said Benjamin Moeller, MD, PhD, Chair of the Guideline Task Force and a radiation oncologist at Levine Cancer Institute, Charlotte, North Carolina. “Following treatment, however, these patients experience a more robust and durable stabilization of their quality of life, including less pain and fewer symptoms.”
The updated guideline is based on more than 30 randomized controlled trials, meta-analyses, and prospective studies. Key recommendations focus on topics such as eligibility for concurrent chemoradiation therapy as well as radiation delivery and dosing. According to the Guideline Task Force, “Optimal palliation for patients with incurable NSCLC requires coordinated interdisciplinary care.”