Title |
Strategies of Dose Escalation in the Treatment of Locally Advanced Non-Small Cell Lung Cancer: Image Guidance and Beyond
|
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Published in |
Frontiers in oncology, June 2014
|
DOI | 10.3389/fonc.2014.00156 |
Pubmed ID | |
Authors |
Alexander Chi, Nam Phong Nguyen, James S. Welsh, William Tse, Manish Monga, Olusola Oduntan, Mohammed Almubarak, John Rogers, Scot C. Remick, David Gius |
Abstract |
Radiation dose in the setting of chemo-radiation for locally advanced non-small cell lung cancer (NSCLC) has been historically limited by the risk of normal tissue toxicity and this has been hypothesized to correlate with the poor results in regard to local tumor recurrences. Dose escalation, as a means to improve local control, with concurrent chemotherapy has been shown to be feasible with three-dimensional conformal radiotherapy in early phase studies with good clinical outcome. However, the potential superiority of moderate dose escalation to 74 Gy has not been shown in phase III randomized studies. In this review, the limitations in target volume definition in previous studies; and the factors that may be critical to safe dose escalation in the treatment of locally advanced NSCLC, such as respiratory motion management, image guidance, intensity modulation, FDG-positron emission tomography incorporation in the treatment planning process, and adaptive radiotherapy, are discussed. These factors, along with novel treatment approaches that have emerged in recent years, are proposed to warrant further investigation in future trials in a more comprehensive and integrated fashion. |
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Geographical breakdown
Country | Count | As % |
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Unknown | 2 | 100% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 2 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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United States | 1 | 2% |
Belgium | 1 | 2% |
Unknown | 50 | 96% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Ph. D. Student | 12 | 23% |
Student > Postgraduate | 6 | 12% |
Professor > Associate Professor | 5 | 10% |
Student > Master | 5 | 10% |
Other | 4 | 8% |
Other | 14 | 27% |
Unknown | 6 | 12% |
Readers by discipline | Count | As % |
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Physics and Astronomy | 7 | 13% |
Unspecified | 3 | 6% |
Engineering | 2 | 4% |
Agricultural and Biological Sciences | 2 | 4% |
Other | 4 | 8% |
Unknown | 8 | 15% |