TY - JOUR
T1 - International consensus on radiotherapy in metastatic non-small cell lung cancer
AU - Zhu, Zhengfei
AU - Ni, Jianjiao
AU - Cai, Xuwei
AU - Su, Shengfa
AU - Zhuang, Hongqing
AU - Yang, Zhenzhou
AU - Chen, Ming
AU - Ma, Shenglin
AU - Xie, Conghua
AU - Xu, Yaping
AU - Li, Jiancheng
AU - Ge, Hong
AU - Liu, Anwen
AU - Zhao, Lujun
AU - Rao, Chuangzhou
AU - Xie, Congying
AU - Bi, Nan
AU - Hui, Zhouguang
AU - Zhu, Guangying
AU - Yuan, Zhiyong
AU - Wang, Jun
AU - Zhao, Lina
AU - Zhou, Wei
AU - Rim, Chai Hong
AU - Navarro-Martin, Arturo
AU - Vanneste, Ben G.L.
AU - De Ruysscher, Dirk
AU - Isabelle Choi, J.
AU - Jassem, Jacek
AU - Chang, Joe Y.
AU - Kepka, Lucyna
AU - Käsmann, Lukas
AU - Milano, Michael T.
AU - Van Houtte, Paul
AU - Suwinski, Rafal
AU - Traverso, Alberto
AU - Doi, Hiroshi
AU - Suh, Yang Gun
AU - Noël, Georges
AU - Tomita, Natsuo
AU - Kowalchuk, Roman O.
AU - Sio, Terence T.
AU - Li, Baosheng
AU - Lu, Bing
AU - Fu, Xiaolong
N1 - Publisher Copyright:
© 2022 AME Publishing Company. All rights reserved.
PY - 2022/9
Y1 - 2022/9
N2 - Background: Lung cancer is the leading cause of cancer-related death worldwide, with non-small cell lung cancer (NSCLC) accounting for most cases. While radiotherapy has historically served as a palliative modality in metastatic NSCLC, considerable advances in its technology and the continuous development of cutting-edge therapeutic agents, such as targeted therapy and immune checkpoint inhibitors (ICIs), are increasing its role in the multi-disciplinary management of the disease. Methods: International radiotherapy experts were convened to consider and reach consensuses on the clinical utilities of radiotherapy in metastatic NSCLC, with the aim to provide patient-focused, up to date, evidence-based, recommendations to assist cancer specialists in the management of patients with metastatic NSCLC worldwide. Results: Timely radiotherapy can offer rapid symptom alleviation and allow subsequent aggressive treatment approaches in patients with heavy tumor burden and/or oncologic emergencies. In addition, appropriate incorporation of radiotherapy as concurrent, consolidation, or salvage therapy makes it possible to achieve long-term survival, or even cure, for patients with oligo-metastatic disease. Cranial radiotherapy plays an important role in the management of brain metastasis, potentially augmenting the response and prolonging survival associated with targeted agents and ICIs. However, key questions remain, such as the appropriate choice of radiation techniques, optimal sequence of systemic therapies and radiotherapy, and optimal patient selection for such combination strategies. Although a strong rationale for combining radiotherapy and ICIs exists, its optimal parameters in this setting remain to be established. Conclusions: In the modern era, radiotherapy serves not only as a palliative tool in metastatic NSCLC, but also plays active roles in patients with oligo-focal disease, CNS metastasis and receiving ICIs.
AB - Background: Lung cancer is the leading cause of cancer-related death worldwide, with non-small cell lung cancer (NSCLC) accounting for most cases. While radiotherapy has historically served as a palliative modality in metastatic NSCLC, considerable advances in its technology and the continuous development of cutting-edge therapeutic agents, such as targeted therapy and immune checkpoint inhibitors (ICIs), are increasing its role in the multi-disciplinary management of the disease. Methods: International radiotherapy experts were convened to consider and reach consensuses on the clinical utilities of radiotherapy in metastatic NSCLC, with the aim to provide patient-focused, up to date, evidence-based, recommendations to assist cancer specialists in the management of patients with metastatic NSCLC worldwide. Results: Timely radiotherapy can offer rapid symptom alleviation and allow subsequent aggressive treatment approaches in patients with heavy tumor burden and/or oncologic emergencies. In addition, appropriate incorporation of radiotherapy as concurrent, consolidation, or salvage therapy makes it possible to achieve long-term survival, or even cure, for patients with oligo-metastatic disease. Cranial radiotherapy plays an important role in the management of brain metastasis, potentially augmenting the response and prolonging survival associated with targeted agents and ICIs. However, key questions remain, such as the appropriate choice of radiation techniques, optimal sequence of systemic therapies and radiotherapy, and optimal patient selection for such combination strategies. Although a strong rationale for combining radiotherapy and ICIs exists, its optimal parameters in this setting remain to be established. Conclusions: In the modern era, radiotherapy serves not only as a palliative tool in metastatic NSCLC, but also plays active roles in patients with oligo-focal disease, CNS metastasis and receiving ICIs.
KW - brain metastasis
KW - immune checkpoint inhibitor
KW - Non-small cell lung cancer
KW - oligo-metastasis
KW - radiotherapy
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U2 - 10.21037/tlcr-22-644
DO - 10.21037/tlcr-22-644
M3 - Article
C2 - 36248338
AN - SCOPUS:85147141085
SN - 2218-6751
VL - 11
SP - 1763
EP - 1795
JO - Translational Lung Cancer Research
JF - Translational Lung Cancer Research
IS - 9
ER -