Avoiding Toxicity With Lung Radiation Therapy: An IASLC Perspective

Abstract

Toxicity concerns from thoracic radiation therapy in the treatment of lung cancers have changed substantially over the past few decades. Survival in the treatment of lung cancer has markedly improved and the introduction of advanced radiation and imaging techniques to treatment planning and delivery has made reducing toxicity possible. Phase 3 dose-escalation trials have revealed that excess dose to critical organs within the thorax can negatively impact overall survival. We summarize the existing literature on the known toxicities of thoracic radiation therapy, summarize the technological advances that have made toxicity reduction possible, and provide an overview of emerging technologies and biomarkers that are being evaluated to assess future toxicity reductions.

Keywords: Early-stage lung cancer; Locally advanced lung cancer; Non–small cell lung cancer; Radiation toxicity; Small cell lung cancer; Stereotactic body radiation therapy.